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Objective: To evaluate the image quality and diagnostic performance for obstructive coronary artery disease of transcatheter aortic valve implantation (TAVI) patients with atrial fibrillation (AF) during TAVI planning CT using a whole-heart coverage CT scanner. Methods: Eighty-eight consecutive TAVI candidates with AF (50 men, 74 ± 6 years) who underwent both TAVI planning CT and invasive coronary catheter angiography (ICA) were retrospectively analyzed. With ICA results as the reference standard, the accuracy of TAVI planning CT for lesion detection on a per-vessel and per-patient level was calculated. Meanwhile, image quality, contrast volume, and effective dose (ED) were evaluated. A 5-point visual scale (1–5) was used to assess the subjective image quality. The CT value and signal-to-noise ratio were measured for the left main coronary artery (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA). Results: The ED for CCTA was 3.25 ± 1.39 mSv and contrast volume was 58.14 ± 12.34 mL. A total of 1371 (1371/1408 = 97.4%) segments with diameter > 1.5 mm were analyzed. For the subjective evaluation, the mean score was 3.99 ± 0.96 for overall image quality. The mean CT values in LM, RCA, LCX, and LAD were all above 400 HU. For the detection of > 50% stenosis, TAVI planning CT provided on the per-vessel and per-patient basis 97.06% and 100% in sensitivity, 96.23% and 89.06% in specificity, 99.7% and 100% in negative predictive value, and 73.3% and 77.4% in positive predictive value, respectively. Conclusion: TAVI planning CT with whole-heart coverage demonstrates good CCTA image quality and a high sensitivity and NPV in excluding obstructive CAD in TAVI candidates with AF. Key Points: • Transcatheter aortic valve implantation planning (TAVI) CT with whole-heart coverage enables good image quality of CCTA in TAVI candidates with atrial fibrillation. • Obstructive coronary artery disease may be excluded with high accuracy in transcatheter aortic valve implantation (TAVI) candidates with atrial fibrillation with the usage of whole-heart coverage TAVI planning CT. [ABSTRACT FROM AUTHOR]

• 80-kVp and DLIR algorithm reduces 45% of radiation dose and 43% contrast dose in CCTA for overweight patients. • CCTA of overweight patients acquired at 1 mSv and 34 mL through the combination of 80-kVp and DLIR algorithm. • DLIR algorithm shows higher capacity of significantly reducing image noise and improving image quality in CCTA. To investigate the use of an 80-kVp tube voltage combined with a deep learning image reconstruction (DLIR) algorithm in coronary CT angiography (CCTA) for overweight patients to reduce radiation and contrast doses in comparison with the 120-kVp protocol and adaptive statistical iterative reconstruction (ASIR-V). One hundred consecutive CCTA patients were prospectively enrolled and randomly divided into a low-dose group (n = 50) with 80-kVp, smart mA for noise index (NI) of 36 HU, contrast dose rate of 18 mgI/kg/s and DLIR and 60 % ASIR-V and a standard-dose group (n = 50) with 120-kVp, smart mA for NI of 25 HU, contrast dose rate of 32 mgI/kg/s and 60 % ASIR-V. The radiation and contrast dose, subjective image quality score, attenuation values, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were compared. The low-dose group achieved a significant reduction in the effective radiation dose (1.01 ± 0.45 mSv vs 1.85 ± 0.40 mSv, P < 0.001) and contrast dose (33.69 ± 3.87 mL vs 59.11 ± 5.60 mL, P < 0.001) compared to the standard-dose group. The low-dose group with DLIR presented similar enhancement but lower noise, higher SNR and CNR and higher subjective quality scores than the standard-dose group. Moreover, the same patient comparison in the low-dose group between different reconstructions showed that DLIR images had slightly and consistently higher CT values in small vessels, indicating better defined vessels, much lower image noise, higher SNR and CNR and higher subjective quality scores than ASIR-V images (all P < 0.001). The application of 80-kVp and DLIR allows for significant radiation and dose reduction while further improving image quality in CCTA for overweight patients. [ABSTRACT FROM AUTHOR]