ArticleEuropean radiology2025
Improving image quality and diagnostic usability in photon-counting coronary CT angiography using a novel reconstruction algorithm.
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Effect of ZeeFree algorithm on the reduction of stair-step artifacts for coronary computed tomography angiography.Scientific reports · 2026Article
- Clinical evaluation of a motion correction software based on partial angle reconstruction in coronary CT angiography.The international journal of cardiovascular imaging · 2026Article
- Spectral computed tomography characterization of coronary atherosclerotic plaque: principles, imaging biomarkers, and clinical significance.Frontiers in cardiovascular medicine · 2026Review
- Thoracic-abdominopelvic contrast-enhanced dual-source computed tomography with a high-pitch acquisition protocol and free breathing for reducing motion artifacts and scan time in patients with cancer: a prospective study.Quantitative imaging in medicine and surgery · 2025Article
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12 authors.
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Abstract
purposeQualitative comparison of image quality and diagnostic usability of the recently introduced ZeeFree (ZF) reconstruction algorithm for photon-counting coronary CT angiography (cCTA) with Standard (SD) and TrueStack (TS) reconstruction algorithms. METHODS AND MATERIALS: This retrospective single-center study included 59 patients (mean age 62.5 ± 13.7, 37 males) who were referred for cCTA on a clinical photon-counting CT scanner between July and December 2023. Curved planar reformations were reconstructed for coronary arteries using ZF, SD, and TS algorithms. Three blinded radiologists individually evaluated image quality on a 5-point Likert scale (5 = excellent; median and interquartile range). Differences were evaluated using Friedman's test with pair-wise post-hoc testing. Readers were advised to assess the image quality to be diagnostic using a dichotomous yes/no question, with results being presented as percentages and significance evaluated by the Pearson Chi-Square test. Interrater reliability for image quality used Gwet's AC2 coefficient with ordinal weights, and Gwet's AC1 coefficient for diagnostic usability.
resultsZF showed superior quality (4 (2)) compared to SD (4 (2), p = 0.03) and TS (4 (1), p < 0.001) while a substantial inter-rater agreement was observed for all algorithms (0.70-0.74). Furthermore, ZF obtained the highest diagnostic usability compared to SD (82.5% vs. 77.0%, p < 0.001) and TS (75.5%, p < 0.001) while yielding an almost perfect inter-rater agreement (0.84).
conclusionCompared to SD and TS, the novel ZF image reconstruction algorithm for photon-counting cCTA provides improved image quality and diagnostic usability, suggesting its primary use for clinical assessment. KEY POINTS: Question How well does the novel ZeeFree algorithm address motion artifacts in photon-counting coronary CT angiography? Findings ZeeFree significantly outperformed Standard and TrueStack reconstruction algorithms for image quality and diagnostic usability. Clinical relevance Enhanced image quality with ZeeFree could improve the diagnosis of coronary artery disease.
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