Publications by authors named "Emrich T"
Purpose: To evaluate the feasibility of aortoiliac CT-Angiography (CTA) using dual-source photon-counting detector (PCD)-CT with minimal iodine dose.
Methods: This IRB-approved, single-center prospective study enrolled patients with indications for aortoiliac CTA from December 2022 to March 2023. All scans were performed using a first-generation dual-source PCD-CT.
Background: This study aimed to determine whether artificial intelligence (AI)-based automated assessment of left atrioventricular coupling index (LACI) can provide incremental value above other traditional risk factors for predicting mortality among patients with severe aortic stenosis (AS) undergoing coronary CT angiography (CCTA) before transcatheter aortic valve replacement (TAVR).
Methods: This retrospective study evaluated patients with severe AS who underwent CCTA examination before TAVR between September 2014 and December 2020. An AI-prototype software fully automatically calculated left atrial and left ventricular end-diastolic volumes and LACI was defined by the ratio between them.
: To evaluate correlations between cardiac magnetic resonance imaging (cMRI) at rest including strain imaging and variables derived from quantitative cardiopulmonary exercise testing using a treadmill in patients with pectus excavatum. : We retrospectively correlated the results of cMRI and cardiopulmonary exercise testing in 17 patients with pectus excavatum, in whom both examinations were performed during their pre-operative clinical evaluation. In addition to cardiac volumetry, we assessed the strain rates of both ventricles using a feature-tracking algorithm of a piece of commercially available post-processing software.
View Article and Find Full Text PDFRationale And Objectives: The prognostic role of computed tomography (CT)-defined skeletal muscle features in COVID-19 is still under investigation. The aim of the present study was to evaluate the prognostic role of CT-defined skeletal muscle area and density in patients with COVID-19 in a multicenter setting.
Materials And Methods: This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the COVID-19 pandemic).
Rationale And Objectives: The purpose of this study was to explore intra-individual differences in pericoronary adipose tissue (PCAT) fat attenuation index (FAI) between photon-counting detector (PCD)- and energy-integrating detector (EID)-CT.
Material And Methods: Patients were prospectively enrolled for a PCD-CT research scan within 30 days of EID-CT. Both acquisitions were reconstructed using a Qr36 kernel at 0.
Background: The impact of novel photon-counting detector (PCD)-CT technology on in-vivo radiomics is not fully understood. This study aimed to compare the intra-individual stability and reproducibility of pericoronary adipose tissue (PCAT) radiomic features between PCD-CT and energy-integrating detector (EID)-CT in patients undergoing coronary CT angiography (CCTA) on both systems.
Methods: Patients undergoing clinically indicated CCTA on an EID-CT were prospectively enrolled for research PCD-CCTA within 30 days.
Article Synopsis
- The text reviews advancements in dual-source photon-counting detector CT (PCD-CT) technology for cardiovascular imaging since its approval in 2021, focusing on innovative applications and research.
- A structured literature review identified studies that highlighted benefits such as improved image quality, better radiation dose management, and feasibility for non-invasive diagnostics in diverse patient populations.
- Despite these advantages, there are ongoing challenges like high costs, extensive data handling, slower reconstruction times, and the need for more clinical evidence to validate the technology's superiority.
Background: The increased specificity of ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT over energy-integrating detector (EID)-CT for coronary CT angiography (CCTA) could defer unwarranted downstream tests. The objective of the study was to simulate the cost-effectiveness of UHR CCTA in stable chest pain patients with coronary calcifications.
Methods: A decision and simulation model was developed using Monte Carlo simulations with 1000 bootstrap resamples to estimate the costs associated with PCD-CT in lieu of EID-CT for CCTA and the referral for subsequent testing.
Purpose: To evaluate the feasibility of CT angiography-derived fractional flow reserve (CT-FFR) calculations on ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT series and to intra-individually compare the results with energy-integrating (EID)-CT measurements.
Method: Prospective patients with calcified plaques detected on EID-CT between April 1st, 2023 and January 31st, 2024 were recruited for a UHR CCTA on PCD-CT within 30 days. PCD-CT was performed using the same or a lower CT dose index and an equivalent volume of contrast media.
Objectives: To compare standard-resolution balanced steady-state free precession (bSSFP) cine images with cine images acquired at low resolution but reconstructed with a deep learning (DL) super-resolution algorithm.
Materials And Methods: Cine cardiovascular magnetic resonance (CMR) datasets (short-axis and 4-chamber views) were prospectively acquired in healthy volunteers and patients at normal (cine: 1.89 × 1.
Article Synopsis
- Coronary computed tomography angiography (CCTA) is a non-invasive method for diagnosing coronary artery issues, utilizing intravenous contrast agents for better imaging, specifically evaluating the potential use of gadolinium-based contrast agents (GBCA) instead of traditional iodinated contrast.
- A dynamic phantom model was employed to test different GBCA injection protocols at varying doses, and virtual monoenergetic image reconstructions were made to analyze the performance of GBCA in CCTA.
- The study found that while higher GBCA doses improved image quality, current dual-source photon-counting-detector CT systems can't effectively use GBCA at approved doses, suggesting a need for future technological advancements to optimize its application, especially for patients with iodine allergies.
Article Synopsis
- The introduction of photon-counting detector computed tomography (PCD-CT) represents a significant advancement in cardiac imaging technology since its market launch in 2021.
- This review examines the benefits of PCD-CT, highlighting improvements in image quality, spatial resolution, contrast-to-noise ratio, reduced artifacts, and lower radiation exposure.
- Despite promising early results, researchers are still evaluating how PCD-CT's advantages will influence future clinical guidelines for cardiac imaging.
