Publication

Coronary artery stent imaging with CT using an integrated electronics detector and iterative reconstructions: first in vitro experience

Journal Paper/Review - Aug 24, 2013

Units
PubMed
Doi
Contact

Citation
von Spiczak J, Stolzmann P, Bunck A, Seifarth H, Maintz D, Flohr T, Leschka S, Frauenfelder T, Winklhofer S, Morsbach F, Alkadhi H. Coronary artery stent imaging with CT using an integrated electronics detector and iterative reconstructions: first in vitro experience. J Cardiovasc Comput Tomogr 2013; 7:215-22.
Type
Journal Paper/Review (English)
Journal
J Cardiovasc Comput Tomogr 2013; 7
Publication Date
Aug 24, 2013
Issn Electronic
1876-861X
Pages
215-22
Brief description/objective

BACKGROUND
Despite continuous improvements in CT technology, accurate stent lumen delineation remains challenging.

PURPOSE
The aim was to evaluate the quality of coronary stent lumen delineation with CT using a detector with integrated electronics.

METHODS
Twelve coronary stents placed in plastic tubes and filled with contrast agent (CT number 250 HU) were imaged with either a 128-section dual-source CT machine equipped with conventional detector or with integrated electronics. On both scanners, images were reconstructed with filtered back projection (slice thickness 0.6 mm; increment 0.4 mm) and sinogram-affirmed iterative reconstruction (slice thickness 0.6 mm; increment 0.4 mm), and with iterative reconstruction (slice thickness 0.5 mm; increment 0.3 mm) on the integrated scanner. Two blinded, independent readers assessed image quality, noise, in-stent diameter, in-stent attenuation, and image sharpness by using signal intensity profiles across stents.

RESULTS
Interreader agreement for image quality assessment was substantial (κ = 0.798). Both readers rated best image quality in data sets from integrated detector at highest spatial resolution (86 or 72% of stents rated best quality). Image noise was significantly lower in data sets scanned with integrated detector, being lowest at 0.6 mm slice thickness (14.3 vs 21.0 HU; P < .001). Differences between measured and true in-stent diameters and differences in attenuation across stents were smallest, and average/maximum image sharpness was highest in data sets from the integrated detector using iterative reconstructions.

CONCLUSION
CT coronary stent imaging is significantly improved by using a detector with integrated electronics combined with iterative reconstructions.