High-temporal resolution dual-energy computed tomography of the heart using a novel hybrid image reconstruction algorithm: initial experience.
OBJECTIVE
Dual-energy computed tomography (DECT) has been proposed for the comprehensive assessment of coronary artery stenosis and myocardial perfusion yet traditionally required reducing the temporal resolution of cardiac studies. We evaluated a reconstruction algorithm that preserves high temporal resolution at cardiac DECT.


METHODS
Twelve consecutive patients (3 women; mean [SD] age, 64 [10] years) with an abnormal single photon emission CT result underwent invasive coronary angiography and cardiac DECT. Dual-energy CT studies were reconstructed using the standard algorithm with 165-millisecond temporal resolution and a hybrid algorithm providing 83-millisecond temporal resolution. These studies were rated for coronary image quality and motion artifacts and compared with invasive coronary angiographic studies.


RESULTS
One hundred sixty-eight coronary artery segments (82%) were evaluated. The standard 165-millisecond reconstruction provided 95% diagnostic segments compared with 100% using the 83-millisecond hybrid reconstruction. Image quality was rated significantly (P < 0.05) better with hybrid reconstruction and had 91.4% sensitivity, 94.7% specificity, 82.1% positive predictive value, and 97.7% negative predictive value for detecting significant stenosis versus 85.7%, 93.2%, 76.9%, and 96.1% with standard reconstruction, respectively.


CONCLUSIONS
Hybrid image reconstruction mitigates the former limitations in temporal resolution of cardiac DECT.
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA. NANCEJ@MUSC.EDU
John William
JW
Nance
Gorka
G
Bastarrika
Doo Kyoung
DK
Kang
Balazs
B
Ruzsics
Sebastian
S
Vogt
Bernhard
B
Schmidt
Rainer
R
Raupach
Thomas G
TG
Flohr
U Joseph
UJ
Schoepf
D000465:Algorithms; D016477:Artifacts; D003287:Contrast Media; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide