ISSN 1004-4140
CN 11-3017/P
| Citation: |
HE T, SUN H Q, DING D, et al. One-stop Solution for Coronary CTA and Pulmonary Vein Imaging Based on Extended Field-of-View Reconstruction Technology: Feasibility and Evaluation of Dual Low Radiation and Contrast Agent Doses[J]. CT Theory and Applications, xxxx, x(x): 1-11. DOI: 10.15953/j.ctta.2024.258.
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Purpose: Atrial fibrillation (AF) and coronary artery disease (CAD) share multiple risk factors. Comprehensive imaging evaluation before radiofrequency catheter ablation (RFCA) is beneficial for assessing overall cardiac condition and exploring the underlying causes of AF. This study aimed to evaluate the feasibility of using coronary computed tomography angiography (CCTA)-derived pulmonary vein CT (PVCT) images obtained via extended field-of-view (extDFOV) reconstruction to achieve single-scan imaging for both CCTA and PVCT, with the goal of reducing contrast agent dosage and radiation exposure while maintaining diagnostic image quality. Methods: A total of 44 CAD patients with AF scheduled for RFCA were prospectively enrolled, with 36 meeting the inclusion criteria. All patients underwent both CCTA and PVCT examinations: the experimental group (Group 1) used extDFOV reconstruction from CCTA images to derive PVCT images, while the control group (Group 2) underwent separate helical PVCT scans. Image quality, motion artifacts, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contrast agent dosage, and radiation dose were analyzed and compared between the two groups. Results: CCTA-derived PVCT images (Group 1) demonstrated superior image quality scores (4.44±0.61 vs. 3.97±0.74, P < 0.05) and significantly reduced motion artifacts (EMA: 1.73±0.47 mm vs. 4.55±1.35 mm, P < 0.05) compared to conventional PVCT images (Group 2). The contrast agent dosage was also lower in Group 1 (33.19±3.82 mL vs. 45 mL, P < 0.05). Due to multiphase acquisition in CCTA, the radiation dose in Group 1 was slightly higher than in Group 2 (2.44±0.89 mSv vs. 1.87±0.07 mSv, P < 0.05). Although the CT attenuation values of CCTA-derived PVCT images were lower than those of conventional PVCT, they still provided sufficient enhancement for diagnostic purposes. Conclusion: The use of CCTA-derived PVCT images with extDFOV reconstruction is a feasible and effective method for pre-procedural assessment in CAD patients with AF. This approach significantly reduces contrast agent dosage, minimizes motion artifacts, and optimizes imaging workflow without compromising diagnostic accuracy.
| [1] |
MICHNIEWICZ E, MLODAWSKA E, LOPATOWSKA P, et al. Patients with atrial fibrillation and coronary artery disease-Double trouble[J]. Advances in Medical Sciences, 2018, 63(1): 30-35. DOI: 10.1016/j.advms.2017.06.005.
|
| [2] |
LIP G Y H, PROIETTI M, POTPARA T, et al. Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal[J]. Europace: European pacing, arrhythmias, and cardiac electrophysiology: Journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023, 25(9): euad226. DOI: 10.1093/europace/euad226.
|
| [3] |
MEKHAEL M, MARROUCHE N, HAJJAR A H E, et al. The relationship between atrial fibrillation and coronary artery disease: Understanding common denominators[J]. Trends in Cardiovascular Medicine, 2024, 34(2): 91-98. DOI: 10.1016/j.tcm.2022.09.006.
|
| [4] |
GLADDING P A, LEGGET M, FATKIN D, et al. Polygenic risk scores in coronary artery disease and atrial fibrillation[J]. Heart, Lung and Circulation, 2020, 29(4): 634-640. DOI: 10.1016/j.hlc.2019.12.004.
|
| [5] |
BERMAN A E, KABIRI M, WEI T, et al. Economic and health value of delaying atrial fibrillation progression using radiofrequency catheter ablation[J]. Circulation: Arrhythmia and Electrophysiology, 2023, 16(4): e011237. DOI: 10.1161/CIRCEP.122.011237.
|
| [6] |
PASTEUR-ROUSSEAU A, SEBAG F. Cardiac CT-scan: Utility for the management of chest pain, cardiovascular screening and before atrial fibrillation ablation procedure[J]. Annales de Cardiologie et d'Angeiologie, 2020, 69(5): 276-288. DOI: 10.1016/j.ancard.2020.09.028.
