In vitro optimization and comparison of CT angiography versus radial cardiovascular magnetic resonance for the quantification of cross-sectional areas and coronary endothelial function.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_646AF863921E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
In vitro optimization and comparison of CT angiography versus radial cardiovascular magnetic resonance for the quantification of cross-sectional areas and coronary endothelial function.
Périodique
Journal of cardiovascular magnetic resonance
Auteur(s)
Yerly J., Becce F., van Heeswijk R.B., Verdun F.R., Gubian D., Meuli R., Stuber M.
ISSN
1532-429X (Electronic)
ISSN-L
1097-6647
Statut éditorial
Publié
Date de publication
07/02/2019
Peer-reviewed
Oui
Volume
21
Numéro
1
Pages
11
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Our objectives were first to determine the optimal coronary computed tomography angiography (CTA) protocol for the quantification and detection of simulated coronary artery cross-sectional area (CSA) differences in vitro, and secondly to quantitatively compare the performance of the optimized CTA protocol with a previously validated radial coronary cardiovascular magnetic resonance (CMR) technique.
256-multidetector CTA and radial coronary CMR were used to obtain images of a custom in vitro resolution phantom simulating a range of physiological responses of coronary arteries to stress. CSAs were automatically quantified and compared with known nominal values to determine the accuracy, precision, signal-to-noise ratio (SNR), and circularity of CSA measurements, as well as the limit of detection (LOD) of CSA differences. Various iodine concentrations, radiation dose levels, tube potentials, and iterative image reconstruction algorithms (ASiR-V) were investigated to determine the optimal CTA protocol. The performance of the optimized CTA protocol was then compared with a radial coronary CMR method previously developed for endothelial function assessment under both static and moving conditions.
The iodine concentration, dose level, tube potential, and reconstruction algorithm all had significant effects (all p <  0.001) on the accuracy, precision, LOD, SNR, and circularity of CSA measurements with CTA. The best precision, LOD, SNR, and circularity with CTA were achieved with 6% iodine, 20 mGy, 100 kVp, and 90% ASiR-V. Compared with the optimized CTA protocol under static conditions, radial coronary CMR was less accurate (- 0.91 ± 0.13 mm <sup>2</sup> vs. -0.35 ± 0.04 mm <sup>2</sup> , p <  0.001), but more precise (0.08 ± 0.02 mm <sup>2</sup> vs. 0.21 ± 0.02 mm <sup>2</sup> , p <  0.001), and enabled the detection of significantly smaller CSA differences (0.16 ± 0.06 mm <sup>2</sup> vs. 0.52 ± 0.04 mm <sup>2</sup> ; p <  0.001; corresponding to CSA percentage differences of 2.3 ± 0.8% vs. 7.4 ± 0.6% for a 3-mm baseline diameter). The same results held true under moving conditions as CSA measurements with CMR were less affected by motion.
Radial coronary CMR was more precise and outperformed CTA for the specific task of detecting small CSA differences in vitro, and was able to reliably identify CSA changes an order of magnitude smaller than those reported for healthy physiological vasomotor responses of proximal coronary arteries. However, CTA yielded more accurate CSA measurements, which may prove useful in other clinical scenarios, such as coronary artery stenosis assessment.
Mots-clé
Accuracy, CT angiography, Coronary artery, Cross-sectional area, Endothelial function, Limit of detection, Precision, Radial CMR, Vasodilation, Vasomotor response
Pubmed
Web of science
Open Access
Oui
Création de la notice
04/03/2019 18:14
Dernière modification de la notice
20/08/2019 14:20
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