ABSTRACT
PURPOSE: To compare the performance of server-based (CSS) versus stand-alone post-processing software (ES) for the evaluation of cardiovascular CT examinations (cvCT) and to determine the crucial steps. MATERIALS AND METHODS: Data of 40 patients (20 patients for coronary artery evaluation and 20 patients prior to transcatheter aortic valve implantation [TAVI]) were evaluated by 5 radiologists with CSS and ES.âData acquisition was performed using a dual-source 128-row CT unit (SOMATOM Definition Flash, Siemens, Erlangen, Germany) and a 64-row CT unit (Brilliance 64, Philips, Hamburg, Germany). The following workflow was evaluated: Data loading, aorta and coronary segmentation, curved multiplanar reconstruction (cMPR) and 3âD volume rendering technique (3D-VRT), measuring of coronary artery stenosis and planimetry of the aortic annulus. The time requirement and subjective quality for the workflow were evaluated. RESULTS: The coronary arteries as well as the TAVI data could be evaluated significantly faster with CSS (5.5 â± â2.9â min and 8.2â ± â4.0 âmin, respectively) than with ES (13.9 â± â5.2â min and 15.2 â±â 10.9 âmin, respectively, p ≤ â0.01). Segmentation of the aorta (CSS: 1.9 ± â2.0â min, ES: 3.7 â± â3.3 âmin), generating cMPR of coronaries (CSS: 0.5 â± â0.2 âmin, ES: 5.1 â± â2.6 âmin), aorta and iliac vessels (CSS: 0.5 â± â0.4 âmin and 0.4 â± â0.4 âmin, respectively, ES: 1.6 â± â0.7 âmin and 2.8 â± â3â min, respectively) could be performed significantly faster with CSS than with ES with higher quality of cMPR, measuring of coronary stenosis and 3D-VRT (pâ<â0.05). CONCLUSION: Evaluation of cvCT can be accomplished significantly faster and better with CSS than with ES.â The segmentation remains the most time-consuming workflow step, so optimization of segmentation algorithms could improve performance even further.