Clinical usefulness of automatic phase selection in coronary CT angiography (CTA)

With high-speed multislice helical CT, the time needed to select the optimal cardiac phase accounts for a large percentage of the coronary CT angiography examination time because the scan time is short. To reduce the phase selection time, we have developed an automatic cardiac phase selection algorithm and implemented it in the Aquilion 64 scanner. This algorithm calculates the absolute sum of the differences between two raw data sets for subsequent cardiac phases (e.g., 4% and 0%) and generates a velocity curve representing the magnitude of cardiac motion velocity for the entire heart volume. Normally, the velocity curve has two local minimum slow-motion phases corresponding to end-systole and mid-diastole. By applying these local minimum phases in reconstruction, stationary cardiac images can be reconstructed automatically. In this report, the algorithm for generating the velocity curve and the processing time for selecting the optimal cardiac phase are discussed. The accuracy of this method is compared with that of the conventional manual method. In the manual method, a sample plane containing all four cardiac chambers was selected, reconstruction was performed for all phases at 2% intervals, and images were visually evaluated. Optimal phase selection required about 5 min/exam. With automatic phase selection, optimal phase selection required only about 1 min/exam, and the cardiac phases were close to those selected using the manual method. Automatic phase selection substantially reduces the time needed to select the optimal phase and increases patient throughput. Moreover, the influence of operator skill in selecting the optimal phase is minimized.