Article Synopsis
- Coronary CT angiography (CCTA) is crucial before transcatheter aortic valve replacement (TAVR), and this study aimed to assess how well AI software can predict major adverse cardiovascular events (MACE) in TAVR patients by analyzing cardiac parameters.
- The study included 648 patients, revealing that 17.9% experienced MACE within an average follow-up of 24 months, with left ventricle long axis shortening (LV-LAS) identified as a key predictor of MACE after considering other clinical factors.
- The results showed that the AI-derived LV-LAS significantly improved prediction models for MACE, demonstrating that automated cardiac assessments can effectively aid in risk stratification prior to TAVR procedures
Article Synopsis
- The study aims to create a deep learning algorithm using MRI to quickly and accurately classify individuals into groups: normal subjects, and patients with dilated cardiomyopathy, hypertrophic cardiomyopathy, and ischemic heart disease.
- A total of 1,337 subjects were analyzed, employing advanced imaging techniques and extracting key cardiac features to train the algorithm, testing its effectiveness through various statistical methods and comparisons against expert evaluations.
- The model achieved high accuracy rates, particularly distinguishing normal subjects with an area under the curve (AUC) of 0.952, while improving classification metrics slightly with the addition of unlabeled normal data.
Background: A recent simulation study proposed that stenosis measurements on coronary computed tomography (CT) angiography are influenced by the improved spatial resolution of photon-counting detector (PCD)-CT. The aim of the current study was to evaluate the impact of ultrahigh-spatial-resolution (UHR) on coronary stenosis measurements and Coronary Artery Disease Reporting and Data System (CAD-RADS) reclassification rates in patients undergoing coronary CT angiography on both PCD-CT and energy-integrating detector (EID)-CT and to compare measurements against quantitative coronary angiography.
Methods: Patients with coronary calcification on EID-CT (collimation, 192×0.
Purpose: To explore the potential differences in epicardial adipose tissue (EAT) volume and attenuation measurements between photon-counting detector (PCD) and energy-integrating detector (EID)-CT systems.
Methods: Fifty patients (mean age 69 ± 8 years, 41 male [82 %]) were prospectively enrolled for a research coronary CT angiography (CCTA) on a PCD-CT within 30 days after clinical EID-based CCTA. EID-CT acquisitions were reconstructed using a Bv40 kernel at 0.
Background: We compared ultra-high resolution (UHR), standard resolution (SR), and virtual non-calcium (VNCa) reconstruction for coronary artery stenosis evaluation using photon-counting computed tomography (PC-CT).
Methods: One vessel phantom (4-mm diameter) containing solid calcified lesions with 25% and 50% stenoses inside a thorax phantom with motion simulation underwent PC-CT using UHR (0.2-mm slice thickness) and SR (0.
Background: Radiomics is not yet used in clinical practice due to concerns regarding its susceptibility to technical factors. We aimed to assess the stability and interscan and interreader reproducibility of myocardial radiomic features between energy-integrating detector computed tomography (EID-CT) and photon-counting detector CT (PCD-CT) in patients undergoing coronary CT angiography (CCTA) on both systems.
Methods: Consecutive patients undergoing clinically indicated CCTA on an EID-CT were prospectively enrolled for a PCD-CT CCTA within 30 days.
Background: Lower extremity peripheral artery disease frequently presents with calcifications which reduces the accuracy of computed tomography (CT) angiography, especially below-the-knee. Photon-counting detector (PCD)-CT offers improved spatial resolution and less calcium blooming. We aimed to identify the optimal reconstruction parameters for PCD-CT angiography of the lower legs.
View Article and Find Full Text PDFBackground: Diagnosing myocarditis relies on multimodal data, including cardiovascular magnetic resonance (CMR), clinical symptoms, and blood values. The correct interpretation and integration of CMR findings require radiological expertise and knowledge. We aimed to investigate the performance of Generative Pre-trained Transformer 4 (GPT-4), a large language model, for report-based medical decision-making in the context of cardiac MRI for suspected myocarditis.
View Article and Find Full Text PDFPurpose To investigate the impact of plaque size and density on virtual noncontrast (VNC)-based coronary artery calcium scoring (CACS) using photon-counting detector CT and to provide safety net reconstructions for improved detection of subtle plaques in patients whose VNC-based CACS would otherwise be erroneously zero when compared with true noncontrast (TNC)-based CACS. Materials and Methods In this prospective study, CACS was evaluated in a phantom containing calcifications with different diameters (5, 3, and 1 mm) and densities (800, 400, and 200 mg/cm) and in participants who underwent TNC and contrast-enhanced cardiac photon-counting detector CT (July 2021-March 2022). VNC images were reconstructed at different virtual monoenergetic imaging (55-80 keV) and quantum iterative reconstruction (QIR) levels (QIR,1-4).
View Article and Find Full Text PDFPurpose: In planning transcatheter aortic valve replacement (TAVR), retrospective cardiac spiral-CT is recommended to measure aortic annulus with subsequent CT-angiography (CTA) to evaluate access routes. Photon-counting detector (PCD)-CT enables to assess the aortic annulus in desired cardiac phases, using prospective ECG-gated high-pitch CTA. The aim of this study was to evaluate the measurement accuracy of aortic annulus using prospective ECG-gated high-pitch CTA against retrospective spiral-CT reference.
View Article and Find Full Text PDFBackground: The potential role of cardiac computed tomography (CT) has increasingly been demonstrated for the assessment of diffuse myocardial fibrosis through the quantification of extracellular volume (ECV). Photon-counting detector (PCD)-CT technology may deliver more accurate ECV quantification compared to energy-integrating detector CT. We evaluated the impact of reconstruction settings on the accuracy of ECV quantification using PCD-CT, with magnetic resonance imaging (MRI)-based ECV as reference.
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