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Article ; Online: Spontaneous Dissection of a Septal Coronary Artery Mimicking Myocarditis.

Károlyi, Mihály / Templin, Christian / Alkadhi, Hatem / Manka, Robert

JACC. Case reports

2023 Volume 29, Issue 1, Page(s) 102151

Abstract: Acute chest pain and dyspnea often raise coronary disease suspicion. When echocardiography and cardiac computed tomography findings appear normal, alternative diagnoses should be explored. We present a case initially suggestive of myocarditis but later ... ...

Abstract	Acute chest pain and dyspnea often raise coronary disease suspicion. When echocardiography and cardiac computed tomography findings appear normal, alternative diagnoses should be explored. We present a case initially suggestive of myocarditis but later revealed as coronary dissection by cardiac magnetic resonance. This case emphasizes the role of advanced imaging in atypical cardiac presentations.
Language	English
Publishing date	2023-11-30
Publishing country	Netherlands
Document type	Case Reports
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2023.102151
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Article ; Online: Photon-counting computed tomography for the diagnosis of myocardial infarction with non-obstructive coronary artery disease.

Polacin, Malgorzata / Templin, Christian / Manka, Robert / Alkadhi, Hatem

European heart journal. Case reports

2022 Volume 6, Issue 2, Page(s) ytac028

Language	English
Publishing date	2022-02-04
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytac028
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Article ; Online: Risk stratification prior to non-cardiac surgery: the role of cardiac CT and MR imaging is underrecognized.

Alkadhi, Hatem / Baettig, Eduardo / Biondo, Andrea / Francone, Marco / Manka, Robert

European radiology

2023 Volume 33, Issue 12, Page(s) 8436–8438

MeSH term(s)	Humans ; Tomography, X-Ray Computed/methods ; Thorax ; Risk Assessment ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2023-07-11
Publishing country	Germany
Document type	Editorial
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09893-6
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Zs.A 3300: Show issues

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Article ; Online: A Novel Reconstruction Technique to Reduce Stair-Step Artifacts in Sequential Mode Coronary CT Angiography.

Moser, Lukas Jakob / Mergen, Victor / Allmendinger, Thomas / Manka, Robert / Eberhard, Matthias / Alkadhi, Hatem

Investigative radiology

2024

Abstract: Purpose: Prospective electrocardiography-triggering is one of the most commonly used cardiac computed tomography (CT) scan modes but can be susceptible to stair-step artifacts in the transition areas of an acquisition over multiple cardiac cycles. We ... ...

Abstract	Purpose: Prospective electrocardiography-triggering is one of the most commonly used cardiac computed tomography (CT) scan modes but can be susceptible to stair-step artifacts in the transition areas of an acquisition over multiple cardiac cycles. We evaluated a novel reconstruction algorithm to reduce the occurrence and severity of such artifacts in sequential coronary CT angiography. Materials and methods: In this institutional review board-approved, retrospective study, 50 consecutive patients (16 females; mean age, 58.9 ± 15.2) were included who underwent coronary CT angiography on a dual-source photon-counting detector CT in the sequential ultra-high-resolution mode with a detector collimation of 120 × 0.2 mm. Each scan was reconstructed without (hereafter called standard reconstruction) and with the novel ZeeFree reconstruction algorithm, which aims to minimize stair-step artifacts. The presence and extent of stair-step artifacts were rated by 2 independent, blinded readers on a 4-point discrete visual scale. The relationship between the occurrences of artifacts was correlated with the average and variability of heart rate and with patient characteristics. Results: A total of 504 coronary segments were included into the analyses. In standard reconstructions, reader 1 reported stair-step artifacts in 40/504 (7.9%) segments, from which 12/504 led to nondiagnostic image quality (2.4% of all segments). Reader 2 reported 56/504 (11.1%) stair-step artifacts, from which 11/504 lead to nondiagnostic image quality (2.2% of all segments). With the ZeeFree algorithm, 9/12 (75%) and 8/11 (73%) of the nondiagnostic segments improved to a diagnostic quality for readers 1 and 2, respectively. The ZeeFree reconstruction algorithm significantly reduced the frequency and extent of stair-step artifacts compared with standard reconstructions for both readers (P < 0.001, each). Heart rate variability and body mass index were significantly related to the occurrence of stair-step artifacts (P < 0.05). Conclusions: Our study demonstrates the feasibility and effectiveness of a novel reconstruction algorithm leading to a significant reduction of stair-step artifacts and, hence, a reduction of coronary segments with a nondiagnostic image quality in sequential ultra-high-resolution coronary photon-counting detector CT angiography.
Language	English
Publishing date	2024-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	80345-5
ISSN	1536-0210 ; 0020-9996
ISSN (online)	1536-0210
ISSN	0020-9996
DOI	10.1097/RLI.0000000000001066
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Zs.A 734: Show issues

