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Diagnostics
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CT Imaging of Coronary Artery Disease
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CT Imaging of Coronary Artery Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 6805

Special Issue Editor

Dr. Christian Tesche

E-Mail Website
Guest Editor
Department of Cardiology and Intensive Care, Augustinum Clinic Munich, Munich, Germany
Interests: computed tomography; fractional flow reserve; interventional cardiology; cardiovascular imaging; coronary artery disease

Special Issue Information

Dear Colleagues,

Cardiac computed tomography (CT) has emerged as a cornerstone and a well-established non-invasive imaging modality in the clinical diagnostic work-up of patients who have suspected coronary artery disease (CAD) with incremental power in cardiovascular risk prediction. Technical advances in scanner technologies, as well as software applications, including artificial intelligence, have brought cardiac CT to the forefront of cardiovascular imaging. Additionally, cardiac CT has become a one-stop shop for guiding cardiovascular interventions.

This Special Issue is related to articles that focus on:

  • Novel technical applications (artificial intelligence/machine learning, photon-counting/spectral-CT);
  • Technical advances in diagnosis of CAD;
  • Cardiovascular risk stratification and preventive care;
  • Biomarkers of cardiovascular inflammation (i.e. epicardial adipose tissue);
  • Hemodynamic assessment of CAD (FFR-CT, CT-Perfusion).

The following article types will be considered for publication:  

  • Original research articles; 
  • Reviews of the hot topics of cardiac CT;
  • Technical reports (of novel technology or imaging techniques) as short communications. 

Dr. Christian Tesche
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronary artery disease
  • atherosclerosis
  • plaque imaging
  • structural heart disease
  • coronary physiology

Published Papers (4 papers)

