Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT

Qin, Le; Zhou, Shanshui; Dong, Haipeng; Li, Jiqiang; Zhang, Ruiyan; Yang, Chendie; Liu, Peng; Xu, Zhihan; Yan, Fuhua; Yang, Wenjie

doi:10.1007/s00330-024-10760-1

Cited by 5 publications

(1 citation statement)

References 37 publications

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“…In vivo studies comparing different reconstruction kernels identified Bv48 in the cerebrovascular angiography module as optimal for assessing intracranial aneurysms [7]. Cardiovascular angiographies have identified higher kernels as better to evaluate coronary arteries: The vessel lumen of coronary arteries after stent implantation was best evaluated at a sharper reconstruction kernel (Body vascular kernel (Bv) 60 and 72) [8]. Studies reporting on imaging post processing in PCD-CT involving spectral reconstructions are scarce in neurovascular imaging.…”

Section: Introductionmentioning

confidence: 99%

Photon-Counting Detector Computed Tomography Angiography to assess intracranial stents and flowdiverters - in vivo study comprising ultra-high resolution spectral reconstructions

De Beukelaer,

Wuyts

et al. 2024

Preprint

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BACKGROUND AND PURPOSENeuroimaging of intracranial vessels with implanted stents (ICS) and flowdiverters (FD) is limited by artifacts. Photon-Counting-Detector-Computed Tomography (PCD-CT) is characterized by a higher resolution. The purpose of this study was to assess the image quality of ultra-high-resolution (UHR) PCD-CT-Angiography (PCD-CTA) and spectral reconstructions to define the best imaging parameters for the evaluation of vessel visibility in ICS and FD.MATERIALS AND METHODSRetrospective analysis of consecutive patients with implanted ICS or FD, who received a PCD-CTA between April 2023 and March 2024. Polyenergetic (PE), virtual monoenergetic imaging (VMI), pure lumen (PL) and iodine (I) reconstructions with different kiloelectron volt (keV) levels (keV 40, 60 and 80) and reconstruction kernels (Body vascular kernel (Bv) 48, Bv56, Bv64, Bv72, Bv76) were acquired to evaluate image quality and assessed by 2 independent radiologists using a 5-point Likert scale and regions of interest (ROI). The different kernels, keV and the optimized spectral reconstructions were compared in descriptive analysis.RESULTSIn total, 12 patients with 9 FDs and 6 ICSs were analyzed. In terms of quantitative image quality, sharper kernels as Bv64 and Bv72 yielded increased image noise, and decreased signal to noise (SNR) and contrast to noise ratio (CNR) compared to the smoothest kernel Bv48, (p<0.01). Among the different keV levels and kernels, readers selected the 40 keV level (p<0.01) and sharper kernels (in the majority of cases Bv72) as the best to visualize the in-stent vessel lumen. Assessing the different spectral reconstructions virtual monoenergetic and iodine reconstructions proved to be best to evaluate in-stent vessel lumen (p<0.01).CONCLUSIONSOur preliminary study suggests that PCD-CTA and spectral reconstructions with sharper reconstruction kernels and a low keV level of 40 seem to be beneficial to achieve optimal image quality for the evaluation of ICS and FD. Iodine and virtual monoenergetic reconstructions were superior to pure lumen and polyenergetic reconstructions to evaluate in-stent vessel lumen.Key pointsPCD-CTA imaging quality can be advanced by image post processing with spectral reconstructions and certain reconstruction kernels.Intracranial in-stent vessel lumen visibility significantly improves using sharp reconstruction kernels (Bv72) and low keV level in high-resolution mode in photon-counting detector computed tomography. Regarding the different optimized spectral reconstructions virtual monoenergetic and iodine reconstructions proved to be best to evaluate in-stent vessel lumen.

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Section: Introductionmentioning

confidence: 99%

Photon-Counting Detector Computed Tomography Angiography to assess intracranial stents and flowdiverters - in vivo study comprising ultra-high resolution spectral reconstructions

De Beukelaer,

Wuyts

et al. 2024

Preprint

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Ultra-high-resolution 40 keV virtual monoenergetic imaging using spectral photon-counting CT in high-risk patients for coronary stenoses

Fahrni,

Boccalini,

Lacombe

et al. 2024

Eur Radiol

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Objectives To assess the image quality of ultra-high-resolution (UHR) virtual monoenergetic images (VMIs) at 40 keV compared to 70 keV, using spectral photon-counting CT (SPCCT) and dual-layer dual-energy CT (DECT) for coronary computed tomography angiography (CCTA). Methods and materials In this prospective IRB-approved study, 26 high-risk patients were included. CCTA was performed both with an SPCCT in UHR mode and with one of two DECT scanners (iQOn or CT7500) within 3 days. 40 keV and 70 keV VMIs were reconstructed for both modalities. Stenoses, blooming artefacts, and image quality were compared between all four reconstructions. Results Twenty-six patients (4 women [15%]) and 28 coronary stenoses (mean stenosis of 56% ± 16%) were included. 40 keV SPCCT gave an overall higher quality score (5 [5, 5]) than 70 keV SPCCT (5 [4, 5], 40 keV DECT (4 [3, 4]) and 70 keV SPCCT (4 [4, 5]), p < 0.001). Less variability in stenosis measurement was found with SPCCT between 40 keV and 70 keV (bias: −1% ± 3%, LoA: 6%) compared with DECT (−6% ± 8%, LoA 16%). 40 keV SPCCT vs 40 keV DECT showed a −3% ± 6% bias, whereas 40 keV SPCCT vs 70 keV DECT showed a −8% ± 6% bias. From 70 keV to 40 keV, blooming artefacts did not increase with SPCCT (mean +2% ± 5%, p = 0.136) whereas they increased with DECT (mean +7% ± 6%, p = 0.005). Conclusion UHR 40 keV SPCCT VMIs outperformed 40 keV and 70 keV DECT VMIs for assessing coronary artery stenoses, with no impairment compared to 70 keV SPCCT VMIs. Key Points QuestionUse of low virtual mono-energetic images at 40 keV using spectral dual-energy and photon-counting CT systems is not yet established for diagnosing coronary artery stenosis. FindingsUHR 40 keV SPCCT enhances diagnostic accuracy in coronary artery assessment. Clinical relevanceBy combining spectral sensitivity with lower virtual mono-energetic imaging and ultra-high spatial resolution, SPCCT enhances coronary artery assessment, potentially leading to more accurate diagnoses and better patient outcomes in cardiovascular imaging.

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Coronary artery disease detection using deep learning and ultrahigh-resolution photon-counting coronary CT angiography

Brendel,

Walterspiel,

Hagen

et al. 2024

Diagnostic and Interventional Imaging

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Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT

Cited by 5 publications

References 37 publications

Photon-Counting Detector Computed Tomography Angiography to assess intracranial stents and flowdiverters - in vivo study comprising ultra-high resolution spectral reconstructions

Photon-Counting Detector Computed Tomography Angiography to assess intracranial stents and flowdiverters - in vivo study comprising ultra-high resolution spectral reconstructions

Ultra-high-resolution 40 keV virtual monoenergetic imaging using spectral photon-counting CT in high-risk patients for coronary stenoses

Coronary artery disease detection using deep learning and ultrahigh-resolution photon-counting coronary CT angiography

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