Young Jun Cho MD, Presenter: Nothing to Disclose

Keum Won Kim MD, Abstract Co-Author: Nothing to Disclose

Cheol Mog Hwang MD, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe, Abstract Co-Author: Nothing to Disclose

Jung Han Hwang, Abstract Co-Author: Nothing to Disclose

To compare traditional filtered back projection (FBP) and sonogram affirmed iterative reconstruction (SAFIRE) for the evaluation of coronary CT image quality and diagnostic accuracy in patients with various body mass indexes (BMI).

One hundred nine consecutive patients (56 men, 53 women; mean age, 57.4 ± 11; range, 20-79) with various BMI underwent both coronary CTA and coronary catheterization. The study population was divided into three groups according to BMI: normal was defined as a BMI of 18.50 to 24.99 kg/m², overweight as a BMI of 25.00 to 29.99 kg/m², and obese as a BMI ≥ 30.00 kg/m². Image data were reconstructed with both FBP and SAFIRE. With two reconstruction techniques, we evaluated subjective image noise of each coronary segmental artery using a five-point scale according to the noise severity. We also evaluated objective image quality with two reconstruction techniques by measuring CT attenuation, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) as objective parameters. Diagnostic accuracies of FBP and SAFIRE were independently evaluated by significant coronary stenosis (≥50%) in comparison of coronary catheterization as the reference standard.

With both reconstruction techniques, the mean subjective image quality scores in all BMI groups were significantly higher with SAFIRE image than FBP image (p = 0.000). In obese and overweight patients, the number of assessable coronary segments was increased with SAFIRE. Image noise, SNR, and CNR were also significantly improved in all BMI groups when using SAFIRE, compared with FBP. In obese and overweight patients, specificity, PPV and accuracy of each SAFIRE for the detection of significant stenosis were significantly better than those of each FBP (p = 0.001, respectively).

Compare with traditional FBP image, the SAFIRE image in obese and overweight patients seems better suited by improvement of image quality and help to decreases the requirements of coronary catheterization by decreasing the number of false positive patient

The SAFIRE image in obese and overweight patients seems better suited by improvement of image quality and help to decreases the requirements of coronary catheterization by decreasing the number of false positive patient  

Cho, Y, Kim, K, Hwang, C, Choe, K, Hwang, J, Evaluation of Image Quality and Diagnostic Accuracy of Coronary CT Angiography in Patients with Various Body Mass Index (BMI): Comparison of Iterative and Filtered Back Projection Image Reconstruction.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045749.html