Motion correction algorithm improves right coronary artery image quality at heart rates > 75 bpm in non‐ECG‐gated coronary CT angiography

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Abstract
Background: Motion artifacts caused by cardiac pulsation remain a major technical challenge in coronary CT angiography (CCTA). Although an advanced cardiac motion correction (CMC) algorithm has been developed and successfully implemented in clinical practice, the effectiveness of this algorithm in improving coronary image quality in clinical settings has not yet been fully investigated. Purpose: To evaluate the impact and clinical value of a motion correction algorithm on image quality in non‐ECG‐gated CCTA. Methods: We retrospectively enrolled 76 patients who underwent CCTA for suspected coronary artery disease. Based on the mean heart rate (HR) recorded during scanning, patients were divided into three groups: low HR (HR ≤ 60 bpm), intermediate HR (60 < HR < 75 bpm), and high HR (HR ≥ 75 bpm). All images were reconstructed using both standard algorithm (STD) and CMC algorithms. The performance of STD and CMC was compared across different HR conditions in terms of subjective (4‐point Likert scale, interpretability) and objective image quality (signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR), and vessel sharpness). Results: At high HRs, the difference in subjective image quality of the right coronary artery (RCA) between STD and CMC reached statistical significance ( p < 0.05). Compared with STD, CMC significantly improved the interpretability of the RCA at high HRs ( p < 0.001). No statistically significant differences were observed between the two algorithms in terms of SNR or CNR ( p > 0.05). However, at high HRs, CMC was significantly superior to STD with respect to vessel sharpness of the RCA ( p < 0.001). Conclusions: The CMC improves image quality in CCTA, with particularly notable benefits for the RCA under high HR conditions.

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