Evidence map›Paper›PMID 30715584›Full record

ArticleEuropean radiology2019

Noise reduction and motion elimination in low-dose 4D myocardial computed tomography perfusion (CTP): preliminary clinical evaluation of the ASTRA4D algorithm.

Steffen Lukas, Sarah Feger, Matthias Rief, Elke Zimmermann, Marc Dewey

Abstract readEvaluation Study
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Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Steffen LukasDepartment of Radiology, Charité Medical School, Charitéplatz 1, 10117, Berlin, Germany.
Sarah FegerDepartment of Radiology, Charité Medical School, Charitéplatz 1, 10117, Berlin, Germany.
Matthias RiefDepartment of Radiology, Charité Medical School, Charitéplatz 1, 10117, Berlin, Germany.
Elke ZimmermannDepartment of Radiology, Charité Medical School, Charitéplatz 1, 10117, Berlin, Germany.
Marc DeweyDepartment of Radiology, Charité Medical School, Charitéplatz 1, 10117, Berlin, Germany. dewey@charite.de.ORCID http://orcid.org/0000-0002-4402-2733

Funding

Berlin Institute of Health Digital Health Accelerator 2017Deutsche Forschungsgemeinschaft DE 1361/14-1
6 · The paper itself

Abstract

objectivesTo propose and evaluate a four-dimensional (4D) algorithm for joint motion elimination and spatiotemporal noise reduction in low-dose dynamic myocardial computed tomography perfusion (CTP).

methodsThirty patients with suspected or confirmed coronary artery disease were prospectively included and underwent dynamic contrast-enhanced 320-row CTP. A novel deformable image registration method based on the principal component analysis (PCA) of the ante hoc temporally smoothed voxel-wise time-attenuation curves (ASTRA4D) is presented. Quantitative (standard deviation, signal-to-noise ratio (SNR), temporal variation, volumetric deformation) and qualitative (motion, contrast, contour sharpness [1, poor; 5, excellent]) measures of CTP quality were assessed for the original and motion-compensated sequences (without and with temporal filtering, PCA/ASTRA4D). Following myocardial perfusion deficit detection by two readers, diagnostic accuracy was evaluated using magnetic resonance myocardial perfusion imaging (MR-MPI) as the reference standard in 15 patients.

resultsRegistration using ASTRA4D was successful in all 30 patients and resulted in comparison with the benchmark PCA in significantly (p < 0.001) reduced noise over time (- 83%, 178.5 vs 29.9) and spatially (- 34%, 21.4 vs 14.1) as well as improved SNR (+ 47%, 3.6 vs 5.3) and subjective image quality (motion, contrast, contour sharpness [+ 1.0, + 1.0, + 0.5]). ASTRA4D had significantly improved per-segment sensitivity of 91% (58/64) and similar specificity of 96% (429/446) compared with PCA (52%, 33/64; 98%, 435/446; p = 0.011) in the visual detection of perfusion deficits.

conclusionsThe ASTRA4D registration algorithm improved the spatiotemporal noise profile and CTP sequence image quality, resulting in significantly improved sensitivity of 4D CTP in the detection of myocardial ischemia. KEY POINTS: • ASTRA4D combines local temporal regression and deformable image registration. • Quantitative and qualitative measures of CTP quality are improved compared to PCA. • Improved spatiotemporal differentiation of ischemic regions leads to an excellent perfusion deficit concordance of ASTRA4D with MRI.

Indexed as

AgedAlgorithmsArtifactsCoronary Artery DiseaseFemaleFour-Dimensional Computed TomographyHumansMagnetic Resonance ImagingMaleMiddle AgedMotionMyocardial IschemiaMyocardial Perfusion ImagingPerfusionRadiographic Image Interpretation, Computer-AssistedSensitivity and SpecificityComputed tomography myocardial perfusion imagingCoronary artery diseaseDeformable registrationMotion artifactsTemporal averaging

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.