Vecsey-Nagy Milán, Jokkel Zsófia, Jermendy Ádám Levente, Nagy Martin, Boussoussou Melinda, Vattay Borbála, Kolossváry Márton, Csobay-Novák Csaba, Amin-Spector Sigal, Merkely Béla, Szilveszter Bálint
Heart and Vascular Center, Semmelweis University, 68. Varosmajor Street, 1122 Budapest, Hungary.
Gottsegen National Cardiovascular Center, 29. Haller Street, 1096 Budapest, Hungary.
Diagnostics (Basel). 2023 Feb 20;13(4):789. doi: 10.3390/diagnostics13040789.
Contemporary reconstruction algorithms yield the potential of reducing radiation exposure by denoising coronary computed tomography angiography (CCTA) datasets. We aimed to assess the reliability of coronary artery calcium score (CACS) measurements with an advanced adaptive statistical iterative reconstruction (ASIR-CV) and model-based adaptive filter (MBAF2) designed for a dedicated cardiac CT scanner by comparing them to the gold-standard filtered back projection (FBP) calculations. We analyzed non-contrast coronary CT images of 404 consecutive patients undergoing clinically indicated CCTA. CACS and total calcium volume were quantified and compared on three reconstructions (FBP, ASIR-CV, and MBAF2+ASIR-CV). Patients were classified into risk categories based on CACS and the rate of reclassification was assessed. Patients were categorized into the following groups based on FBP reconstructions: 172 zero CACS, 38 minimal (1-10), 87 mild (11-100), 57 moderate (101-400), and 50 severe (400<). Overall, 19/404 (4.7%) patients were reclassified into a lower-risk group with MBAF2+ASIR-CV, while 8 additional patients (27/404, 6.7%) shifted downward when applying stand-alone ASIR-CV. The total calcium volume with FBP was 7.0 (0.0-133.25) mm, 4.0 (0.0-103.5) mm using ASIR-CV, and 5.0 (0.0-118.5) mm with MBAF2+ASIR-CV (all comparisons < 0.001). The concomitant use of ASIR-CV and MBAF2 may allow the reduction of noise levels while maintaining similar CACS values as FBP measurements.
当代重建算法通过对冠状动脉计算机断层扫描血管造影（CCTA）数据集进行去噪，有潜力降低辐射暴露。我们旨在通过将先进的自适应统计迭代重建（ASIR-CV）和为专用心脏CT扫描仪设计的基于模型的自适应滤波器（MBAF2）与金标准滤波反投影（FBP）计算进行比较，来评估冠状动脉钙化评分（CACS）测量的可靠性。我们分析了404例连续接受临床指征CCTA的患者的非增强冠状动脉CT图像。对三种重建方式（FBP、ASIR-CV和MBAF2+ASIR-CV）的CACS和总钙体积进行了量化和比较。根据CACS将患者分类为风险类别，并评估重新分类的比率。根据FBP重建将患者分为以下几组：172例CACS为零，38例最低（1-10），87例轻度（11-100），57例中度（101-400），50例重度（400以上）。总体而言，使用MBAF2+ASIR-CV时，19/404（4.7%）的患者被重新分类到较低风险组，而单独应用ASIR-CV时，另有8例患者（27/404，6.7%）风险等级下降。FBP的总钙体积为7.0（0.0-133.2）mm，ASIR-CV为4.0（0.0-103.5）mm，MBAF2+ASIR-CV为5.0（0.0-118.5）mm（所有比较P<0.001）。同时使用ASIR-CV和MBAF2可能在保持与FBP测量相似的CACS值的同时降低噪声水平。
