CCTA without ECG Leads Using Whole-Heart Motion Correction Algorithm Based on Wide-Detector CT.

PURPOSE: This study evaluates the impact of a whole heart motion correction algorithm on image quality and interpretability in coronary computed tomography angiography (CCTA) without ECG leads. MATERIALS AND METHODS: Seventy patients with acute chest pain underwent CCTA without ECG leads examination. Images were reconstructed with standard (STD), coronary vessel tracking motion correction (Snapshot Freeze 1, SSF1), and whole‑heart motion correction (Snapshot Freeze 2, SSF2) algorithms. Additionally, all three groups underwent deep learning image reconstruction (DLIR) algorithm. Objective evaluation, including noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Subjective image quality was scored by two radiologists using a 5 - point Likert scale. Interpretability of coronary vessels was assessed per segment, vessel, and patient. RESULTS: SSF2 significantly reduced noise and improved SNR/CNR compared to STD and SSF1 (all P < .05). Subjective scores were highest for SSF2 (median 5.0 vs 4.0 for SSF1 and 3.0 for STD, P < .001), with inter-observer agreement (κ = 0.87). SSF2 achieved higher interpretability for proximal/mid-segments (99.6%) and improved distal/small-branch interpretability (97.2% vs 89.4% for SSF1, P < .017). Patient-level interpretability reached 100% with SSF2, vs 92.9% (SSF1) and 51.4% (STD). CONCLUSION: SSF2 enhances image quality and interpretability in CCTA without ECG leads, and exhibits favorable in the visualization of distal vessels and small branches.