The effect of a whole heart motion-correction algorithm on CT image quality and measurement reproducibility in Pre-TAVR aortic annulus evaluation

• Published in: Journal of cardiovascular computed tomography 2016-09, Vol.10 (5), p.386-390
• Main Authors: Soon, Jeanette, Sulaiman, Nada, Park, Jong Kwan, Kueh, Shaw-Hua (Anthony), Naoum, Christopher, Murphy, Darra, Ellis, Jennifer, Hague, Cameron J, Blanke, Philipp, Leipsic, Jonathon
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Algorithms; Aortic annulus; Aortic Valve - diagnostic imaging; Aortic Valve - physiopathology; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - therapy; Cardiac Catheterization - methods; Cardiac-Gated Imaging Techniques; Cardiovascular; Computed tomography; Databases, Factual; Electrocardiography; Female; Heart Rate; Heart Valve Prosthesis Implantation - methods; Humans; Male; Middle Aged; Motion-correction algorithm; Multidetector Computed Tomography - methods; Observer Variation; Predictive Value of Tests; Radiation Dosage; Radiographic Image Interpretation, Computer-Assisted - methods; Reproducibility of Results; Retrospective Studies; Severity of Illness Index; Transcatheter aortic valve replacement
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2016.08.001

Abstract Background Motion correction (MC) algorithms have been shown to improve image quality, interpretability and diagnostic accuracy in coronary CT angiography. We sought to determine whether MC extended to the whole heart would demonstrate improved image quality and reproducibility of aortic annular measurements in pre-TAVR CT. Materials and methods Twenty-two consecutive contrast enhanced CT data sets acquired for pre TAVR evaluation using retrospective ECG synchronization during a single heart beat were retrospectively identified. Image data sets were obtained from raw data acquired at 35% and 75% of the R-R interval using both standard (STD) and motion corrected (MC) reconstruction algorithms. Four data sets (2 STD, 2 MC) per patient were analyzed by 2 independent, blinded readers for aortic annular area, short and long axis, perimeter and average diameter. Image quality was graded using a 5 point Likert score (1 and 2 non diagnostic, 5 excellent). Statistical analysis was performed using Wilcoxon matched paired tests, Bland-Altman (B-A) plots and Lin's concordance coefficient comparing 35% STD to 35% MC, and 75% STD to 75% MC. Results Eighty-eight datasets were analyzed (44 STD, 44 MC). At 35%, there was a significant improvement in image quality for MC (Likert score 3.3 ± 0.9 STD vs. 3.9 ± 0.7 MC, p