Comparison of Dental Findings with Computed Tomographic and Clinical Examination in Patients with End-Stage Heart Failure.

: This study aimed to evaluate the diagnostic value of pre-existing computed tomography (CT) examinations for the detection of dental pathologies compared with clinical dental examination in patients with end-stage heart failure. : For this purpose, 59 patients with end-stage heart failure and pre-existing non-dental CT images of the craniofacial region were included. Virtual orthopantomograms (vOPG) were reconstructed.

Interrater Variability of ML-Based CT-FFR in Patients without Obstructive CAD before TAVR: Influence of Image Quality, Coronary Artery Calcifications, and Location of Measurement.

CT-derived fractional flow reserve (CT-FFR) can improve the specificity of coronary CT-angiography (cCTA) for ruling out relevant coronary artery disease (CAD) prior to transcatheter aortic valve replacement (TAVR). However, little is known about the reproducibility of CT-FFR and the influence of diffuse coronary artery calcifications or segment location. The objective was to assess the reliability of machine-learning (ML)-based CT-FFR prior to TAVR in patients without obstructive CAD and to assess the influence of image quality, coronary artery calcium score (CAC), and the location of measurement within the coronary tree.

Interrater variability of ML-based CT-FFR during TAVR-planning: influence of image quality and coronary artery calcifications.

Objective: To compare machine learning (ML)-based CT-derived fractional flow reserve (CT-FFR) in patients before transcatheter aortic valve replacement (TAVR) by observers with differing training and to assess influencing factors.

Background: Coronary computed tomography angiography (cCTA) can effectively exclude CAD, e.g.

Comparison of aortic blood flow rotational direction in healthy volunteers and patients with bicuspid aortic valves using volumetric velocity-sensitive cardiovascular magnetic resonance imaging.

Background: The rotational direction (RD) of helical blood flow can be classified as either a clockwise (RD) or counter-clockwise (RD) flow. We hypothesized that this simple classification might not be sufficient for analysis and a simultaneous existence of RD may occur. We utilized volumetric velocity-sensitive cardiovascular magnetic resonance imaging (4D flow MRI) to analyze rotational blood flow in the thoracic aorta.

CT-derived coronary artery calcium density is affected by regional lesion distribution and image reconstruction parameters.

Purpose: The prognostic relevance of coronary artery calcium (CAC) density, assessed from cardiac CT scans, is established. However, the influence of CAC distribution, volume, image reconstruction, and clinical factors on CAC density warrants further examination.

Methods: In this study, 120 patients underwent non-contrast ECG-gated cardiac CT scans using a prospectively defined CAC scoring protocol with 1-, 3-, and 5-mm thick image reconstructions, both with and without a 20% image overlap.

High-pitch CT pulmonary angiography (CTPA) with ultra-low contrast medium volume for the detection of pulmonary embolism: a comparison with standard CTPA.

Objective: To investigate the feasibility and image quality of high-pitch CT pulmonary angiography (CTPA) with reduced iodine volume in normal weight patients.

Methods: In total, 81 normal weight patients undergoing CTPA for suspected pulmonary arterial embolism were retrospectively included: 41 in high-pitch mode with 20 mL of contrast medium (CM); and 40 with normal pitch and 50 mL of CM. Subjective image quality was assessed and rated on a 3-point scale.

Pulmonary perfusion defect volume on dual-energy CT: prognostic marker of adverse events in patients with suspected pulmonary embolism.

To assess whether quantification of pulmonary perfusion defects on dual-energy computed tomography (DECT) relates to adverse events beyond clinical parameters and traditional embolus detection in patients with suspected pulmonary embolism (PE). We included consecutive patients who underwent DECT to rule out acute PE in 2018-2020 and recorded incident adverse events, defined as a composite of short-term (< 30 days) in-hospital all-cause mortality or admission to intensive care unit. Relative perfusion defect volume (PDV) was measured on DECT and indexed by total lung volume.