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Research

12 pages, 1436 KiB  
Article
Optimization of Kernel Type and Sharpness Level Improves Objective and Subjective Image Quality for High-Pitch Photon Counting Coronary CT Angiography
by Yang Yang, Nicola Fink, Tilman Emrich, Dirk Graafen, Rosa Richter, Stefanie Bockius, Elias V. Wolf, Gerald Laux, Larissa Kavermann, Lukas Müller, Michaela Hell and Moritz C. Halfmann
Diagnostics 2023, 13(11), 1937; https://doi.org/10.3390/diagnostics13111937 - 01 Jun 2023
Cited by 3 | Viewed by 1514
Abstract
(1) Background: Photon-counting detector (PCD) CT offers a wide variety of kernels and sharpness levels for image reconstruction. The aim of this retrospective study was to determine optimal settings for coronary CT angiography (CCTA). (2) Methods: Thirty patients (eight female, mean age 63 [...] Read more.
(1) Background: Photon-counting detector (PCD) CT offers a wide variety of kernels and sharpness levels for image reconstruction. The aim of this retrospective study was to determine optimal settings for coronary CT angiography (CCTA). (2) Methods: Thirty patients (eight female, mean age 63 ± 13 years) underwent PCD-CCTA in a high-pitch mode. Images were reconstructed using three different kernels and four sharpness levels (Br36/40/44/48, Bv36/40/44/48, and Qr36/40/44/48). To analyze objective image quality, the attenuation, image noise, contrast-to-noise ratio (CNR), and vessel sharpness were quantified in proximal and distal coronaries. For subjective image quality, two blinded readers assessed image noise, visually sharp reproduction of coronaries, and the overall image quality using a five-point Likert scale. (3) Results: Attenuation, image noise, CNR, and vessel sharpness significantly differed across kernels (all p < 0.001), with the Br-kernel reaching the highest attenuation. With increasing kernel sharpness, image noise and vessel sharpness increased, whereas CNR continuously decreased. Reconstruction with Br-kernel generally had the highest CNR (Br > Bv > Qr), except Bv-kernel had a superior CNR at sharpness level 40. Bv-kernel had significantly higher vessel sharpness than Br- and Qr-kernel (p < 0.001). Subjective image quality was rated best for kernels Bv40 and Bv36, followed by Br36 and Qr36. (4) Conclusion: Reconstructions with kernel Bv40 are beneficial to achieve optimal image quality in spectral high-pitch CCTA using PCD-CT. Full article
(This article belongs to the Special Issue CT Imaging of Coronary Artery Disease)
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11 pages, 905 KiB  
Article
Gender Differences in Epicardial Adipose Tissue and Plaque Composition by Coronary CT Angiography: Association with Cardiovascular Outcome
by Ullrich Ebersberger, Maximilian J. Bauer, Florian Straube, Nicola Fink, U. Joseph Schoepf, Akos Varga-Szemes, Tilman Emrich, Joseph Griffith, Ellen Hoffmann and Christian Tesche
Diagnostics 2023, 13(4), 624; https://doi.org/10.3390/diagnostics13040624 - 08 Feb 2023
Cited by 2 | Viewed by 1288
Abstract
Background: To investigate gender differences in epicardial adipose tissue (EAT) and plaque composition by coronary CT angiography (CCTA) and the association with cardiovascular outcome. Methods: Data of 352 patients (64.2 ± 10.3 years, 38% female) with suspected coronary artery disease (CAD) who underwent [...] Read more.
Background: To investigate gender differences in epicardial adipose tissue (EAT) and plaque composition by coronary CT angiography (CCTA) and the association with cardiovascular outcome. Methods: Data of 352 patients (64.2 ± 10.3 years, 38% female) with suspected coronary artery disease (CAD) who underwent CCTA were retrospectively analyzed. EAT volume and plaque composition from CCTA were compared between men and women. Major adverse cardiovascular events (MACE) were recorded from follow-up. Results: Men were more likely to have obstructive CAD, higher Agatston scores, and a larger total and non-calcified plaque burden. In addition, men displayed more adverse plaque characteristics and EAT volume compared to women (all p < 0.05). After a median follow-up of 5.1 years, MACE occurred in 8 women (6%) and 22 men (10%). In multivariable analysis, Agatston calcium score (HR 1.0008, p = 0.014), EAT volume (HR 1.067, p = 0.049), and low-attenuation plaque (HR 3.82, p = 0.036) were independent predictors for MACE in men, whereas only low-attenuation plaque (HR 2.42, p = 0.041) showed predictive value for events in women. Conclusion: Women demonstrated less overall plaque burden, fewer adverse plaque characteristics, and a smaller EAT volume compared to men. However, low-attenuation plaque is a predictor for MACE in both genders. Thus, a differentiated plaque analysis is warranted to understand gender differences of atherosclerosis to guide medical therapy and prevention strategies. Full article
(This article belongs to the Special Issue CT Imaging of Coronary Artery Disease)
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10 pages, 1569 KiB  
Article
Coronary CTA Amidst the COVID-19 Pandemic: A Quicker Examination Protocol with Preserved Image Quality Using a Dedicated Cardiac Scanner
by Alexisz Panajotu, Milán Vecsey-Nagy, Ádám Levente Jermendy, Melinda Boussoussou, Borbála Vattay, Márton Kolossváry, Örs Zs. Dombrády, Csaba Csobay-Novák, Béla Merkely and Bálint Szilveszter
Diagnostics 2023, 13(3), 406; https://doi.org/10.3390/diagnostics13030406 - 22 Jan 2023
Viewed by 1625
Abstract
There has been an ongoing debate on the means to minimize the time patients spend at health care providers during the COVID-19 pandemic. We propose a strategy relying solely on intravenous (i.v.) beta-blocker administration for heart-rate (HR) control prior to coronary CT angiography [...] Read more.
There has been an ongoing debate on the means to minimize the time patients spend at health care providers during the COVID-19 pandemic. We propose a strategy relying solely on intravenous (i.v.) beta-blocker administration for heart-rate (HR) control prior to coronary CT angiography (CCTA). We aimed to assess a potential difference in CCTA image quality (IQ) after implementation of a modified strategy compared to our standard protocol of oral premedication during the first wave of COVID-19. We analyzed CCTA examinations conducted one year before (n = 1511) and after (n = 1064) implementation of this new regime. Examinations were performed both on our 256-slice multidetector CT (MDCT) and dedicated cardiac CT (DCCT) scanners. We used a four-point Likert scale (excellent/good/moderate/non-diagnostic) for IQ assessment of the coronaries. We detected a significant increase in mean HR during examinations on both CT scanners (MDCT: 62.4 ± 10.0 vs. 65.3 ± 9.7, p < 0.001; DCCT: 61.7 ± 15.2 vs. 65.0 ± 10.7, p < 0.001). The rate of moderate/non-diagnostic IQ significantly increased on the MDCT (192/1005, 19.1% vs. 144/466, 30.9%, p < 0.001), while this ratio did not change significantly on the DCCT (62/506, 12.3% vs. 84/598, 14.0%, p = 0.38). The improved temporal resolution of DCCT allows the stand-alone use of i.v. premedication with preserved IQ; hence, the duration of visits can be shortened. Full article
(This article belongs to the Special Issue CT Imaging of Coronary Artery Disease)
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11 pages, 1463 KiB  
Article
Dedicated CCTA Followed by High-Pitch Scanning versus TRO-CT for Contrast Media and Radiation Dose Reduction: A Retrospective Study
by Kun Wang, Xiaodong Wang, Shaoqiang Zheng, Cheng Li, Liang Jin and Ming Li
Diagnostics 2022, 12(11), 2647; https://doi.org/10.3390/diagnostics12112647 - 31 Oct 2022
Viewed by 1530
Abstract
We aimed to compare dedicated coronary computed tomography angiography (CCTA) followed by high-pitch scanning and triple-rule-out computed tomography angiography (TRO-CTA) in terms of radiation dose, contrast media (CM) use, and image quality. Patients with acute chest pain were retrospectively enrolled and assigned to [...] Read more.
We aimed to compare dedicated coronary computed tomography angiography (CCTA) followed by high-pitch scanning and triple-rule-out computed tomography angiography (TRO-CTA) in terms of radiation dose, contrast media (CM) use, and image quality. Patients with acute chest pain were retrospectively enrolled and assigned to group A (n = 55; scanned with dedicated CCTA followed by high-pitch scanning) or group B (n = 45; with TRO-CTA). Patient characteristics, radiation dose, CM use, and quantitative parameters (CT value, image noise, signal-to-noise ratio, contrast-to-noise ratio, and image quality score) of pulmonary arteries (PAs), thoracic aortae (TAs), and coronary arteries (CAs) were compared. The total effective dose was significantly lower in group A (6.25 ± 2.94 mSv) than B (8.93 ± 4.08 mSv; p < 0.001). CM volume was significantly lower in group A (75.7 ± 8.9 mL) than B (95.0 ± 0 mL; p < 0.001). PA and TA image quality were significantly better in group B, whereas that of CA was significantly better in group A. Qualitative image scores of PA and TA scans rated by radiologists were similar, whereas that of CA scans was significantly higher in group A than B (p < 0.001). Dedicated CCTA followed by high-pitch scanning demonstrated lower radiation doses and CM volume without debasing qualities of PA, TA, and CA scans than did TRO-CTA. Full article
(This article belongs to the Special Issue CT Imaging of Coronary Artery Disease)
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