Deep-Learning Image Reconstruction in CCTA

NCT ID: NCT03980470

Last Updated: 2021-11-24

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-08

Study Completion Date

2019-06-20

Brief Summary

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Cardiac CT allows the assessment of the heart and of the coronary arteries by use of ionising radiation. Although radiation exposure was significantly reduced in recent years, further decrease in radiation exposure is limited by increased image noise and deterioration in image quality. Recent evidence suggests that further technological refinements with artificial intelligence allows improved post-processing of images with reduction of image noise.

The present study aims at assessing the potential of a deep-learning image reconstruction algorithm in a clinical setting. Specifically, after a standard clinical scan, patients are scanned with lower radiation exposure and reconstructed with the DLIR algorithm. This interventional scan is then compared to the standard clinical scan.

Detailed Description

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Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Normal-dose versus Low-dose

The standard intervention consists of the routinely performed cardiac CT datasets reconstructed with a standard iterative reconstruction algorithm (ASIR-V). Median radiation dose is about 0.5 mSv, range between about 0.2 and 1.2 mSv; median contrast agent administration about 45 mL, range between 35 and 55 mL.

The experimental intervention is an additional CT scan with a lower dose (about 20 to 50% decrease) and a similar contrast agent administration that is reconstructed with a deep-learning image reconstruction immediately after the clinical CT scan. The additional time required is about 5 minutes.

Group Type OTHER

TrueFidelity

Intervention Type DEVICE

TrueFidelity (Deep Learning Image Reconstruction, DLIR) software by GE Healthcare.

The medical device in question is a novel reconstruction algorithm for raw CT data which is based on artificial intelligence approaches, namely deep-learning iterative reconstruction (DLIR). This DLIR algorithm will be installed on the console of the CT Revolution scanning device, which is in routine clinical use for cardiac CT scans at the Department of Nuclear Medicine at the University Hospital Zurich. Purpose of this installation is the assessment of the performance of the DLIR algorithm during a limited time span of six weeks.

The algorithm will be CE-marked at the time of installation and use (statement by GE Healthcare provided separately). Its intended use is the reconstruction of CT datasets.

Of note, the novel DLIR algorithm will not substitute any clinical routine procedures currently in use. That is, diagnosis will still be made using the standard reconstruction algorithms.

Interventions

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TrueFidelity

TrueFidelity (Deep Learning Image Reconstruction, DLIR) software by GE Healthcare.

The medical device in question is a novel reconstruction algorithm for raw CT data which is based on artificial intelligence approaches, namely deep-learning iterative reconstruction (DLIR). This DLIR algorithm will be installed on the console of the CT Revolution scanning device, which is in routine clinical use for cardiac CT scans at the Department of Nuclear Medicine at the University Hospital Zurich. Purpose of this installation is the assessment of the performance of the DLIR algorithm during a limited time span of six weeks.

The algorithm will be CE-marked at the time of installation and use (statement by GE Healthcare provided separately). Its intended use is the reconstruction of CT datasets.

Of note, the novel DLIR algorithm will not substitute any clinical routine procedures currently in use. That is, diagnosis will still be made using the standard reconstruction algorithms.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients referred for cardiac CT angiography
* Age ≥ 18 years
* Written informed consent

Exclusion Criteria

* Pregnancy or breast-feeding
* Enrollment of the investigator, his/her family members, employees and other dependent persons
* Renal insufficiency (GFR below 35 mL/min/1.73 m²)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Zurich

OTHER

Sponsor Role lead

Responsible Party

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Ronny R Buechel, MD

PD Dr. med. Ronny R. Buechel

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ronny R Buechel, MD

Role: PRINCIPAL_INVESTIGATOR

Director of Cardiac Imaging

Locations

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University Hospital

Zurich, , Switzerland

Site Status

Countries

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Switzerland

References

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Benz DC, Grani C, Hirt Moch B, Mikulicic F, Vontobel J, Fuchs TA, Stehli J, Clerc OF, Possner M, Pazhenkottil AP, Gaemperli O, Buechel RR, Kaufmann PA. Minimized Radiation and Contrast Agent Exposure for Coronary Computed Tomography Angiography: First Clinical Experience on a Latest Generation 256-slice Scanner. Acad Radiol. 2016 Aug;23(8):1008-14. doi: 10.1016/j.acra.2016.03.015. Epub 2016 May 9.

Reference Type BACKGROUND
PMID: 27174030 (View on PubMed)

Benz DC, Fuchs TA, Grani C, Studer Bruengger AA, Clerc OF, Mikulicic F, Messerli M, Stehli J, Possner M, Pazhenkottil AP, Gaemperli O, Kaufmann PA, Buechel RR. Head-to-head comparison of adaptive statistical and model-based iterative reconstruction algorithms for submillisievert coronary CT angiography. Eur Heart J Cardiovasc Imaging. 2018 Feb 1;19(2):193-198. doi: 10.1093/ehjci/jex008.

Reference Type BACKGROUND
PMID: 28200212 (View on PubMed)

Sahiner B, Pezeshk A, Hadjiiski LM, Wang X, Drukker K, Cha KH, Summers RM, Giger ML. Deep learning in medical imaging and radiation therapy. Med Phys. 2019 Jan;46(1):e1-e36. doi: 10.1002/mp.13264. Epub 2018 Nov 20.

Reference Type BACKGROUND
PMID: 30367497 (View on PubMed)

Toprak O. Conflicting and new risk factors for contrast induced nephropathy. J Urol. 2007 Dec;178(6):2277-83. doi: 10.1016/j.juro.2007.08.054. Epub 2007 Oct 22.

Reference Type BACKGROUND
PMID: 17936812 (View on PubMed)

Benz DC, Grani C, Hirt Moch B, Mikulicic F, Vontobel J, Fuchs TA, Stehli J, Clerc OF, Possner M, Pazhenkottil AP, Gaemperli O, Buechel RR, Kaufmann PA. A low-dose and an ultra-low-dose contrast agent protocol for coronary CT angiography in a clinical setting: quantitative and qualitative comparison to a standard dose protocol. Br J Radiol. 2017 Jun;90(1074):20160933. doi: 10.1259/bjr.20160933. Epub 2017 May 25.

Reference Type BACKGROUND
PMID: 28406318 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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USZ-2019-00533

Identifier Type: -

Identifier Source: org_study_id