Early Intraluminal Frozen Elephant Trunk Stent Graft Thrombosis After Aortic Arch Surgery.

Background: Partial intraluminal thrombosis of the frozen elephant trunk (FET) stent graft is a poorly described but not infrequent complication after aortic arch surgery. This study aims to describe and analyze the occurrence of early FET stent graft thrombosis.

Methods: Retrospective single-center analysis including patients who underwent aortic arch replacement with FET technique between 2006 and 2020.

[Computed tomography and magnetic resonance imaging in cardiac diagnostics-how to choose the right modality : A guide based on the new guidelines of the European Society of Cardiology (ESC)].

In the guideline updates of the European Society of Cardiology (ESC), noninvasive radiological cross-sectional imaging is taking an increasingly prominent role, while at the same time invasive diagnostic approaches are becoming less important. Especially for the diagnosis and treatment of chronic and acute coronary syndromes, there are fundamental changes in clinical routine. In addition, cross-sectional imaging also offers an alternative to diagnostic algorithms for other cardiac pathologies, especially echocardiography, which is increasingly used in the differential diagnosis of cardiac diseases.

Quantitative normal values of helical flow, flow jets and wall shear stress of healthy volunteers in the ascending aorta.

Objectives: 4D flow MRI enables quantitative assessment of helical flow. We sought to generate normal values and elucidate changes of helical flow (duration, volume, length, velocities and rotational direction) and flow jet (displacement, flow angle) as well as wall shear stress (WSS).

Methods: We assessed the temporal helical existence (TH), maximum helical volume (HV), accumulated helical volume (HV), accumulated helical volume length (HVL), maximum forward velocity (maxV), maximum circumferential velocity (maxV), rotational direction (RD) and maximum wall shear stress (WSS) as reported elsewhere using the software tool Bloodline in 86 healthy volunteers (46 females, mean age 41 ± 13 years).

Risk Assessment of Coronary Obstruction During Transcatheter Aortic Valve Replacement: Insights From Post-BASILICA Computed Tomography.

Objectives: The aim of this study was to examine the predictive value of preprocedural computed tomography (CT)-based risk stratification of coronary obstruction during transcatheter aortic valve replacement (TAVR) on the basis of geometric measurements on postprocedural CT.

Background: Proper patient selection for additional procedures to prevent coronary obstruction during TAVR has not been adequately evaluated.

Methods: Pre- and postprocedural computed tomographic scans of 28 patients treated using bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) and TAVR were analyzed.

CT Planning prior to Transcatheter Mitral Valve Replacement (TMVR).

Background: Transcatheter mitral valve replacement (TMVR) is a treatment option for patients with therapy refractory high-grade mitral valve regurgitation and a high perioperative risk.During TMVR, the mitral annulus cannot be visualized directly. Therefore, comprehensive pre-interventional planning and a precise visualization of the patient's specific mitral valve anatomy, outflow tract anatomy and projected anchoring of the device are necessary.

Combined Coronary CT-Angiography and TAVI Planning: Utility of CT-FFR in Patients with Morphologically Ruled-Out Obstructive Coronary Artery Disease.

: Coronary artery disease (CAD) is a frequent comorbidity in patients undergoing transcatheter aortic valve implantation (TAVI). If significant CAD can be excluded on coronary CT-angiography (cCTA), invasive coronary angiography (ICA) may be avoided. However, a high plaque burden may make the exclusion of CAD challenging, particularly for less experienced readers.

Quality and safety of coronary computed tomography angiography at academic and non-academic sites: insights from a large European registry (ESCR MR/CT Registry).

Objectives: To compare the use of coronary computed tomography angiography (CCTA) between academic and non-academic sites across Europe over the last decade.

Methods: We analyzed a large multicenter registry (ESCR MR/CT Registry) of stable symptomatic patients who received CCTA 01/2010-01/2020 at 47 (22%) academic and 165 (78%) non-academic sites across 19 European countries. We compared image quality, radiation dose, contrast-media-related adverse events, patient characteristics, CCTA findings, and downstream testing between academic and non-academic sites.