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Article ; Online: Effect of temporal resolution on calcium scoring: insights from photon-counting detector CT.

Sartoretti, Thomas / Mergen, Victor / Dzaferi, Amina / Allmendinger, Thomas / Manka, Robert / Alkadhi, Hatem / Eberhard, Matthias

The international journal of cardiovascular imaging

2024

Abstract: To intra-individually investigate the variation of coronary artery calcium (CAC), aortic valve calcium (AVC), and mitral annular calcium (MAC) scores and the presence of blur artifacts as a function of temporal resolution in patients undergoing non- ... ...

Abstract	To intra-individually investigate the variation of coronary artery calcium (CAC), aortic valve calcium (AVC), and mitral annular calcium (MAC) scores and the presence of blur artifacts as a function of temporal resolution in patients undergoing non-contrast cardiac CT on a dual-source photon counting detector (PCD) CT. This retrospective, IRB-approved study included 70 patients (30 women, 40 men, mean age 78 ± 9 years) who underwent ECG-gated cardiac non-contrast CT with PCD-CT (gantry rotation time 0.25 s) prior to transcatheter aortic valve replacement. Each scan was reconstructed at a temporal resolution of 66 ms using the dual-source information and at 125 ms using the single-source information. Average heart rate and heart rate variability were calculated from the recorded ECG. CAC, AVC, and MAC were quantified according to the Agatston method on images with both temporal resolutions. Two readers assessed blur artifacts using a 4-point visual grading scale. The influence of average heart rate and heart rate variability on calcium quantification and blur artifacts of the respective structures were analyzed by linear regression analysis. Mean heart rate and heart rate variability during data acquisition were 76 ± 17 beats per minute (bpm) and 4 ± 6 bpm, respectively. CAC scores were smaller on 66 ms (median, 511; interquartile range, 220-978) than on 125 ms reconstructions (538; 203-1050, p < 0.001). Median AVC scores [2809 (2009-3952) versus 3177 (2158-4273)] and median MAC scores [226 (0-1284) versus 251 (0-1574)] were also significantly smaller on 66ms than on 125ms reconstructions (p < 0.001). Reclassification of CAC and AVC risk categories occurred in 4% and 11% of cases, respectively, whereby the risk category was always overestimated on 125ms reconstructions. Image blur artifacts were significantly less on 66ms as opposed to 125 ms reconstructions (p < 0.001). Intra-individual analyses indicate that temporal resolution significantly impacts on calcium scoring with cardiac CT, with CAC, MAC, and AVC being overestimated at lower temporal resolution because of increased motion artifacts eventually leading to an overestimation of patient risk.
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2055311-0
ISSN	1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
ISSN (online)	1875-8312 ; 1573-0743
ISSN	1569-5794 ; 0167-9899
DOI	10.1007/s10554-024-03070-6
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Zs.A 2104: Show issues

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Article: CME-EKG 70/Antworten: Thoraxschmerzen bei einem jungen Patienten – Differenzialdiagnosen neben dem akuten Koronarsyndrom.

