Abstract
The aim of this study was to evaluate the workflow efficiency of a new automatic coronary-specific reconstruction technique (Smart Phase, GE Healthcare—SP) for selection of the best cardiac phase with least coronary motion when compared with expert manual selection (MS) of best phase in patients with high heart rate. A total of 46 patients with heart rates above 75 bpm who underwent single beat coronary computed tomography angiography (CCTA) were enrolled in this study. CCTA of all subjects were performed on a 256-detector row CT scanner (Revolution CT, GE Healthcare, Waukesha, Wisconsin, US). With the SP technique, the acquired phase range was automatically searched in 2% phase intervals during the reconstruction process to determine the optimal phase for coronary assessment, while for routine expert MS, reconstructions were performed at 5% intervals and a best phase was manually determined. The reconstruction and review times were recorded to measure the workflow efficiency for each method. Two reviewers subjectively assessed image quality for each coronary artery in the MS and SP reconstruction volumes using a 4-point grading scale. The average HR of the enrolled patients was 91.1±19.0bpm. A total of 204 vessels were assessed. The subjective image quality using SP was comparable to that of the MS, 1.45±0.85 vs 1.43±0.81 respectively (p = 0.88). The average time was 246 seconds for the manual best phase selection, and 98 seconds for the SP selection, resulting in average time saving of 148 seconds (60%) with use of the SP algorithm. The coronary specific automatic cardiac best phase selection technique (Smart Phase) improves clinical workflow in high heart rate patients and provides image quality comparable with manual cardiac best phase selection. Reconstruction of single-beat CCTA exams with SP can benefit the users with less experienced in CCTA image interpretation.
Highlights
Coronary computed tomography angiography (CCTA) plays an important role in coronary artery disease management, especially for exclusion of significant coronary artery stenosis because of the test’s high negative predictive value [1,2,3]
Recent developments of multi-slice CT scanner make it possible to acquire abundant data with excellent temporal and spatial resolution with a short scan time [5,6,7]. It is a timeconsuming process for radiologists or medical imaging technologists to pick up the best phase with the least motion from the phase of the cardiac cycle for reconstruction, in particular this presents a challenge for newer users of the technology in clinical centers with large patient volumes, and in clinical settings where CT imaging is done even in the presence of higher heart rates
The objective of this study was to evaluate, in high heart rate patients, the performance and workflow efficiency of this new automatic coronary-specific cardiac phase selection reconstruction technique (Smart Phase, GE Healthcare) for selecting the best phase with least coronary motion compared with manual selection of the best phase by an expert
Summary
Coronary computed tomography angiography (CCTA) plays an important role in coronary artery disease management, especially for exclusion of significant coronary artery stenosis because of the test’s high negative predictive value [1,2,3]. Recent developments of multi-slice CT scanner make it possible to acquire abundant data with excellent temporal and spatial resolution with a short scan time [5,6,7]. It is a timeconsuming process for radiologists or medical imaging technologists to pick up the best phase with the least motion from the phase of the cardiac cycle for reconstruction, in particular this presents a challenge for newer users of the technology in clinical centers with large patient volumes, and in clinical settings where CT imaging is done even in the presence of higher heart rates. It would be useful to find an automatic way to determine the best phase of the cardiac cycle for CCTA reconstruction
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