Cardiac-Specific AI Reconstruction Versus Hybrid Iterative Reconstruction for Emergency Coronary CT Angiography: A Paired Single-Center Study Including Triple-Rule-Out CT

Background/Objectives: Optimizing coronary image quality is important in emergency computed tomography (CT), including coronary CT angiography (CCTA) and triple-rule-out CT angiography (TRO-CTA). We compared objective and subjective image quality between cardiac-specific artificial intelligence (AI) reconstruction and hybrid iterative reconstruction (HIR) using paired images from the same acquisition.

Methods

This retrospective single-center study included 66 of 75 consecutively assessed emergency examinations: 28 standard CCTA and 38 TRO-CTA examinations acquired without pharmacologic heart-rate control. Both protocols used identical cardiac acquisition settings. AI and HIR images were reconstructed from the same acquisition with matched cardiac phases and motion-correction settings. Objective measurements were obtained at nine coronary locations, and two readers independently assessed overall image quality and perceived vessel-edge sharpness in unmasked paired comparisons.