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

Jeanette Soon, Nada Sulaiman, Jong Kwan Park, Shaw Hua Anthony Kueh, Christopher Naoum, Darra Murphy, Jennifer Ellis, Cameron J. Hague, Philipp Blanke, Jonathon Leipsic*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

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 < 0.007). While B-A analysis demonstrated narrower interobserver agreement for aortic annular area (bias 0.03 vs 0.02 cm2, range −0.32 to 0.39 cm2 vs −0.50 to 0.55 cm2), and perimeter (bias 0.3 vs 0.3 mm, range −3.1 to 3.8 mm vs −4.6 to 5.3 mm), this was not statistically significant by concordance correlation coefficient. At 75%, there was no significant difference in image quality (Likert score 3.3 ± 0.9 vs. 3.5 ± 0.76, p = 0.454) or annular measurement agreement intervals. Conclusion Motion correction algorithms may yield significant improvements of image quality in systolic CT data sets of the heart. Further validation studies are required to determine the effect on annular measurements and translation into clinical practice.

Original languageEnglish
Pages (from-to)386-390
Number of pages5
JournalJournal of Cardiovascular Computed Tomography
Volume10
Issue number5
DOIs
Publication statusPublished - 1 Sep 2016
Externally publishedYes

Keywords

  • Aortic annulus
  • Computed tomography
  • Motion-correction algorithm
  • Transcatheter aortic valve replacement

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