In the past, it’s been common practice to look to advances in CT system hardware for improvements in cardiac imaging. Innovation in hardware has helped make it possible to reach the speeds necessary to obtain high-quality cardiac images. However, hardware is rapidly reaching its physical limitations for providing the additional rotation speed for the temporal resolution needed to increase quality in cardiac exams.
The next leap in image quality for cardiac exams is being made possible by refinements in software and through AI. Fortunately, these AI advances are now found in the types of CT systems that are more accessible to a wide range of institutions, which means more patients will have the opportunity to benefit from high-quality cardiac scanning.
This is so important because coronary computed tomography angiography (coronary CTA) has become the preferred noninvasive imaging exam for the detection and rule-out of coronary artery disease (CAD), by providing an assessment of the coronary anatomy and visualization of atherosclerotic plaque to aid in detection of lesions that may limit blood flow to the myocardium. Recently updated guidelines1 affirm the value of coronary CTA for stable or atypical chest pain or other anginal symptoms, and we expect demand for CTA exams to increase.
In the past, it’s been common practice to look to advances in CT system hardware for improvements in cardiac imaging. Innovation in hardware has helped make it possible to reach the speeds necessary to obtain high-quality cardiac images. However, hardware is rapidly reaching its physical limitations for providing the additional rotation speed for the temporal resolution needed to increase quality in cardiac exams.
The next leap in image quality for cardiac exams is being made possible by refinements in software and through AI. Fortunately, these AI advances are now found in the types of CT systems that are more accessible to a wide range of institutions, which means more patients will have the opportunity to benefit from high-quality cardiac scanning.
This is so important because coronary computed tomography angiography (coronary CTA) has become the preferred noninvasive imaging exam for the detection and rule-out of coronary artery disease (CAD), by providing an assessment of the coronary anatomy and visualization of atherosclerotic plaque to aid in detection of lesions that may limit blood flow to the myocardium. Recently updated guidelines1 affirm the value of coronary CTA for stable or atypical chest pain or other anginal symptoms, and we expect demand for CTA exams to increase.
There are multiple challenges in imaging coronary arteries with the use of CT. These arteries are small with a caliber approaching 1 mm or less at their most distal ends, and they exhibit motion in multiple planes during the cardiac cycle, which contributes to motion artifacts during cardiac imaging. Unpredictable cardiac motion due to irregular heart rates and high heart rates can lead to sub-optimal or non-diagnostic cardiac exams. The limited temporal resolution of coronary CTA is insufficient to address motion artifacts, resulting in non-evaluable coronary segments, which impacts diagnostic performance. This is why AI solutions, paired with advanced hardware, are so promising.
How hardware, software, and AI go hand in hand for improved cardiac imaging
Philips CT 5300 system features NanoPanel Precise, the industry’s first detector built from the ground up specifically for AI-based reconstruction. This detector leverages the full capabilities of Philips Precise Image AI-reconstruction software to deliver high-quality images at a much lower radiation dose. Combined with Precise Cardiac motion compensation, Precise Image makes the CT 5300 system particularly suitable for high-quality, motion-free cardiac imaging in patients with high heart rates or heart-rate variability.
Correcting for cardiac artery motion
Precise Cardiac is a zero-click reconstruction technique that compensates for cardiac motion to improve visualization of the coronary arteries during CT imaging. This artifact reduction results in a 6x gain in effective temporal resolution for CT 5300, for an effective temporal resolution of 29.2 ms.2
Precise Cardiac demonstrates significant improvements in image quality of the coronary arteries, compared with standard cardiac reconstructions. Applicable both retrospectively for gated helical exams and prospectively for gated axial exams, Precise Cardiac employs efficient filtering techniques in a predefined region around the targeted cardiac phase to identify relevant objects and dynamically track their motion behavior in the localized portion of the cardiac cycle. Motion-corrected images are generated by taking into account the displacement of structures and performing the relevant corrections as part of the back-projection process.
Smart automation
Precise Cardiac is built into the CT console workflow, avoiding the need for any manual intervention, data transfer, or additional workstations. It improves diagnostic confidence in challenging patients with high or irregular heart rates and can help salvage some coronary segments previously deemed nondiagnostic using standard cardiac reconstructions, thus increasing diagnostic confidence in coronary CTA exams. Coronary motion correction can potentially reduce the need for a repeat scan.
AI-enabled cardiac scanning at every step
Cardiac imaging is advancing. From scan prep through reconstruction, Philips' powerful AI-enabled innovations in cardiac imaging matter. Tools such as Precise Image AI reconstruction and Precise Cardiac for motion-corrected images help deliver precision in dose, speed, and image quality. As more institutions have access to AI-enabled CT systems that can offer high-quality cardiac scans at low doses, more patients can benefit. We’d love to continue the conversation. Talk with your Philips representative to learn more about AI and cardiac scanning or click here to download our latest whitepaper.
Narula J, Chandrashekhar Y, Ahmadi A, et al. SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr. 2021 May-Jun;15(3):192-217. doi: 10.1016/j.jcct.2020.11.001. Epub 2020 Nov 20. PMID: 33303384; PMCID: PMC8713482
