Application of one heartbeat acquisition with motion correction algorithm in CCTA of patients with atrial fibrillation: Evaluation of coronary artery stenose using Artificial Intelligence Assisted Diagnostic System

Shumeng Zhu¹Xing Li¹Qian Tian¹Xiaoqian Jia¹Tingting Qu¹Jianying Li²Xueyan Zhang¹Yannan Cheng¹Le Cao¹Lihong Chen¹Jianxin Guo^1*

• ¹The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
• ²CT Research Center, GE Healthcare, Beijing, China

Abstract Introduction: Motion artifacts induced by atrial fibrillation (AF) present a substantial challenge in coronary computed tomography angiography (CCTA). Wide detectors, rapid scanning, and motion correction algorithms can effectively improve image quality in CCTA. This study aims to evaluate the impact of one-beat acquisition with a motion correction algorithm (Snapshot Freeze 1, SSF1) on the image quality of prospective CCTA in patients with AF, and its diagnostic performance using an artificial intelligence assisted diagnostic system (AI-ADS). Materials and methods: A total of 91 consecutive patients with AF, who underwent one-beat CCTA were analyzed. Images were reconstructed with SSF1. The subjective and objective image quality of the coronary arteries were evaluated. Using the invasive coronary catheter angiography (ICA) as the reference standard, the diagnostic performance of AI-ADS and AI-ADS + radiologist for stenoses above moderate and severe degrees were calculated. Results: Effective radiation dose was 2.43 ± 0.88 mSv. The average CT values of all major coronary arteries and branches were greater than 400HU. All vessels were diagnosable (scores≥3) with good or above ratings at 96.15% (350/364) and 96.70% (352/364). The diagnostic accuracy, sensitivity, specificity and AUC of AI-ADS vs AI-ADS + radiologist for above moderate stenoses were: (84.62% vs 91.21%), (89.61% vs 98.70%), (57.14% vs 50.00%) and (0.73 vs 0.74) on patient level; (84.07% vs 87.64%), (74.07% vs 85.19%), (89.96% vs 89.08%) and (0.82 vs 0.87) on vessel level; (90.84% vs 93.11%), (63.59% vs 78.34%), (95.99% vs 95.91%) and (0.80 vs 0.87) on segment level. For severe stenoses, these values were: (62.64% vs 82.42%), (58.62% vs 91.38%), (69.70% vs 66.67%) and (0.64 vs 0.79) on patient level; (82.97% vs 89.29%), (46.43% vs 75.00%), (93.93% vs 93.57%) and (0.70 vs 0.84) on vessel level; (92.23% vs 95.16%), (36.92% vs 66.92%), (98.06% vs 98.14%) and (0.68 vs 0.83) on segment level. Conclusion: One-beat CCTA with SSF1 provides high-quality coronary images for patients with AF. AI-ADS automatically distinguishes coronary images with different stenoses, but the sensitivity of AI-ADS is low, especially for severe stenoses. AI-ADS + radiologist further improves the diagnostic performance.