What is the clinical evidence from this study?

Study design: Observational. Population: Severe aortic stenosis (n=90). Intervention: Second-generation whole-heart motion correction algorithm (SSF2) vs. Standard reconstruction. Primary outcome: Image quality score (1-5 scale) at 40% R-R interval in patients with high heart rate (>70 bpm) (p=<0.001).

March 3, 2023Open Access

Evaluation of the second-generation whole-heart motion correction algorithm (SSF2) used to demonstrate the aortic annulus on cardiac CT

Q: What are the key findings of this study?

The second-generation whole-heart motion correction algorithm (SSF2) significantly improved the mean image quality score (3.7 vs 2.5, p<0.001) compared to standard reconstruction in patients with a high heart rate at 40% R-R interval.

Key Result

The second-generation whole-heart motion correction algorithm (SSF2) significantly improved the mean image quality score (3.7 vs 2.5, p<0.001) compared to standard reconstruction in patients with a high heart rate at 40% R-R interval.

Study Design

Type

Observational (n=90)

Blinding

Single-blind

Multicenter

Structured PICO

Does the second-generation whole-heart motion correction algorithm (SSF2) improve image quality and measurement accuracy of the aortic annulus in patients with severe aortic stenosis undergoing pre-TAVI cardiac CT?

Population

90 older adults (median age 84 years) with severe aortic stenosis undergoing pre-TAVI cardiac CT were evaluated retrospectively.

Intervention

Second-generation whole-heart motion correction algorithm (SnapShot Freeze 2.0, SSF2) applied to pre-TAVI cardiac CT reconstruction

Comparator

Standard reconstruction (without motion correction) with deep-learning image reconstruction

Outcome

Measurement accuracy and image quality of the aortic annulus (assessed via edge rise distance, dispersion of sizing [SD of area and perimeter], contrast-to-noise ratio, and qualitative image quality on a 5-point Likert scale)surrogate

The SSF2 whole-heart motion correction algorithm significantly improves the image quality and measurement accuracy of the aortic annulus on pre-TAVI cardiac CT, particularly in patients with high heart rates or during the systolic phase.

Main Result

Absolute Event Rate: 3.7% vs 2.5%

p-value: p=<0.001

Limitations

Relatively small study population
Single-center experience
Lack of reference standard such as transesophageal echocardiography for all patients
Only evaluated differences on the same CT scanner

Abstract

The main purpose of pre-transcatheter aortic valve implantation (TAVI) cardiac computed tomography (CT) for patients with severe aortic stenosis is aortic annulus measurements. However, motion artifacts present a technical challenge because they can reduce the measurement accuracy of the aortic annulus. Therefore, we applied the recently developed second-generation whole-heart motion correction algorithm (SnapShot Freeze 2.0, SSF2) to pre-TAVI cardiac CT and investigated its clinical utility by stratified analysis of the patient's heart rate during scanning. We found that SSF2 reconstruction significantly reduced aortic annulus motion artifacts and improved the image quality and measurement accuracy compared to standard reconstruction, especially in patients with high heart rate or a 40% R-R interval (systolic phase). SSF2 may contribute to improving the measurement accuracy of the aortic annulus.

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