Tilman Hickethier1, Bettina Baeßler2, Jan Robert Kroeger2, Jonas Doerner2, Gregor Pahn3, David Maintz2, Guido Michels4, Alexander C Bunck2. 1. Department of Radiology, University Hospital of Cologne, Cologne, Germany. Electronic address: tilman.hickethier@uk-koeln.de. 2. Department of Radiology, University Hospital of Cologne, Cologne, Germany. 3. Clinical Science CT, Philips Germany GmbH, Hamburg, Germany. 4. Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
Abstract
PURPOSE: Accurate assessment of coronary stents using non-invasive CT imaging remains challenging despite new stent materials and improvements in CT technology. Virtual monoenergetic (monoE) images reconstructed from dual energy CT acquisitions potentially decrease artifacts caused by coronary stents. A novel spectral detector technology provides monoE and conventional images simultaneously for all conducted scans. The purpose of our study was to systematically investigate the influence of different monoE reconstructions on the visualization of coronary stent lumen in comparison to conventional images. METHOD AND MATERIALS: Ten different coronary stents (diameter 3.0 mm) embedded in plastic tubes filled with contrast agent (500 HU) were scanned with a 128-row spectral detector CT (IQon, Philips, 120 kV, 125 mAs). Images were reconstructed (0.67 mm slice thickness, 0.35 mm increment) with a stent-specific conventional reconstruction kernel and 6 different monoE settings (60, 70, 80, 90, 100, 150 keV). Image quality for each stent and reconstruction was quantified using established parameters: image noise (standard deviation (SD) within a standardized ROI), in-stent attenuation difference (mean attenuation difference between stented and non-stented lumen) and visible lumen diameter (mean visible diameter of the stented tube). RESULTS: Image noise was significantly lower in all monoE data dets compared to conventional images (conventional: 13.41, 60 keV: 11.62, 70 keV: 11.67, 80 keV: 11.69, 90 keV: 11.71, 100 keV: 11.75, 150 keV: 11.80 HU SD; p < 0.01). The in-stent attenuation difference was significantly smaller in monoE data with higher keV levels than in conventional images (conventional: 148.18, 60 keV: 154.13 p = 0.036, 70 keV: 143.43 p = 0.109, 80 keV: 137.25 p = 0.052, 90 keV: 133.02 p = 0.043, 100 keV: 130.12 p = 0.039, 150 keV: 123.99 HU p = 0.035). The visible lumen diameter was significantly greater in monoE data with higher keV levels than in conventional images (conventional: 0.65, 60 keV: 0.68 p = 0.542, 70 keV: 0.71 p = 0.053, 80 keV: 0.74 p < 0.01, 90 keV: 0.77 p < 0.01, 100 keV: 0.82 p < 0.01, 150 keV: 0.87 mm p < 0.01). CONCLUSION: In comparison to conventional CT images, well-established parameters for objective assessment of CT image quality for coronary stents are significantly improved by utilization of monoE reconstructions with adequate keV levels derived from data acquired on a novel spectral detector CT platform.
PURPOSE: Accurate assessment of coronary stents using non-invasive CT imaging remains challenging despite new stent materials and improvements in CT technology. Virtual monoenergetic (monoE) images reconstructed from dual energy CT acquisitions potentially decrease artifacts caused by coronary stents. A novel spectral detector technology provides monoE and conventional images simultaneously for all conducted scans. The purpose of our study was to systematically investigate the influence of different monoE reconstructions on the visualization of coronary stent lumen in comparison to conventional images. METHOD AND MATERIALS: Ten different coronary stents (diameter 3.0 mm) embedded in plastic tubes filled with contrast agent (500 HU) were scanned with a 128-row spectral detector CT (IQon, Philips, 120 kV, 125 mAs). Images were reconstructed (0.67 mm slice thickness, 0.35 mm increment) with a stent-specific conventional reconstruction kernel and 6 different monoE settings (60, 70, 80, 90, 100, 150 keV). Image quality for each stent and reconstruction was quantified using established parameters: image noise (standard deviation (SD) within a standardized ROI), in-stent attenuation difference (mean attenuation difference between stented and non-stented lumen) and visible lumen diameter (mean visible diameter of the stented tube). RESULTS: Image noise was significantly lower in all monoE data dets compared to conventional images (conventional: 13.41, 60 keV: 11.62, 70 keV: 11.67, 80 keV: 11.69, 90 keV: 11.71, 100 keV: 11.75, 150 keV: 11.80 HU SD; p < 0.01). The in-stent attenuation difference was significantly smaller in monoE data with higher keV levels than in conventional images (conventional: 148.18, 60 keV: 154.13 p = 0.036, 70 keV: 143.43 p = 0.109, 80 keV: 137.25 p = 0.052, 90 keV: 133.02 p = 0.043, 100 keV: 130.12 p = 0.039, 150 keV: 123.99 HU p = 0.035). The visible lumen diameter was significantly greater in monoE data with higher keV levels than in conventional images (conventional: 0.65, 60 keV: 0.68 p = 0.542, 70 keV: 0.71 p = 0.053, 80 keV: 0.74 p < 0.01, 90 keV: 0.77 p < 0.01, 100 keV: 0.82 p < 0.01, 150 keV: 0.87 mm p < 0.01). CONCLUSION: In comparison to conventional CT images, well-established parameters for objective assessment of CT image quality for coronary stents are significantly improved by utilization of monoE reconstructions with adequate keV levels derived from data acquired on a novel spectral detector CT platform.
Authors: N R van der Werf; M J Willemink; T P Willems; R Vliegenthart; M J W Greuter; T Leiner Journal: Int J Cardiovasc Imaging Date: 2017-12-28 Impact factor: 2.357
Authors: Giuseppe Cicero; Giorgio Ascenti; Moritz H Albrecht; Alfredo Blandino; Marco Cavallaro; Tommaso D'Angelo; Maria Ludovica Carerj; Thomas J Vogl; Silvio Mazziotti Journal: Radiol Med Date: 2020-01-10 Impact factor: 3.469
Authors: Bernhard Petritsch; Pauline Pannenbecker; Andreas M Weng; Jan-Peter Grunz; Simon Veldhoen; Thorsten A Bley; Aleksander Kosmala Journal: Quant Imaging Med Surg Date: 2021-05