From the Division of Radiology, Department of Medical Technology, Kyushu University Hospital.
Departments of Clinical Radiology.
J Comput Assist Tomogr. 2024;48(1):77-84. doi: 10.1097/RCT.0000000000001525. Epub 2023 Aug 11.
The purpose of this study is to evaluate the efficacy of deep learning reconstruction (DLR) on low-tube-voltage computed tomographic angiography (CTA) for transcatheter aortic valve implantation (TAVI).
We enrolled 30 patients who underwent TAVI-CT on a 320-row CT scanner. Electrocardiogram-gated coronary CTA (CCTA) was performed at 100 kV, followed by nongated aortoiliac CTA at 80 kV using a single bolus of contrast material. We used hybrid-iterative reconstruction (HIR), model-based IR (MBIR), and DLR to reconstruct these images. The contrast-to-noise ratios (CNRs) were calculated. Five-point scales were used for the overall image quality analysis. The diameter of the aortic annulus was measured in each reconstructed image, and we compared the interobserver and intraobserver agreements.
In the CCTA, the CNR and image quality score for DLR were significantly higher than those for HIR and MBIR ( P < 0.01). In the aortoiliac CTA, the CNR for DLR was significantly higher than that for HIR ( P < 0.01) and significantly lower than that for MBIR ( P ≤ 0.02). The image quality score for DLR was significantly higher than that for HIR ( P < 0.01). No significant differences were observed between the image quality scores for DLR and MBIR. The measured aortic annulus diameter had high interobserver and intraobserver agreement regardless of the reconstruction method (all intraclass correlation coefficients, >0.89).
In low tube voltage TAVI-CT, DLR provides higher image quality than HIR, and DLR provides higher image quality than MBIR in CCTA and is visually comparable to MBIR in aortoiliac CTA.
本研究旨在评估深度学习重建（DLR）在经导管主动脉瓣植入术（TAVI）低管电压计算机断层血管造影（CTA）中的疗效。
我们纳入了 30 名在 320 排 CT 扫描仪上接受 TAVI-CT 的患者。行 100kV 心电门控冠状动脉 CTA（CCTA）检查，然后使用单剂造影剂行 80kV 非心电门控腹主动脉 CTA 检查。我们使用混合迭代重建（HIR）、基于模型的重建（MBIR）和 DLR 重建这些图像。计算对比噪声比（CNR）。采用 5 分制评估整体图像质量。在每个重建图像上测量主动脉瓣环的直径，并比较观察者间和观察者内的一致性。
在 CCTA 中，DLR 的 CNR 和图像质量评分明显高于 HIR 和 MBIR（P＜0.01）。在腹主动脉 CTA 中，DLR 的 CNR 明显高于 HIR（P＜0.01），明显低于 MBIR（P≤0.02）。DLR 的图像质量评分明显高于 HIR（P＜0.01）。DLR 和 MBIR 的图像质量评分无显著差异。无论重建方法如何，测量的主动脉瓣环直径均具有较高的观察者间和观察者内一致性（所有组内相关系数，＞0.89）。
在低管电压 TAVI-CT 中，DLR 提供的图像质量优于 HIR，在 CCTA 中提供的图像质量优于 MBIR，在腹主动脉 CTA 中与 MBIR 视觉上可比。
