Improving cardiac computed tomography angiography image quality and diagnostic confidence for atrial fibrillation after left atrial appendage closure using a second-generation whole-heart motion correction algorithm

Sep 30, 2026

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Left atrial appendage (LAA) closure is a key strategy for preventing stroke in non-valvular atrial fibrillation, yet follow-up cardiac CT angiography (CTA) can suffer from reduced image quality and diagnostic confidence due to device-related artifacts and cardiac motion. This retrospective study evaluates whether a second-generation whole-heart motion correction algorithm (SSF2) improves CTA reconstruction compared with standard reconstruction and the first-generation Snapshot Freeze (SSF1). Quantitative and qualitative assessments from 42 patients show SSF2 lowers artifact burden and enhances visualization and diagnostic confidence, supporting better detection of device complications.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Methods

Results

Conclusions

Keywords

Original Article Improving cardiac computed tomography angiography image quality and diagnostic confidence for atrial fibrillation after left atrial appendage closure using a second-generation whole-heart motion correction algorithm Yanan Li1, Ganglian Fan1, Tingting Qu1, Lihong Chen1, Le Cao1, Jianying Li2, Jianxin Guo1 1Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China; 2GE Healthcare, Computed Tomography Research Center, Beijing, China Contributions: (I) Conception and design: Y Li, T Qu, J Guo; (II) Administrative support: J Guo; (III) Provision of study materials or patients: Y Li, G Fan, L Cao; (IV) Collection and assembly of data: Y Li, T Qu, L Chen; (V) Data analysis and interpretation: Y Li, G Fan, L Chen, L Cao; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Jianxin Guo, PhD. Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an 710061, [China. Email: gjx1665@xjtufh.edu.cn](China. Email: gjx1665@xjtufh.edu.cn). Background: Left atrial appendage (LAA) closure is a key stroke prevention strategy for non-valvularatrial fibrillation (AF) . Cardiac computed tomography angiography (CTA) has emerged as an effective noninvasive alternative to transesophageal echocardiography for follow-up assessment. However, image quality and diagnostic confidence are often compromised by device-related artifacts and cardiac motion, highlighting the need for advanced motion correction techniques such as Snapshot Freeze 2 (SSF2), a second-generation whole-heart algorithm. The effects of SSF2 on patients with LAA closure have not yet been examined. Thus, this study sought to examine the ability of SSF2 to improve cardiac CTA image quality and diagnostic confidence for AF after LAA closure. Methods: This retrospective study included 42 LAA closure patients who underwent single-heartbeat cardiac CTA on a 16-cm detector computed tomography scanner. The images were reconstructed using the standard reconstruction method (SRM), the first-generation Snapshot Freeze 1 (SSF1), and SSF2 . Two experienced radiologists assessed the image artifacts caused by the LAA (at the proximal, central, and distal regions), boundaries, visualization clarity, and diagnostic confidence for LAA closures using a five-point scale. Regions of interest (ROIs) were placed in three areas of LAA closures with heavy artifacts to measure the standard deviation (SD). The Friedman test with a post-hoc analysis was used to compare the quantitative and qualitative results. All the continuous variables are presented as mean ± SD or median (interquartile range), while the subjective image scores are expressed as median (interquartile range) unless otherwise specified. Results: In relation to the quantitative assessment, SSF2 had the smallest SD values, while the SRM had the largest SD values. SSF2 had significantly lower (better) artifact scores for the proximal, central, and distal regions of the LAA [1 (0–1), 1 (0–1), 1 (0–1), respectively] than the SRM [2 (1–2), 2 (1–3), 1 (0–3)] and SSF1 [1 (1–2), 2 (1–3), 1 (0–2)], as well as better scores for the LAA closure boundaries [4 (4–5)] and LAA visualization [4 (4–5)] than the SRM [3 (2–4) and 3 (3–4)] and SSF1 [4 (3–4) and 4 (3–4)], respectively. Excellent diagnostic confidence (i.e., scores of four or greater) was achieved in 30.9%, 52.4%, and 90.5% of the cases using the SRM, SSF1, and SSF2, respectively. Conclusions: SSF2 significantly reduces the artifacts caused by LAA closure, and improves image quality, visualization, and diagnostic confidence in cardiac CTA of patients with LAA closure, compared with the SRM and SSF1 . This could improve both the detection of device-related complications and patient management. © AME Publishing Company. Quant Imaging Med Surg 2026;16(1):57 | [https://dx.doi.org/10.21037/qims-2025-689](https://d

FAQs

What clinical problem does the study address after left atrial appendage closure?

It addresses compromised CTA image quality and diagnostic confidence caused by LAA closure device-related artifacts and cardiac motion during follow-up in patients with atrial fibrillation.

How was the SSF2 algorithm evaluated in the study?

A retrospective cohort of 42 LAA closure patients underwent single-heartbeat cardiac CTA, reconstructed using standard reconstruction, SSF1, and SSF2, then assessed quantitatively and qualitatively by two experienced radiologists.

What did the results show about artifact reduction and diagnostic confidence?

SSF2 produced the smallest quantitative standard-deviation values and significantly lower artifact scores across proximal, central, and distal LAA regions, with higher excellent diagnostic confidence rates than SRM and SSF1.

Sep 30, 2026

Uploaded by Cipher