Dataset Information

Association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography.

ABSTRACT:

Objective

Coronary artery disease (CAD) is an important cause of mortality and morbidity, therefore, recognizing its severity and related factors is important. This study was performed to evaluate the association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography. In this observational cross-sectional comparative study, 110 patients who were under coronary angiography in Firoozgar Hospital in 2017 were enrolled, and the association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in their chest CT scan and number of involved vessels in angiography were assessed.

Results

In this study, number of involved vessels in angiography was related to PA/Ao ratio (P?=?0.001) and further vessels were accompanied with higher ratio. It may be concluded that, a higher ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan is related to higher number of involved vessels in coronary angiography, and it may have a predictive role.

SUBMITTER: Mohseni I

PROVIDER: S-EPMC7866663 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography.

Mohseni Iman I Shiri Afshin A Mojahedin Simindokht S

BMC research notes 20210205 1

<h4>Objective</h4>Coronary artery disease (CAD) is an important cause of mortality and morbidity, therefore, recognizing its severity and related factors is important. This study was performed to evaluate the association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography. In this observational cross-sectional comparative study, 110 patients who were under coronary angiography in Firoozgar Hospital ...[more]

PMID: 33546751

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Project description:BackgroundIt is unclear whether an evaluation incorporating coronary computed tomographic angiography (CCTA) is more effective than standard evaluation in the emergency department in patients with symptoms suggestive of acute coronary syndromes.MethodsIn this multicenter trial, we randomly assigned patients 40 to 74 years of age with symptoms suggestive of acute coronary syndromes but without ischemic electrocardiographic changes or an initial positive troponin test to early CCTA or to standard evaluation in the emergency department on weekdays during daylight hours between April 2010 and January 2012. The primary end point was length of stay in the hospital. Secondary end points included rates of discharge from the emergency department, major adverse cardiovascular events at 28 days, and cumulative costs. Safety end points were undetected acute coronary syndromes.ResultsThe rate of acute coronary syndromes among 1000 patients with a mean (±SD) age of 54±8 years (47% women) was 8%. After early CCTA, as compared with standard evaluation, the mean length of stay in the hospital was reduced by 7.6 hours (P<0.001) and more patients were discharged directly from the emergency department (47% vs. 12%, P<0.001). There were no undetected acute coronary syndromes and no significant differences in major adverse cardiovascular events at 28 days. After CCTA, there was more downstream testing and higher radiation exposure. The cumulative mean cost of care was similar in the CCTA group and the standard-evaluation group ($4,289 and $4,060, respectively; P=0.65).ConclusionsIn patients in the emergency department with symptoms suggestive of acute coronary syndromes, incorporating CCTA into a triage strategy improved the efficiency of clinical decision making, as compared with a standard evaluation in the emergency department, but it resulted in an increase in downstream testing and radiation exposure with no decrease in the overall costs of care. (Funded by the National Heart, Lung, and Blood Institute; ROMICAT-II ClinicalTrials.gov number, NCT01084239.).

Project description:ObjectivesCardiac computed tomography (CT) is essential in diagnosing coronary heart disease. However, a disadvantage is the associated radiation exposure to the patient which depends in part on the scan range. This study aimed to develop a deep neural network to optimize the delimitation of scan ranges in CT localizers to reduce the radiation dose.MethodsOn a retrospective training cohort of 1507 CT localizers randomly selected from calcium scoring and angiography scans and acquired between 2010 and 2017, optimized scan ranges were delimited by two radiologists in consensus. A neural network was trained to reproduce the scan ranges and was tested on two randomly selected and independent validation cohorts: an internal cohort of 233 CT localizers (January 2018-June 2020) and an external cohort from a nearby hospital of 298 CT localizers (July 2020-December 2020). Localizers where a bypass surgery was visible were excluded. The effective radiation dose to the patient was simulated using a Monte Carlo simulation. Scan ranges of radiographers, radiologists, and the network were compared using an equivalence test; likewise, the reduction in effective dose was tested using a superior test.ResultsThe network replicated the radiologists' scan ranges with a Dice score of 96.5 ± 0.02 (p < 0.001, indicating equivalence). The generated scan ranges resulted in an effective dose reduction of 10.0% (p = 0.002) in the internal cohort and 12.6% (p < 0.001) in the external cohort compared to the scan ranges delimited by radiographers in clinical routine.ConclusionsAutomatic delimitation of the scan range can result in a radiation dose reduction to the patient.Clinical relevance statementFully automated delimitation of the scan range using a deep neural network enables a significant reduction in radiation exposure during CT coronary angiography compared to manual examination planning. It can also reduce the workload of the radiographers.Key points• Scan range delimitation for coronary computed tomography angiography could be performed with high accuracy by a deep neural network. • Automated scan ranges showed a high agreement of 96.5% with the scan ranges of radiologists. • Using a Monte Carlo simulation, automated scan ranges reduced the effective dose to the patient by up to 12.6% (0.9 mSv) compared to the scan ranges of radiographers in clinical routine.

Dataset Information

Association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography.

Objective

Results

Publications

Association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography.

Similar Datasets

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