Fang Xin, Li Shuang, Xie Ping, Hu Huanrui, Ting Wenyu, You Yongchun, Li Jianying, Diao Kaiyue, Li Wanjiang
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiology, Meishan City People Hospital, Meishan, China.
Quant Imaging Med Surg. 2025 Sep 1;15(9):8205-8218. doi: 10.21037/qims-2025-287. Epub 2025 Aug 15.
Coronary computed tomography angiography (CCTA) plays an increasingly important role in coronary artery disease (CAD) evaluation, but radiation dose remains a clinical concern. Conventional multi-cardiac phase (CMP) scanning covers wide R-R intervals to ensure optimal image quality, leading to higher radiation exposure. Recent advances in motion correction technology, particularly whole-heart motion correction algorithms, offer potential solutions for dose reduction. This study aimed to evaluate the feasibility of using dual single-cardiac phase (DSP) acquisition (end-systole: 45% R-R interval and end-diastole: 75% R-R interval) in CCTA with a whole-heart motion correction (SnapShot Freeze 2, SSF2) technology to minimize radiation dose and maintain image quality in comparison with CMP scanning.
In this prospective randomized study, 140 patients were randomly assigned to either DSP (n=70) or CMP (n=70) scanning groups. All examinations were performed on a 256-row wide-detector computed tomography (CT) scanner with similar data acquisition parameters and reconstruction algorithms except cardiac phase range selections. Image quality was assessed both objectively [signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)] and subjectively (5-point scale). Image quality, diagnostic confidence, and acceptability between the two groups and across different heart rates were evaluated.
DSP scanning achieved 29% radiation dose reduction [volume CT dose index (CTDIvol): 19.24±4.59 27.01±6.02 mGy, P<0.001] with comparable image quality scores in both systolic {5, [interquartile range (IQR), 5.0-5.0] 5 (IQR, 5.0-5.0), Reader 1: P=0.591, Reader 2: P=0.587} and diastolic phases [5 (IQR, 4.0-5.0) 5 (IQR, 4.0-5.0), Reader 1: P=0.908, Reader 2: P=0.951]. All scans in our study cohort were diagnostically acceptable (100%) when both phases were available. Using only systolic or diastolic phases reduced acceptability to 97.1% and 94.3%, respectively.
DSP scanning with SSF2 technology achieves significant radiation dose reduction while maintaining comparable image quality to CMP, with 100% diagnostic acceptability when both phases are available.
冠状动脉计算机断层扫描血管造影（CCTA）在冠状动脉疾病（CAD）评估中发挥着越来越重要的作用，但辐射剂量仍是临床关注的问题。传统的多心动周期（CMP）扫描覆盖较宽的R-R间期以确保最佳图像质量，导致辐射暴露增加。运动校正技术的最新进展，特别是全心运动校正算法，为降低剂量提供了潜在的解决方案。本研究旨在评估在具有全心运动校正（SnapShot Freeze 2，SSF2）技术的CCTA中使用双单心动周期（DSP）采集（收缩末期：R-R间期的45%，舒张末期：R-R间期的75%）以最小化辐射剂量并与CMP扫描相比保持图像质量的可行性。
在这项前瞻性随机研究中，140例患者被随机分配到DSP组（n = 70）或CMP组（n = 70）。所有检查均在256排宽探测器计算机断层扫描（CT）扫描仪上进行，除了心动周期范围选择外，数据采集参数和重建算法相似。图像质量通过客观指标[信噪比（SNR）、对比噪声比（CNR）]和主观指标（5分制）进行评估。评估了两组之间以及不同心率下的图像质量、诊断信心和可接受性。
DSP扫描实现了29%的辐射剂量降低[容积CT剂量指数（CTDIvol）：19.24±4.59对27.01±6.02 mGy，P<0.001]，收缩期{5，[四分位数间距（IQR），5.0 - 5.0]对5（IQR，5.0 - 5.0），读者1：P = 0.591，读者2：P = 0.587}和舒张期[5（IQR，4.0 - 5.0）对5（IQR，4.0 - 5.0），读者1：P = 0.908，读者2：P = 0.951]的图像质量评分相当。当两个心动周期都可用时，我们研究队列中的所有扫描在诊断上都是可接受的（100%）。仅使用收缩期或舒张期时，可接受性分别降至97.1%和94.3%。
采用SSF2技术的DSP扫描可显著降低辐射剂量，同时保持与CMP相当的图像质量，当两个心动周期都可用时诊断可接受性为100%。
