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Use of Model-based Iterative Reconstruction to Improve Detection of Congenital Cardiovascular Anomalies in Infants Undergoing Free-breathing Computed Tomographic Angiography.

Publication ,  Journal Article
Kligerman, S; Bolster, F; Mitchell, J; Henry, T; Jeudy, J; White, CS
Published in: J Thorac Imaging
March 2017

PURPOSE: The aim of the study was to assess the detection of congenital cardiovascular anomalies (congenital heart disease) in neonates and infants using model-based iterative reconstruction (MBIR) algorithm compared with hybrid iterative reconstruction (HIR) and filtered back projection (FBP) reconstructions on axial computed tomography (CT) performed at minimum scanner dose. MATERIALS AND METHODS: Over 1 year, all CT angiographies performed in infants below 3 months of age with congenital heart disease were assessed retrospectively. All were scanned on a 256-slice CT (Brilliance iCT) using single axial rotation at minimum allowable scanner dose (80 kV/10 mAs), with patients free-breathing. Intravenous contrast was 1 mL/kg. Scan reconstruction was 0.9 mm/0.45 mm overlap, reconstructed with FBP, HIR (iDose5), and MBIR (IMR2). The 3 reconstructions per study were anonymized and randomized. Four cardiac radiologists (23, 9, 7, and 6 y experience) evaluated each reconstruction on a workstation for presence of an atrial septal defect, a ventricular septal defect, patent ductus arteriosus, and surgical shunt or anomalies of the aorta, pulmonary arteries, and pulmonary veins. Unevaluable structures were classified as nondiagnostic. Gold standard was surgery or both echocardiogram and cardiac catheterization. The sensitivity, specificity, and accuracy were determined for each reconstruction. RESULTS: Fifteen scans in 14 infants met the inclusion criteria, with a total of 48 anomalies. Pooled sensitivity for MBIR of 0.82 (range, 0.75 to 0.9) was significantly better than those for FBP (0.58; range, 0.54 to 0.6; P<0.001) and HIR (0.67; range, 0.60 to 0.79; P<0.001). Pooled accuracy of MBIR, HIR, and FBP was 0.91, 0.84, and 0.81, respectively. Readers deemed 39 and 15 structures nondiagnostic with FBP and HIR, respectively, versus 2 with MBIR (MBIR-FBP, MBIR-HIR, P<0.0001). The CTDIvol, DLP, and estimated dose for all cases was 0.52 mGy, 4.2 mGy×cm, and 0.16 mSv. CONCLUSIONS: MBIR significantly improves the detection of congenital anomalies in neonates and infants undergoing CT angiography at minimum allowable dose.

Duke Scholars

Published In

J Thorac Imaging

DOI

EISSN

1536-0237

Publication Date

March 2017

Volume

32

Issue

2

Start / End Page

127 / 135

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Respiration
  • Radiographic Image Interpretation, Computer-Assisted
  • Nuclear Medicine & Medical Imaging
  • Male
  • Infant, Newborn
  • Infant
  • Image Processing, Computer-Assisted
  • Humans
  • Heart Defects, Congenital
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kligerman, S., Bolster, F., Mitchell, J., Henry, T., Jeudy, J., & White, C. S. (2017). Use of Model-based Iterative Reconstruction to Improve Detection of Congenital Cardiovascular Anomalies in Infants Undergoing Free-breathing Computed Tomographic Angiography. J Thorac Imaging, 32(2), 127–135. https://doi.org/10.1097/RTI.0000000000000257
Kligerman, Seth, Ferdia Bolster, Jason Mitchell, Travis Henry, Jean Jeudy, and Charles S. White. “Use of Model-based Iterative Reconstruction to Improve Detection of Congenital Cardiovascular Anomalies in Infants Undergoing Free-breathing Computed Tomographic Angiography.J Thorac Imaging 32, no. 2 (March 2017): 127–35. https://doi.org/10.1097/RTI.0000000000000257.
Kligerman, Seth, et al. “Use of Model-based Iterative Reconstruction to Improve Detection of Congenital Cardiovascular Anomalies in Infants Undergoing Free-breathing Computed Tomographic Angiography.J Thorac Imaging, vol. 32, no. 2, Mar. 2017, pp. 127–35. Pubmed, doi:10.1097/RTI.0000000000000257.

Published In

J Thorac Imaging

DOI

EISSN

1536-0237

Publication Date

March 2017

Volume

32

Issue

2

Start / End Page

127 / 135

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Respiration
  • Radiographic Image Interpretation, Computer-Assisted
  • Nuclear Medicine & Medical Imaging
  • Male
  • Infant, Newborn
  • Infant
  • Image Processing, Computer-Assisted
  • Humans
  • Heart Defects, Congenital