Combined cCTA and TAVR Planning for Ruling Out Significant CAD: Added Value of ML-Based CT-FFR.

Objectives: The purpose of this study was to analyze the ability of machine-learning (ML)-based computed tomography (CT)-derived fractional flow reserve (CT-FFR) to further improve the diagnostic performance of coronary CT angiography (cCTA) for ruling out significant coronary artery disease (CAD) during pre-transcatheter aortic valve replacement (TAVR) evaluation in patients with a high pre-test probability for CAD.

Background: CAD is a frequent comorbidity in patients undergoing TAVR. Current guidelines recommend its assessment before TAVR.

Segmentation and characterization of visceral and abdominal subcutaneous adipose tissue on CT with and without contrast medium: influence of 2D- and 3D-segmentation.

Background: Adipose tissue is a valuable biomarker. Although validation and correlation to clinical data have mostly been performed on non-enhanced scans (NES), a previous study has shown conversion of values of contrast enhanced scan (CES) into those of NES to be feasible with segmentation of the entire abdomen (3D-segmentation). In this study we analyzed if density and area of abdominal adipose tissue segmented in a single slice (2D-segmentation) of CES may be converted into that of NES.

3D-segmentation and characterization of visceral and abdominal subcutaneous adipose tissue on CT: influence of contrast medium and contrast phase.

Background: Adipose tissue as part of body composition analysis may serve as a powerful biomarker. Validation of segmented adipose tissue and correlation to clinical data has been performed on non-enhanced scans (NES). As many patients require a contrast enhanced scan (CES) for other aspects of clinical decision making, the utility of CES for body composition analysis would be most useful.

[Is FFR a game changer in coronary CT angiography?].

Coronary computed tomography angiography (CCTA) is already of great importance for the primary diagnostic testing for coronary artery disease (CAD) due to its high negative predictive value (NPV) and high sensitivity but, however, limited specificity. The specificity of invasive coronary angiography (ICA) could be increased by integrating the fractional flow reserve (FFR) into the invasive workflow with proof of the hemodynamic relevance of a morphologically detected coronary stenosis. New noninvasive methods of FFR calculations in CT based on computational fluid dynamics (CFD) or machine learning (ML) demonstrate very encouraging results; however, the widespread use of FFR is mainly determined by the image quality and the resulting capabilities of coronary artery segmentation, which could be insufficient in up to 7-12% of CCTAs to calculate FFR, although a morphological assessment is still possible in most cases.

Combined Coronary CT-Angiography and TAVI-Planning: A Contrast-Neutral Routine Approach for Ruling-out Significant Coronary Artery Disease.

Background: Significant coronary artery disease (CAD) is a common finding in patients undergoing transcatheter aortic valve implantation (TAVI). Assessment of CAD prior to TAVI is recommended by current guidelines and is mainly performed via invasive coronary angiography (ICA). In this study we analyzed the ability of coronary CT-angiography (cCTA) to rule out significant CAD (stenosis ≥ 50%) during routine pre-TAVI evaluation in patients with high pre-test probability for CAD.

Quantitative coronary computed tomography angiography for the detection of cardiac allograft vasculopathy.

Objectives: To associate coronary wall volume and composition, derived from coronary computed tomography angiography (CTA), with cardiac allograft vasculopathy (CAV) detected on invasive coronary angiography (ICA) in heart-transplanted (HTX) patients.

Methods: We included consecutive adults who received ICA and coronary CTA for evaluation of CAV ≥ 10 months after HTX. In all coronary segments, we assessed lumen and wall volumes and segmental length, calculated volume-length ratio (VLR) (volumes indexed by segmental length; mm/mm), wall burden (WB) (wall/wall + lumen volumes; %), and assessed proportions of calcified, fibrotic, fibro-fatty, and low-attenuation tissue (%) in coronary wall.