CT angiography for planning transcatheter aortic valve replacement using automated tube voltage selection: Image quality and radiation exposure

2017 ◽  
Vol 86 ◽  
pp. 276-283 ◽  
Author(s):  
Stefanie Mangold ◽  
Carlo N. De Cecco ◽  
U. Joseph Schoepf ◽  
Taylor S. Kuhlman ◽  
Akos Varga-Szemes ◽  
...  
Keyword(s):  
Image Quality ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Radiation Exposure ◽  
Ct Angiography ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Tube Voltage ◽  
Transcatheter Aortic Valve ◽  
Automated Tube Voltage Selection

Abstract 17600: Improved Iterative Reconstruction Reduces Artifacts and Results in Larger Measurements of Ileofemoral Artery Size on Computed Tomography in Patients Referred for Transcatheter Aortic Valve Replacement

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anum Minhas ◽  
Smita Patel ◽  
Ella Kazerooni ◽  
Antonio Conte ◽  
Troy Labounty
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Iterative Reconstruction ◽  
Transcatheter Aortic Valve Replacement ◽  
Beam Hardening ◽  
Transcatheter Aortic Valve ◽  
Blinded Reader

Background: Computed tomography (CT) is typically used to measure ileofemoral artery size in patients considered for transcatheter aortic valve replacement (TAVR). However, these patients often have significant arterial calcification, which can introduce artifacts and limit measurement accuracy. We hypothesized that improved iterative reconstruction would improve image quality and reduce artifacts, resulting in larger measured size. Methods: We examined 56 patients undergoing CT for possible TAVR, and compared image quality and ileofemoral arterial size between separate reconstructions of the same studies, comparing standard (STD) advanced statistical iterative reconstruction and improved model-based iterative reconstruction (MBIR). A blinded reader identified the sites with the smallest luminal diameter, and provided identical short-axis reformats for both reconstructions. A separate blinded reader graded image quality and made measurements in a random sequence. We compared mean and minimal diameters, image quality (1 poor, 4 excellent), and signal and noise. Results: Mean age was 77 ± 10 years and 54% were male. Table 1 compares measured diameters and image quality between STD and MBIR reconstructions. Between STD and MBIR images, ≥moderate beam-hardening artifacts were observed in 30% (17/56) and 9% (5/56) of patients, respectively (p=0.008); severe artifacts were seen in 23% (13/56) and 5% (3/56) of patients, respectively (p=0.01). Overall image quality of STD and MBIR images was graded as good or excellent in 70% (39/56) and 91% (51/56) of cases, respectively (p=0.008). Conclusion: In patients referred for TAVR, improved iterative reconstruction resulted in higher image quality, fewer beam-hardening artifacts, and larger measurements of ileofemoral artery size.

Predictors of patient radiation exposure during transcatheter aortic valve replacement

2017 ◽  
Vol 92 (4) ◽  
pp. 768-774 ◽  
Author(s):  
Andrew M. Goldsweig ◽  
Kevin F. Kennedy ◽  
Dhaval Kolte ◽  
J. Dawn Abbott ◽  
Paul C. Gordon ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Radiation Exposure ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Patient Radiation Exposure

scholarly journals Feasibility of a High-Pitch Protocol for Transcatheter Aortic Valve Replacement Evaluation in Patients not Suitable for ECG-Gated CT

2020 ◽  
Author(s):  
Seyd Shnayien ◽  
Keno Bressem ◽  
Nick Beetz ◽  
Janis Vahldiek ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Image Quality ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Transcatheter Aortic Valve Replacement ◽  
The United States ◽  
Image Noise ◽  
High Pitch ◽  
Transcatheter Aortic Valve

Abstract High-Pitch CT for TAVR Evaluation in Patients not Suitable for ECG-GatingThe use of transcatheter aortic valve replacement (TAVR) has been established to be non-inferior to surgical aortic valve replacement (SAVR). As a result, in the United States, more patients now undergo TAVR than SAVR. It is recommended that preprocedural CT imaging for aortic valve evaluation and optimal sizing should include an ECG-gated scan of, at least, the aortic root. However, many patients suffer from concomitant tachyarrhythmias such as atrial fibrillation, which may seriously degrade the diagnostic accuracy of ECG-gated scans. The aim of the present study is to explore whether a high-pitch non-ECG-gated computed tomography angiography (CTA) of the entire aorta can render similar diagnostic preprocedural images as a standard ECG-gated scan. 108 patients were included. Objective image quality parameters such as image noise, CNR and SNR as well as subjective image quality analysis by two different readers were compared. The results showed a significant increase in image noise at the level of the aortic root with use of the high-pitch protocol (p = 0.001). Otherwise, our study revealed no significant differences in subjective and objective image quality. Diagnostic image quality was achieved in all patients without a record of inaccurate sizing in the surgical reports or subsequent patient histories.

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