SUPPLEMENTAL MATERIAL Supplementary Tables
Table 1. Details of computed tomography acquisition and reconstruction protocol NCE examination CE examination
ECG-gating Prospective (axial mode) Prospective (axial mode) ECG padding range 0%–50% of the R-R interval 20%–120% of the R-R
interval
Scan range (z-axis) 16 cm 16 cm
Tube voltage Fixed (100 kV) Fixed (100 kV for BMI <30, 120 kV for BMI ≥30) Tube current-time product Fixed without tube current
modulation (70 mAs)
Selected and modulated by automated exposure control software (Smart mA, GE Healthcare)
Reconstruction interval 10% of the R-R interval 10% of the R-R interval Number of reconstructed
datasets
6 11
Use of iterative
reconstruction technique
No Yes (ASIR-V with 50%
strength, GE Healthcare)
CT, computed tomography; NCE, non-contrast enhanced; CE, contrast-enhanced; ECG, electrocardiogram; BMI, body mass index; ASIR-V, adaptive statistical iterative
reconstruction-V
Table 2. Sizing regimen for hypothetical prosthesis sizing for the self-expandable CoreValve Evolut R bioprosthesis and balloon-expandable Sapien 3 bioprosthesis based on annular assessment
Aortic valve annulus size on CT Area-derived
average diameter
Perimeter Prosthesis size
CoreValve Evolut R
18–20 mm 56.5-62.8 mm 23 mm
20–23 mm 62.8-72.3 mm 26 mm
23–26 mm 72.3–81.7 mm 29 mm
26–30 mm 81.7–94.2 mm 34 mm
Sapien 3
18.6–21 mm N/A 20 mm
20.7–23.4 mm N/A 23 mm
23.4–26.4 mm N/A 26 mm
26.2–29.5 mm N/A 29 mm
CT, computed tomography
Table 3. Interobserver agreement for the optimal phase of annular measurement
(a) Optimal phase of R-R interval on non-contrast examination (weighted kappa 0.390, 95%
confidence interval 0.145–0.635)
Observer 1
Observer 2 10% 20% 30% 40% 50%
10% 1 0 0 0 0
20% 0 4 2 2 0
30% 0 0 10 5 0
40% 3 0 5 13 1
50% 0 0 0 0 0
(b) Optimal phase of R-R interval contrast-enhanced scan (weighted kappa 0.732, 95%
confidence interval 0.591–0.873)
Observer 1
Observer 2 10% 20% 30% 40% 50%
10% 4 2 0 0 0
20% 0 9 2 0 0
30% 0 0 18 0 0
40% 0 1 5 4 0
50% 0 0 0 1 0
Supplementary Figures
Figure 1. Bland–Altman plots for comparison of annular measurements between observers
(a) Average diameter on non-contrast-enhanced examination
-3 -2 -1 0 1 2 3
18 20 22 24 26 28 30
Mean of average diameter (observer 1 and observer 2) (mm)
Average diameter (observer 1-observer 2) (mm)
Mean -0.2
-1.96 SD -2.2 +1.96 SD 1.8
(b) Perimeter on non-contrast-enhanced examination
-10 -8 -6 -4 -2 0 2 4 6 8
60 65 70 75 80 85 90 95
Mean of perimeter (observer 1 and observer 2) (mm)
Peimeter (observer 1-observer 2) (mm)
Mean -1.0
-1.96 SD -6.9 +1.96 SD 5.0
(c) Average diameter on contrast-enhanced examination
-1.5 -1.0 -0.5 0.0 0.5 1.0 1.5
16 18 20 22 24 26 28
Mean of average diameter (observer 1 and observer 2) (mm)
Average diameter (observer 1-observer 2) (mm)
Mean 0.16
-1.96 SD -0.71 +1.96 SD 1.03
(d) Perimeter on contrast-enhanced examination
-5 -4 -3 -2 -1 0 1 2 3 4 5
55 60 65 70 75 80 85 90
Mean of perimeter (observer 1 and observer 2) (mm)
Peimeter (observer 1-observer 2) (mm)
Mean 0.4
-1.96 SD -2.5 +1.96 SD 3.3