|
| [7] |
STOJANOVSKA J. Enhancing epicardial fat at cardiac CT as foe in atrial fibrillation[J]. Radiology, 2022, 305(1): 66-67. DOI: 10.1148/radiol.221022.
|
| [8] |
GUO T, DONG Y, YU S. The comparison of the diagnostic value of left atrial pulmonary vein single-phase and dual-phase enhanced CT scanning for left atrial appendage thrombosis and SEC in patients with atrial fibrillation[J]. Computational and Mathematical Methods in Medicine, 2022, 2022: 8679511. DOI: 10.1155/2022/8679511.
|
| [9] |
IZOE Y, NAGAO M, TOKAI M, et al. Radiation dose for 320-row dose-modulated dynamic coronary CT angiography[J]. Journal of Applied Clinical Medical Physics, 2021, 22(9): 307-312. DOI: 10.1002/acm2.13390.
|
| [10] |
JIN L, GAO P, WANG K, et al. Intraindividual evaluation of effects of image filter function on image quality in coronary computed tomography angiography[J]. Frontiers in Cardiovascular Medicine, 2022, 9: 840735. DOI: 10.3389/fcvm.2022.840735.
|
| [11] |
TERES C, SOTO-IGLESIAS D, PENELA D, et al. Personalized paroxysmal atrial fibrillation ablation by tailoring ablation index to the left atrial wall thickness: The 'Ablate by-LAW' single-centre study-a pilot study[J]. Europace: European pacing, arrhythmias, and cardiac electrophysiology: Journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2022, 24(3): 390-399. DOI: 10.1093/europace/euab216.
|
| [12] |
SCHWARTZ A L, CHORIN E, MANN T, et al. Reconstruction of the left atrium for atrial fibrillation ablation using the machine learning CARTO 3m-FAM software[J]. Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing. 2022, 64(1): 39-47. DOI: 10.1007/s10840-021-01045-4.
|
| [13] |
CAPPELLO I A, PANNONE L, DELLA ROCCA D G, et al. Coronary artery disease in atrial fibrillation ablation: Impact on arrhythmic outcomes[J]. Europace: European pacing, arrhythmias, and cardiac electrophysiology: Journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023, 25(12): euad328. DOI: 10.1093/europace/euad328.
|
| [14] |
BORDI LL, BENEDEK T, KOVÁCS I, et al. Association of atrial fibrillation recurrence with right coronary atherosclerosis and increased left arterial epicardial fat following catheter ablation-results of a multimodality study[J]. Life (Basel), 2023, 13(9): 1891. DOI: 10.3390/life13091891.
|
| [15] |
WEST H W, SIDDIQUE M, WILLIAMS M C, et al. Deep-learning for epicardial adipose tissue assessment with computed tomography: implications for cardiovascular risk prediction[J]. Cardiovascular imaging Journal of the American College of Cardiology cardiovascular imaging, 2023, 16(6): 800-816. DOI: 10.1016/j.jcmg.2022.11.018.
|
| [16] |
AHN J, LEE Y S, LEE W, et al. Randomized comparison of progression of atherosclerotic plaques and calcification of coronary artery in atrial fibrillation patients treated with edoxaban versus warfarin (The REPRESENT-AF trial)[J]. The American Journal of Cardiology, 2024, 229: 56-62. DOI: 10.1016/j.amjcard.2024.08.002.
|
| [17] |
GOITEIN O, FINK N, HAY I, et al. Cardiac CT Angiography (CCTA) predicts left atrial appendage occluder device size and procedure outcome[J]. The American Journal of Cardiology, 2017, 33(5): 739-747. DOI: 10.1007/s10554-016-1050-6.
|
| [18] |
CHANDIRAMANI R, CAO D, NICOLAS J, et al. Contrast-induced acute kidney injury[J]. Cardiovascular Intervention and Therapeutics, 2020, 35(3): 209-217. DOI: 10.1007/s12928-020-00660-8.
|
| [19] |
SHI L, WANG C, CHEN H, et al. Ventricular arrhythmias originating from the basal septum of the ventricle: Clinical and electrophysiological characteristics and a systematic ablation approach[J]. Frontiers in Cardiovascular Medicine, 2022, 9: 879381. DOI: 10.3389/fcvm.2022.879381.
|
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