Image quality of automatic coronary CT angiography reconstruction for patients with HR ≥ 75 bpm using an AI-assisted 16-cm z-coverage CT scanner.

Background: Coronary CT angiography (CCTA) is a complicated CT exam in comparison to other CT protocols. Exam success highly depends on image assessment of experienced radiologist and the procedure is often time-consuming. This study aims to evaluate feasibility of automatic CCTA reconstruction in 0.25 s rotation time, 16 cm coverage CT scanner with best phase selection and AI-assisted motion correction.
Methods: CCTA exams of 90 patients with heart rates higher than 75 bpm were included in this study. Two image series were reconstructed-one at automatically selected phase and another with additional motion correction. All reconstructions were performed without manual interaction of radiologist. A four-point Likert scale rating system was used to evaluate the image quality of coronary artery segment by two experienced radiologists, according to the 18-segment model. Analysis was done on per-segment basis.
Results: Total 1194 out of the 1620 segments were identified for quality evaluation in 90 patients. After automatic best phase selection, 1172 segments (98.3%) were rated as having diagnostic image quality (scores 2-4) and the average score is 3.64 ± 0.55. When motion corrections were applied, diagnostic segment number increases to 1192 (99.8%) and the average score is 3.85 ± 0.37.
Conclusions: With the help of 0.25 s rotation speed, 16-cm z-coverage and AI-assisted motion correction algorithm, CCTA exam reconstruction could be performed with minimum radiologist involvement and still meet image quality requirement.