title: Low-dose CT coronary angiography with a novel IntraCycle motion-correction algorithm in patients with high heart rate or heart rate variability.
abstract: OBJECTIVE
  Motion artefacts due to high or irregular heart rate (HR) are common limitations of coronary computed tomography (CT) angiography (CCTA). The aim of the study was to evaluate the impact of a new motion-correction (MC) algorithm used in conjunction with low-dose prospective ECG-triggering CCTA on motion artefacts, image quality, and coronary assessability.
  
  
  RESULTS
  Among 380 patients undergoing CCTA for suspected CAD, we selected 120 patients with pre-scanning HR >70 bpm or HR variability (HRv) >10 bpm during scanning irrespective of pre-scanning HR or both conditions. In patients with pre-scanning HR <65 or ≥65 bpm, prospective ECG triggering with padding of 80 ms (58 cases) or padding of 200 ms (62 cases) was used, respectively. Mean pre-scanning HR and HRv were 70 ± 7 and 10.9 ± 4 bpm, respectively. Overall, the mean effective dose was 3.4 ± 1.3 mSv, while a lower dose (2.4 ± 0.9 mSv) was measured for padding of 80 ms. In a segment-based analysis, coronary assessability was significantly higher (P < 0.0001) with MC (97%) when compared with standard (STD) reconstruction (81%) due to a significant reduction (P < 0.0001) in severe artefacts (54 vs. 356 cases, respectively). An artefact sub-analysis showed significantly lower number of motion artefacts and artefacts related to chest movement with MC (16 and 4 cases) than with STD reconstruction (286 and 24 cases, P < 0.0001 and P < 0.05, respectively). The number of coronary segments ranked among those of excellent image quality was significantly higher with MC (P < 0.001).
  
  
  CONCLUSIONS
  The MC algorithm improves CCTA image quality and coronary assessability in patients with high HR and HRv, despite low radiation dose.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via C. Parea 4, Milan 20138, Italy daniele.andreini@ccfm.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Bertella
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Conte
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Segurini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baggiano
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via C. Parea 4, Milan 20138, Italy.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Annoni
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Formenti
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Petullà
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Virginia
authors.initials: V
authors.lastname: Beltrama
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via C. Parea 4, Milan 20138, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Fiorentini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D000465:Algorithms; D016477:Artifacts; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography coronary angiography; Motion correction algorithm; Radiation exposure