All patients had an appointment for evaluation of suspected ischemia via high resolution CCTA with a dual-source 256 slice scanner (Siemens Flash Definition CT scanner; Siemens, Berlin, Germany). After a calcium score scan, we used either a prospective electrocardiography (ECG) triggering or a retrospective ECG gating acquisition. Post-processing and reconstruction of the CCTA were carried out with a Multimodality Workplace (Siemens Medical Solutions, Erlangen, Germany).
Flash definition ct scanner
Manufactured by Siemens
Sourced in Germany
The Siemens Flash Definition CT scanner is a medical imaging device that utilizes advanced computed tomography (CT) technology to capture high-resolution images of the human body. The core function of this equipment is to provide healthcare professionals with detailed, three-dimensional visualizations of internal structures, enabling more accurate diagnoses and informed treatment decisions.
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4 protocols using flash definition ct scanner
1
High-Resolution CCTA for Ischemia Evaluation
2
Coronary CT Angiography Protocol
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Using a dual-source scanner (Siemens Flash® Definition CT scanner, Siemens Healthcare, Forchheim, Germany rotation time 280 ms), scout images were obtained from all patients, and calcium score scan (with 3-mm slice thickness) was performed. Electrocardiography (ECG) gating was used with either prospective or retrospective scans during deep inspiration. The “test bolus” technique was used with a 4-second delay time after the peak contrast enhancement of a region of interest in ascending aorta, using 15 mL contrast agent (370 mg iodine/mL), then 25 mL normal saline. The CCTA scan was carried out by injecting 80 mL contrast and 45 mL saline solution at a rate of 6 mL/s. Sublingual nitroglycerin was administered during the scan, along with beta-blockers, to maintain the heart rate at less than 65 beats/min.
For patients with body weight ≥85 kg a tube voltage of 120 kV was used, whereas 100 kV was used in patients with body weight <85 kg. The tube current was set to 320 mA for all prospective ECGs triggering the gating scan. We excluded patients who were imaged in the prospectively ECG-triggered high-pitch spiral acquisition mode.
For patients with body weight ≥85 kg a tube voltage of 120 kV was used, whereas 100 kV was used in patients with body weight <85 kg. The tube current was set to 320 mA for all prospective ECGs triggering the gating scan. We excluded patients who were imaged in the prospectively ECG-triggered high-pitch spiral acquisition mode.
3
Contrast-Enhanced CT Angiography Protocol
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Images were acquired on a Siemens Definition EDGE or a Definition Flash CT scanner (Siemens Healthcare GmbH, Erlangen, Germany), with the standard local hospital CTA protocol. Scan parameters of the University Medical Center Groningen were variable tube voltage according to the Care-kV protocol, or variable tube current according to the Care Dose 4D protocol, 0.8 mm pitch, 128 × 0.6 mm collimation, and 0.5 s rotation time. Per CTA scan, 100 mL (4 mL per second) of diluted contrast (Xenetrix 300; Guerbet, Sulzbach, Germany) was administered intravenously. Acquisition was obtained in the early arterial phase. Scan parameters of the Skåne University hospital were tube voltage 80/140 kV, 0.55 mm pitch, 128 × 0.6 mm collimation, and 0.55 s rotation time. Acquisition was obtained in the arterial phase after intravenous injection of an individual contrast volume based on body weight (Omnipaque 350 mg/mL; GE Healthcare, Oslo, Norway; maximum dose weight of 80 kg and dose of 300 mg/kg). Bolus tracking was used with the region of interest (ROI) placed at the level of the diaphragm with a threshold of 120 Hounsfield units (HUs).
4
Evaluating AI Model for Post-Mortem CT Hemopericardium
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Our model was tested on an external dataset consisting of 22 post-mortem CTs (PMCTs) with autopsy-confirmed hemopericardium, performed on a Siemens Definition Flash CT scanner. The image acquisition parameters are based on the chest and abdomen scanning protocol described by Flach et al. [22 (link)]. Patient selection criteria are described by Ebert et al. [23 (link)]. The CTs were cropped using the aforementioned technique at our institution. Our model’s performance was compared to the external institution’s post-mortem volume measurements and manual segmentation masks, the methodology of which is described by Ebert et al. [15 (link)].
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