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Effectiveness Best R-R Reconstruction Interval Determination Software for the Evaluation of Dual-Source Coronary CT Angiography Examinations

Erol, Bekir MD*; Karcaaltincaba, Musturay MD; Cay, Nurdan MD*; Hazirolan, Tuncay MD; Aytemir, Kudret MD; Akata, Deniz MD

Journal of Computer Assisted Tomography: March-April 2011 - Volume 35 - Issue 2 - p 229-234
doi: 10.1097/RCT.0b013e318204dcd6
Cardiac Imaging

Purpose: The purpose of this study was to investigate the effectiveness of automated best R-R interval determination software for the evaluation of dual-source coronary multidetector computed tomography (MDCT) angiography.

Methods: One hundred and nine consecutive patients who underwent dual-source coronary MDCT angiography are included in the study. The indications were chest pain syndrome of low-intermediate risk and/or nonspecific electrocardiographic changes (n = 91), stenting (n = 9), and bypass grafts (n = 9). Imaging was performed using dual-source MDCT. Temporal resolution was 0.83 milliseconds and slice thickness was 0.6 mm. None of the patients received β-blockers. Best R-R interval software has determined the best intervals in diastole and systole. The visibility of coronary arteries was evaluated using 15-segment (total 1635 segments) AHA classification by 2 radiologists in consensus.

Results: The mean patient age was 55 years. The mean heart rate was 73 beats per minute (range, 47-110 beats per minute). The mean (SD) best diastole R-R interval was determined as 73 (5) (95% CI, 63-83), and the mean (SD) best systole interval as 38 (5) (95% CI, 28-48). When only best diastole, only best systole, and both best systole and diastole reconstructions were evaluated, all coronary artery segments were visualized in 65 (60%), 61 (56%), and 93 (85%) patients, respectively. In 12 patients' evaluation of additional 1(n = 11) or 2(n = 1), R-R reconstruction intervals allowed visualization of all coronary artery segments. In 4 patients with arrhythmia, all segments cannot be visualized, but after electrocardiographic editing, all segments were visible in 3 of 4 patients.

Conclusions: Automatic determination of best R-R reconstruction interval allows evaluation of all coronary artery segments in most patients (85%) without additional reconstructions. By means of this software, coronary CT angiography studies can be evaluated faster and easier. The most significant limitation of the software is patients with arrhythmia.

From the *Department of Radiology, Ataturk Education and Research Hospital; and Departments of †Radiology, and ‡Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Received for publication August 10, 2010; accepted October 27, 2010.

Reprints: Musturay Karcaaltincaba, MD, Hacettepe University Hospitals, Department of Radiology, Ankara, Turkey (e-mail:

This manuscript is the authors' own work. It has not received any funding for research. The authors have no conflicts of interest.

© 2011 Lippincott Williams & Wilkins, Inc.