Significant impact of a novel whole heart motion correction algorithm on cardiac computed tomography and aortic valve calcium scores

Abstract Introduction A new whole-heart motion-correction algorithm has been available in cardiac computed tomography (CT), and it has already revealed the higher diagnostic accuracy of significant coronary artery stenosis in cases with higher heart rate at the CT scan. Recently, aortic valve calcium scores (AVCS) are often measured for the decision-making of surgical treatment of aortic valve stenosis. However, the measurement of AVCS of the aortic valve has potential risks of motion artifact of the aortic valve. Therefore, we would like to know the clinical impact of a new whole-heart motion correction algorithm for accurately measuring aortic valve AVCS without motion artifacts. Purpose The purpose of this study is to evaluate the impact of a new whole-heart motion-correction algorithm on non-contrast cardiac CT images and the AVCS in trans-catheter aortic valve regurgitation (TAVR) candidates with severe aortic valve stenosis. Materials and methods Forty-two consecutive TAVR candidates (83 ± 7 years old, 21 males) who underwent ECG-gated CT using 256-row detector CT from November 2023 to February 2024 at our hospital were analyzed. The best phase non-contrast cardiac images were automatically selected, and they were reconstructed with both the standard (STD) algorithm and the new whole-heart motion-correction algorithm. AVCS was calculated using semi-automatic commercially available software. The aortic valve's image noise was also measured. Results Non-contrast best cardiac phase images were successfully reconstructed using the new motion correction algorithm in 36 patients (86%). The best cardiac phase was mainly the diastolic phase in 29 patients (81%). The overall Agatston score and calcified volume of the aortic valve in SSF2 were 1779 ± 896, and 1403 ± 689, respectively, and they were lower than 2195 ± 1132 and 1656 ± 851 of STD (all P < 0.01). Conclusion The new whole-heart motion-correction algorithm worked in almost all TAVR candidates, and revealed lower AVCS and shows a potential for increasing AVCS accuracy.