Improvement of automated right ventricular segmentation using dual-bolus contrast media injection with 256-slice coronary CT angiography.
OBJECTIVE
To investigate the effect of dual-bolus contrast media injection (dual-CM) on the accuracy of automated right ventricular (RV) segmentation on coronary computed tomography angiography (CCTA).


METHODS
A total of 104 patients with suspected and known coronary artery disease underwent 256-slice CCTA with retrospective electrocardiographic (ECG) gating. The patients were divided into 51 patients who underwent single-bolus CM injection (single-CM) and 53 patients who underwent dual-CM. The dual-CM method consisted of an initial bolus of CM followed by an injection of dilute CM with saline (CM:saline, 1:9). Three-dimensional CCTA images were automatically segmented into the RV, left ventricle (LV), and myocardium using commercially available software (Comprehensive Cardiac Analysis; Philips Medical Systems, Cleveland, OH). Prevalence and locations of segmentation errors were compared between single-CM and dual-CM. Segmentation errors were defined as segment deviation of >1 cm from the actual ventricular margin.


RESULTS
Prevalence of segmentation errors was significantly lower with dual-CM than with single-CM in the diastolic phase (4/41 vs. 20/41, respectively; P < .01), and there was no difference between the two methods in the systolic phase (2/12 vs. 2/10, respectively). With dual-CM and single-CM, the locations of segmentation errors were mostly the RV wall (4/53 and 18/51, respectively) and secondly the LV wall (2/53 and 9/51, respectively).


CONCLUSIONS
Dual-CM improved the accuracy of automated ventricular segmentation using diastolic data from 256-slice CCTA.
Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka City, Fukuoka 812-8582, Japan. Electronic address: m-kondo@med.kyushu-u.ac.jp.
Masatoshi
M
Kondo
Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan.
Michinobu
M
Nagao
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan.
Masato
M
Yonezawa
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan.
Yuzo
Y
Yamazaki
Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka City, Fukuoka 812-8582, Japan.
Takashi
T
Shirasaka
Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka City, Fukuoka 812-8582, Japan.
Yasuhiko
Y
Nakamura
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan.
Hiroshi
H
Honda
D000368:Aged; D000465:Algorithms; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007479:Iopamidol / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology
D003287:Contrast Media; D007479:Iopamidol
Coronary CT angiography; automated heart segmentation; contrast media injection