Mulitmedia Library
Are risk factors necessary for pretest probability assessment of coronary artery disease? A patient similarity network analysis of the PROMISE trial
Pretest probability (PTP) calculators utilize epidemiological-level findings to provide patient-level risk assessment of obstructive coronary artery disease (CAD). However, their limited accuracies question whether dissimilarities in risk factors necessarily result in differences in CAD. Using patient similarity network (PSN) analyses, we wished to assess the accuracy of risk factors and imaging markers to identify ≥50% luminal narrowing on coronary CT angiography (CCTA) in stable chest-pain patients.Value of semiquantitative assessment of high-risk plaque features on coronary CT angiography over stenosis in selection of studies for FFRct
The degree of stenosis on coronary CT angiography (CCTA) guides referral for CT-derived flow reserve (FFRct). We sought to assess whether semiquantitative assessment of high-risk plaque (HRP) features on CCTA improves selection of studies for FFRct over stenosis assessment alone.The accuracy of coronary CT angiography in patients with coronary calcium score above 1000 Agatston Units: Comparison with quantitative coronary angiography
High amounts of coronary artery calcium (CAC) pose challenges in interpretation of coronary CT angiography (CCTA). The accuracy of stenosis assessment by CCTA in patients with very extensive CAC is uncertain.Validation of deep-learning image reconstruction for coronary computed tomography angiography: Impact on noise, image quality and diagnostic accuracy
The present study evaluated the impact of deep-learning image reconstruction (DLIR) on noise, image quality, and diagnostic accuracy. In 43 patients who underwent clinically indicated coronary CT angiography and invasive coronary angiography, image quality was improved by up to 62% at similar noise levels. In addition, DLIR-H yielded the highest noise reduction (up to 43%) and best image quality (improvement of up to 138%). More importantly, sensitivity (92% vs. 88%), specificity (73% vs. 73%) and diagnostic accuracy (82% vs. 80%) of DLIR were at least non-inferior to ASiR-V.Low-kV coronary artery calcium scoring with tin filtration using a kV-independent reconstruction algorithm
To investigate the accuracy of Agatston scoring and potential for radiation dose reduction of a coronary artery calcium scoring (CACS) CT protocol at 100 kV with tin filtration (Sn100kV) and kV-independent iterative reconstruction, compared to standard 120 kV acquisitions.Influence of operator expertise and coronary luminal segmentation technique on diagnostic performance, precision and reproducibility of reduced-order CT-derived fractional flow reserve technique
Onsite workstation-based CT-derived Fractional-Flow-Reserve (CT-FFR) is accurate in assessing hemodynamic-significance of coronary stenoses. We aim to describe the influence of operator expertise and luminal-segmentation technique on the diagnostic performance, precision and reproducibility of CT-FFR in identifying hemodynamically-significant stenosis (FFR≤0.8).A rare coronary anomaly -- type 4 dual left anterior descending artery accompanying anomalous origin of the left coronary artery from the right coronary sinus
Invasive coronary angiographyQuantitative CT assessment identifies more heart transplanted patients with progressive coronary wall thickening than standard clinical read
We sought to compare quantitative coronary CT angiography (CTA) assessment versus standard clinical reading to identify heart transplanted (HTX) patients with progressive coronary wall thickening.Artificial intelligence machine learning-based coronary CT fractional flow reserve (CT-FFRML): Impact of iterative and filtered back projection reconstruction techniques
The influence of computed tomography (CT) reconstruction algorithms on the performance of machine-learning-based CT-derived fractional flow reserve (CT-FFRML) has not been investigated. CT-FFRML values and processing time of two reconstruction algorithms were compared using an on-site workstation.The feasibility of Forward-projected model-based Iterative Reconstruction SoluTion (FIRST) for coronary 320-row computed tomography angiography: A pilot study
We aimed to assess and compare the influence of Forward projected model-based Iterative Reconstruction SoluTion (FIRST), a recently introduced full iterative reconstruction method, on radiation doses and image quality with that of Adaptive Iterative Dose Reduction (AIDR) 3D for 320-row cardiac computed tomography (CT).Expanding pseudoaneurysm compressing the coronary arteries and causing cardiogenic shock
A 37-year-old man who recently underwent aortic valve replacement after endocarditis presented with cardiogenic shock. A large expansile pseudoaneurysm was subsequently discovered using multiple imaging modalities. Although transesophageal echocardiography is important in diagnosing valve endocarditis, coronary CT angiography of prosthetic valves is feasible and image quality is good. In this case, coronary CT angiography allowed for better understanding of transesophageal echocardiography images and earlier diagnosis of coronary involvement as cause for left ventricular dysfunction.Inadvertent anastomosis of saphenous vein graft to a cardiac vein detected with coronary computed tomographic angiography
A 34-year-old man with a prior history of Hodgkin’s disease and coronary artery bypass surgery for radiation-induced left main disease presented with persistent chest pain. Cardiac catheterization showed near simultaneous filling of the venous system during arterial injection and could not precisely delineate the insertion point of the vein graft anastamosis to the diagonal branch, and the patient was referred for coronary computed tomography angiography (CTA). CTA demonstrated that the anastamosis of the graft was with a cardiac vein.
