Image-based coronary calcium and metal subtraction in coronary computed tomography angiography

Aaron So, Chun Bi Chang, I. Chang Hsieh, Ming Shien Wen, Ting Yim Lee, Yao Shieh, Chun Chi Chen, Yung Liang Wan*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

4 Scopus citations

Abstract

Coronary artery disease is one of the leading causes of death in the world, and is a major socioeconomic issue due to its high health care expenditure. Coronary computed tomography angiography is a useful non-invasive tool for diagnosing coronary artery disease in contrast to conventional invasive coronary angiography. However, the diagnostic performance of coronary computed tomography angiography, especially the positive predictive value and specificity, can be substantially affected by the presence of metallic stents or severe calcification of coronary arteries when the Agatston calcium score is greater than 400. The subtracted coronary computed tomography angiography has been proposed to overcome this deficiency. In this approach, high-density objects such as metal and calcium in the coronary arteries are removed by subtracting the pre-enhanced images from the post-enhanced images after the two image sets are properly registered to each other. This article reviews the recent literature on subtracted coronary computed tomography angiography and discusses the causes of image artifacts arising from high-density objects in the field-of-view. It also addresses the potential pitfalls of subtracted coronary computed tomography angiography and alternative solutions for improving the diagnostic performance of coronary computed tomography angiography when severe calcification or metallic stents are present in the coronary artery.

Original languageEnglish
Pages (from-to)1780-1788
Number of pages9
JournalJournal of Medical Imaging and Health Informatics
Volume7
Issue number8
DOIs
StatePublished - 12 2017

Bibliographical note

Publisher Copyright:
Copyright © 2017 American Scientific Publishers.

Keywords

  • 320-Row Computed Tomography
  • Coronary Artery Disease
  • Coronary Calcification
  • Coronary Stent
  • Subtraction CT Angiography

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