Exploring the best monochromatic energy level in dual energy spectral imaging for coronary stents after percutaneous coronary intervention

Abstract

In this study, the optimal monochromatic energy level in dual-energy spectral CT required for imaging coronary stents after percutaneous coronary intervention (PCI) was explored. Thirty-five consecutive patients after PCI were examined using the dual-energy spectral CT imaging mode. The original images were reconstructed at 40–140 keV (10-keV interval) monochromatic levels. The in-stent and out-stent CT values at each monochromatic level were measured to calculate the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) for the vessel and the CT value difference between the in-stent and out-stent lumen (dCT (in–out)), which reflects the artificial CT number increase due to the beam hardening effect caused by the stents. The subjective image quality of the stent and in-stent vessel was evaluated by two radiologists using a 5-point scale. With the increase in energy level, the CT value, SNR, CNR, and dCT (in–out) all decreased. At 80 keV, the mean CT value in-stent reached (345.24 ± 93.43) HU and dCT (in–out) started plateauing. In addition, the subjective image quality of the stents and vessels peaked at 80 keV. The 80 keV monochromatic images are optimal for imaging cardiac patients with stents after PCI, balancing the enhancement and SNR and CNR in the vessels while minimizing the beam hardening artifacts caused by the stents.

High-Pitch Multienergy Coronary CT Angiography in Dual-Source Photon-Counting Detector CT Scanner at Low Iodinated Contrast Dose

“…The ideal type of image, including the specific energy level of VMI, depends on several factors, including the scanner technology, body part, the specific clinical task, and noise. 25,[31][32][33] Our study showed that 50 keV images are superior to 120 kV images for overall image quality, vascular enhancement, and coronary artery sharpness with mild increased noise. Knowledge of the preferred image is essential to simplify the workflow, both for the scanning technologist and interpreting cardiac imager.…”

“…With the availability of ME capabilities on PCD-CT, additional image sets can be generated, including full spectrum (120 kV) and VMIs. The ideal type of image, including the specific energy level of VMI, depends on several factors, including the scanner technology, body part, the specific clinical task, and noise 25,31–33 . Our study showed that 50 keV images are superior to 120 kV images for overall image quality, vascular enhancement, and coronary artery sharpness with mild increased noise.…”

Photon counting computed tomography of in-stent-stenosis in a phantom: Optimal virtual monoenergetic imaging in ultra high resolution

“…The value of VMI for CCTA has been proven for various dual-energy CT and PCCT scanners [ [13] , [14] , [15] ]. Few studies have looked at the impact of VMI and optimal keV level in the presence of cardiac stents [ 16 , 17 ]. However, these studies were carried out with dual energy CT systems using energy integrating detectors, incapable of generating comparable UHR imaging.…”

Application of metal artifact reduction software in gemstone spectral computed tomography for patients after total knee arthroplasty

“…To date, there have been some studies on MARs technology for artifact reduction in metal implants such as hip prostheses and pedicle screws, but only a few studies have examined the use of MARs in TKA (13,15,16). The purpose of this study was to explore the feasibility and effectiveness of the MARs reconstruction algorithm in reducing metal artifacts of knee prostheses and to explore the optimal monochromatic level of the VMS images for artifact reduction to provide high-quality images and reliable diagnosis for patients after TKA.…”