{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:58:39Z","timestamp":1792789119185,"version":"4.5.0"},"reference-count":25,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Hospital Administration, NHC","award":["2024MEB315"],"award-info":[{"award-number":["2024MEB315"]}],"id":[{"id":"https:\/\/ror.org\/00xdrzy17","id-type":"ROR","asserted-by":"crossref"}]},{"award":["2024MEB315"],"award-info":[{"award-number":["2024MEB315"]}],"id":[{"id":"https:\/\/ror.org\/00xdrzy17","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Dedicated coronary CT angiography (CCTA) without physical electrocardiographic gating may simplify acquisition, but segment-level interpretability may vary across the coronary tree. We evaluated coronary segment evaluability and factors associated with non-evaluability on dedicated non-ECG-gated CCTA. Methods: This retrospective single-center study included 320 patients and 3739 anatomically present coronary segments with a reference diameter of at least 1.5 mm. Evaluability required confident classification of diameter stenosis as &lt;50% or \u226550%. Segment calcification was graded separately using a prespecified visual scale as none, mild, moderate, or severe. Patient-clustered generalized estimating equations used a binomial distribution, logit link, exchangeable working correlation, and robust standard errors. Results: Overall, 3378 segments (90.3%) were evaluable. All included segments were evaluable in 118\/320 patients (36.9%); 202\/320 (63.1%) had at least one non-evaluable segment and 111\/320 (34.7%) had at least one proximal\/mid non-evaluable segment. Examination success was 320\/336 (95.2%). When 182 observed eligible segments from the 16 globally non-diagnostic examinations were included as non-evaluable, segment evaluability was 3378\/3921 (86.2%); an additional 18-segment worst-case boundary yielded 3378\/4027 (83.9%). Evaluability declined from 93.4% without calcification to 88.8%, 84.3%, and 74.3% with mild, moderate, and severe calcification. Adjusted odds ratios for non-evaluability were 1.95 (95% CI, 1.46\u20132.60), 3.13 (2.18\u20134.49), and 6.53 (4.39\u20139.71), respectively, versus no calcification. Higher heart rate (per 10 beats\/min: OR, 1.52; 95% CI, 1.36\u20131.69) and right coronary artery location (OR, 1.56; 95% CI, 1.20\u20132.02) were associated with non-evaluability, whereas larger reference diameter was associated with lower odds (per 1 mm: OR, 0.69; 95% CI, 0.53\u20130.89). Conclusions: Most included coronary segments were evaluable on dedicated non-ECG-gated CCTA, but interpretability varied with calcification, heart rate, vessel territory, and caliber. These findings characterize segment-level feasibility and do not establish diagnostic accuracy, equivalence to ECG-gated CCTA, or a clinical eligibility threshold.<\/jats:p>","DOI":"10.3390\/diagnostics16193234","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:13:02Z","timestamp":1791367982000},"page":"3234","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Segment-Level Evaluability of Dedicated Non-ECG-Gated Coronary CT Angiography: Associations with Calcification, Heart Rate, Vessel Territory, and Caliber"],"prefix":"10.3390","volume":"16","author":[{"given":"Kun","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Aiyun","family":"Sun","sequence":"additional","affiliation":[{"name":"CT Imaging Research Center, GE HealthCare, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Chunqiao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Hong","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Yueqiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1055\/a-1747-3554","article-title":"Update for the performance of CT coronary angiography\u2014Evidence-based application and technical guidance according to current consensus guidelines and practical advice from the clinical routine","volume":"194","author":"Soschynski","year":"2022","journal-title":"Rofo"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"126","DOI":"10.21037\/qims-2025-1338","article-title":"Diagnostic performance of coronary computed tomography (CT) angiography without electrocardiographic (ECG)-gating: Comparison with invasive coronary angiography","volume":"16","author":"Wang","year":"2026","journal-title":"Quant. 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