Rett, Eva / Manka, Robert / Brunckhorst, Corinna B

Praxis

2022 Volume 110, Issue 1, Page(s) 8–10

Abstract: CME-ECG 70: Chest Pain in a Young Patient - Differential Diagnoses beyond the Acute Coronary ... ...

Title translation	CME-ECG 70: Chest Pain in a Young Patient - Differential Diagnoses beyond the Acute Coronary Syndrome.
Abstract	CME-ECG 70: Chest Pain in a Young Patient - Differential Diagnoses beyond the Acute Coronary Syndrome
MeSH term(s)	Acute Coronary Syndrome/diagnosis ; Chest Pain/diagnosis ; Chest Pain/etiology ; Diagnosis, Differential ; Electrocardiography ; Humans
Language	German
Publishing date	2022-01-04
Publishing country	Switzerland
Document type	Case Reports ; Journal Article
ZDB-ID	209026-0
ISSN	1661-8165 ; 1661-8157 ; 0369-8394
ISSN (online)	1661-8165
ISSN	1661-8157 ; 0369-8394
DOI	10.1024/1661-8157/a003796
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Ua VI Zs.118: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 12: Show issues

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Article: CME-EKG 70: Thoraxschmerzen bei einem jungen Patienten – Differenzialdiagnosen neben dem akuten Koronarsyndrom.

Rett, Eva / Manka, Robert / Brunckhorst, Corinna B

Praxis

2021 Volume 110, Issue 16, Page(s) 947–954

Abstract: CME-ECG 70: Chest Pain in a Young Patient - Differential Diagnoses beyond the Acute Coronary ... ...

Title translation	CME-ECG 70: Chest Pain in a Young Patient - Differential Diagnoses beyond the Acute Coronary Syndrome.
Abstract	CME-ECG 70: Chest Pain in a Young Patient - Differential Diagnoses beyond the Acute Coronary Syndrome
MeSH term(s)	Acute Coronary Syndrome/diagnosis ; Chest Pain/diagnosis ; Chest Pain/etiology ; Diagnosis, Differential ; Electrocardiography ; Humans
Language	German
Publishing date	2021-12-08
Publishing country	Switzerland
Document type	Case Reports ; Journal Article
ZDB-ID	209026-0
ISSN	1661-8165 ; 1661-8157 ; 0369-8394
ISSN (online)	1661-8165
ISSN	1661-8157 ; 0369-8394
DOI	10.1024/1661-8157/a003795
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Ua VI Zs.118: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 12: Show issues

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Article: Virtual calcium removal in calcified coronary arteries with photon-counting detector CT-first

Mergen, Victor / Rusek, Stéphane / Civaia, Filippo / Rossi, Philippe / Rajagopal, Rengarajan / Bättig, Eduardo / Manka, Robert / Candreva, Alessandro / Eberhard, Matthias / Alkadhi, Hatem

Frontiers in cardiovascular medicine

2024 Volume 11, Page(s) 1367463

Abstract: Purpose: To evaluate the feasibility and accuracy of quantification of calcified coronary stenoses using virtual non-calcium (VNCa) images in coronary CT angiography (CCTA) with photon-counting detector (PCD) CT compared with quantitative coronary ... ...

Abstract	Purpose: To evaluate the feasibility and accuracy of quantification of calcified coronary stenoses using virtual non-calcium (VNCa) images in coronary CT angiography (CCTA) with photon-counting detector (PCD) CT compared with quantitative coronary angiography (QCA). Materials and methods: This retrospective, institutional-review board approved study included consecutive patients with calcified coronary artery plaques undergoing CCTA with PCD-CT and invasive coronary angiography between July and December 2022. Virtual monoenergetic images (VMI) and VNCa images were reconstructed. Diameter stenoses were quantified on VMI and VNCa images by two readers. 3D-QCA served as the standard of reference. Measurements were compared using Bland-Altman analyses, Wilcoxon tests, and intraclass correlation coefficients (ICC). Results: Thirty patients [mean age, 64 years ± 8 (standard deviation); 26 men] with 81 coronary stenoses from calcified plaques were included. Ten of the 81 stenoses (12%) had to be excluded because of erroneous plaque subtraction on VNCa images. Median diameter stenosis determined on 3D-QCA was 22% (interquartile range, 11%-35%; total range, 4%-88%). As compared with 3D-QCA, VMI overestimated diameter stenoses (mean differences -10%, Conclusion: First experience in mainly minimal to moderate stenoses suggests that virtual calcium removal in CCTA with PCD-CT, when feasible, has the potential to improve the quantification of calcified stenoses.
Language	English
Publishing date	2024-02-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2024.1367463
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Article ; Online: Impact of late gadolinium enhancement image acquisition resolution on neural network based automatic scar segmentation.

