Leipsic J et al. - The use of a novel motion-corrected (MC) algorithm improves image quality, interpretability, and diagnostic accuracy in persons undergoing coronary CT angiography (CTA) without rate-control medications.Methods
- Thirty-six consecutive patients with severe aortic stenosis undergoing coronary CTA without rate control and invasive coronary angiography as part of an evaluation for transcatheter aortic valve replacement.
- The authors compared image quality and diagnostic accuracy between standard (STD) and motion-corrected (MC) reconstructions.
- Coronary CTAs were interpreted in an intent-to-diagnose fashion by 2 experienced readers; a third reader provided consensus for interpretability and obstructive coronary stenosis (≥50% stenosis).
- All studies were interpreted with and without motion correction using both 45% and 75% of the R-R interval for reconstructions.
- Quantitative coronary angiography was performed by a core laboratory.
- Mean age was 83.0 ± 6.4 years; 47% were men.
- Overall image quality (graded 1–4) was higher with the use of MC versus STD reconstructions (2.9 ± 0.9 vs 2.4 ± 1.0; P < 0.001).
- MC reconstructions showed higher interpretability on a per-segment [97% (392/406) vs 88% (357/406); P < 0.001] and per-artery [96% (128/134) vs 84% (112/134); P = 0.002] basis, with no difference on a per-patient level [92% (33/36) vs 89% (32/36); P = 1.0].
- Diagnostic accuracy by MC reconstruction was higher than STD reconstruction on a per-segment [91% (370/406) vs 78% (317/406); P < 0.001] and per-artery level [86% (115/134) vs 72% (96/134); P = 0.007] basis, with no significant difference on a per-patient level [86% (31/36) vs 69% (25/36); P = 0.16].