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Evaluation of motion artifact metrics for coronary CT angiography. Med Phys 2018 Feb;45(2):687-702 PMID: 29222954 PMCID: PMC5807165

Pubmed ID



PURPOSE: This study quantified the performance of coronary artery motion artifact metrics relative to human observer ratings. Motion artifact metrics have been used as part of motion correction and best-phase selection algorithms for Coronary Computed Tomography Angiography (CCTA). However, the lack of ground truth makes it difficult to validate how well the metrics quantify the level of motion artifact. This study investigated five motion artifact metrics, including two novel metrics, using a dynamic phantom, clinical CCTA images, and an observer study that provided ground-truth motion artifact scores from a series of pairwise comparisons.

METHOD: Five motion artifact metrics were calculated for the coronary artery regions on both phantom and clinical CCTA images: positivity, entropy, normalized circularity, Fold Overlap Ratio (FOR), and Low-Intensity Region Score (LIRS). CT images were acquired of a dynamic cardiac phantom that simulated cardiac motion and contained six iodine-filled vessels of varying diameter and with regions of soft plaque and calcifications. Scans were repeated with different gantry start angles. Images were reconstructed at five phases of the motion cycle. Clinical images were acquired from 14 CCTA exams with patient heart rates ranging from 52 to 82 bpm. The vessel and shading artifacts were manually segmented by three readers and combined to create ground-truth artifact regions. Motion artifact levels were also assessed by readers using a pairwise comparison method to establish a ground-truth reader score. The Kendall's Tau coefficients were calculated to evaluate the statistical agreement in ranking between the motion artifacts metrics and reader scores. Linear regression between the reader scores and the metrics was also performed.

RESULTS: On phantom images, the Kendall's Tau coefficients of the five motion artifact metrics were 0.50 (normalized circularity), 0.35 (entropy), 0.82 (positivity), 0.77 (FOR), 0.77(LIRS), where higher Kendall's Tau signifies higher agreement. The FOR, LIRS, and transformed positivity (the fourth root of the positivity) were further evaluated in the study of clinical images. The Kendall's Tau coefficients of the selected metrics were 0.59 (FOR), 0.53 (LIRS), and 0.21 (Transformed positivity). In the study of clinical data, a Motion Artifact Score, defined as the product of FOR and LIRS metrics, further improved agreement with reader scores, with a Kendall's Tau coefficient of 0.65.

CONCLUSION: The metrics of FOR, LIRS, and the product of the two metrics provided the highest agreement in motion artifact ranking when compared to the readers, and the highest linear correlation to the reader scores. The validated motion artifact metrics may be useful for developing and evaluating methods to reduce motion in Coronary Computed Tomography Angiography (CCTA) images.

Author List

Ma H, Gros E, Szabo A, Baginski SG, Laste ZR, Kulkarni NM, Okerlund D, Schmidt TG


Zachary R. Laste MD Assistant Professor in the Radiology department at Medical College of Wisconsin
Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin


2-s2.0-85041746359   2 Citations

MESH terms used to index this publication - Major topics in bold

Computed Tomography Angiography
Coronary Angiography
Phantoms, Imaging
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6