Hoh, Tobias / Margolis, Isabel / Weine, Jonathan / Joyce, Thomas / Manka, Robert / Weisskopf, Miriam / Cesarovic, Nikola / Fuetterer, Maximilian / Kozerke, Sebastian

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

2024 Volume 26, Issue 1, Page(s) 101031

Abstract: Background: Automatic myocardial scar segmentation from late gadolinium enhancement (LGE) images using neural networks promises an alternative to time-consuming and observer-dependent semi-automatic approaches. However, alterations in data acquisition, ... ...

Abstract	Background: Automatic myocardial scar segmentation from late gadolinium enhancement (LGE) images using neural networks promises an alternative to time-consuming and observer-dependent semi-automatic approaches. However, alterations in data acquisition, reconstruction as well as post-processing may compromise network performance. The objective of the present work was to systematically assess network performance degradation due to a mismatch of point-spread function between training and testing data. Methods: Thirty-six high-resolution (0.7×0.7×2.0 mm Results: The prediction of relative scar areas showed the highest precision when the resolution of the test data was identical to or close to the resolution used during training. The median fractional scar errors and precisions (IQR) from networks trained and tested on the same resolution were 0.0 percentage points (p.p.) (1.24 - 1.45), and - 0.5 - 0.0 p.p. (2.00 - 3.25) for networks trained and tested on the most differing resolutions, respectively. Deploying the network trained on multiple resolutions resulted in reduced resolution dependency with median scar errors and IQRs of 0.0 p.p. (1.24 - 1.69) for all investigated test resolutions. Conclusion: A mismatch of the imaging point-spread function between training and test data can lead to degradation of scar segmentation when using current U-Net architectures as demonstrated on LGE porcine myocardial infarction data. Training networks on multi-resolution data can alleviate the resolution dependency.
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1458034-2
ISSN	1532-429X ; 1097-6647
ISSN (online)	1532-429X
ISSN	1097-6647
DOI	10.1016/j.jocmr.2024.101031
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Zs.A 5045: Show issues

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Article: First in-human quantitative plaque characterization with ultra-high resolution coronary photon-counting CT angiography.

Mergen, Victor / Eberhard, Matthias / Manka, Robert / Euler, André / Alkadhi, Hatem

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 981012

Abstract: Purpose: To assess the effect of ultra-high-resolution coronary CT angiography (CCTA) with photon-counting detector (PCD) CT on quantitative coronary plaque characterization.: Materials and methods: In this IRB-approved study, 22 plaques of 20 ... ...

Abstract	Purpose: To assess the effect of ultra-high-resolution coronary CT angiography (CCTA) with photon-counting detector (PCD) CT on quantitative coronary plaque characterization. Materials and methods: In this IRB-approved study, 22 plaques of 20 patients (7 women; mean age 77 ± 8 years, mean body mass index 26.1 ± 3.6 kg/m Results: Median plaque volume was highest (23.5 mm Conclusion: This patient study indicates significant differences of ultra-high-resolution scanning with PCD-CT on quantitative coronary plaque characterization. Reduced blooming artifacts may allow improved visualization of fibrotic and lipid-rich plaque components with the ultra-high-resolution mode of PCD-CT.
Language	English
Publishing date	2022-09-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.981012
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