Effect of a Novel Intracycle Motion Correction Algorithm on Dual-Energy Spectral Coronary CT Angiography: A Study with Pulsating Coronary Artery Phantom at High Heart Rates

Objective: Using a pulsating coronary artery phantom at high heart rate settings, we investigated the efficacy of a motion correction algorithm (MCA) to improve the image quality in dual-energy spectral coronary CT angiography (CCTA). Materials and Methods: Coronary flow phantoms were scanned at heart rates of 60-100 beats/min at 10-beats/min increments, using dual-energy spectral CT mode. Virtual monochromatic images were reconstructed from 50 to 90 keV at 10-keV increments. Two blinded observers assessed image quality using a 4-point Likert Scale (1 = non-diagnostic, 4 = excellent) and the fraction of interpretable segments using MCA versus conventional algorithm (CA). Comparison of variables was performed with the Wilcoxon rank sum test and McNemar test. Results: At heart rates of 70, 80, 90, and 100 beats/min, images with MCA were rated as higher image scores compared to those with CA on monochromatic levels of 50, 60, and 70 keV (each p < 0.05). Meanwhile, at a heart rate of 90 beats/min, image interpretability was improved by MCA at a monochromatic level of 60 keV (p < 0.05) and 70 keV (p < 0.05). At a heart rate of 100 beats/min, image interpretability was improved by MCA at monochromatic levels of 50 keV (from 69.4% to 86.1%, p < 0.05), 60 keV (from 55.6% to 83.3%, p < 0.05) and 70 keV (from 33.3% to 69.3%, p < 0.05). Conclusion: Low-keV monochromatic images combined with MCA improves image quality and image interpretability in CCTAs at high heart rates.