Coronary stent imaging in photon counting computed tomography: improved imaging of in-stent stenoses in a phantom with optimized reconstruction kernels.

BJR open Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.1093/bjro/tzae030
Arwed Elias Michael, Denise Schoenbeck, Jendrik Becker-Assmann, Nina Pauline Haag, Julius Henning Niehoff, Bernhard Schmidt, Christoph Panknin, Matthias Baer-Beck, Tilman Hickethier, David Maintz, Alexander C Bunck, Roman Johannes Gertz, Jan Borggrefe, Jan Robert Kroeger
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引用次数: 0

Abstract

Objectives: Coronary CT angiography (CCTA) is becoming increasingly important in the workup of coronary artery disease. Imaging of stents and in-stent stenoses remains a challenge. This work investigates the assessability of in-stent stenoses in photon counting CT (PCCT) using ultra-high-resolution (UHR) imaging and optimized reconstruction kernels.

Methods: In an established phantom, 6 stents with inserted hypodense stenoses were scanned in both standard resolution (SRM) and UHR in a clinical PCCT scanner (NAEOTOM Alpha, Siemens Healthineers, Germany). Reconstructions were made both with the clinically established and optimized kernels. The visible stent lumen and the extent of stenosis were quantitatively measured and compared with the angiographic reference standard. Also, region-of-interest (ROI)-based measurements and a qualitative assessment of image quality were performed.

Results: The visible stent lumen and the extent of stenosis were measured more precisely in UHR compared to SRM (0.11 ± 0.19 vs 0.41 ± 0.22 mm, P < .001). The optimized kernel further improved the accuracy of the measurements and image quality in UHR (0.35 ± 0.23 vs 0.47 ± 0.19 mm, P < .001). Compared to angiography, stenoses were overestimated in PCCT, on average with an absolute difference of 18.20% ± 4.11%.

Conclusions: Photon counting CCTA allows improved imaging of in-stent stenoses in a phantom using UHR imaging and optimized kernels. These results support the use of UHR and optimized kernels in clinical practice and further studies.

Advances in knowledge: UHR imaging and optimized reconstruction kernels should be used in CCTA in the presence of cardiac stents.

光子计数计算机断层扫描中的冠状动脉支架成像:利用优化的重建核对模型改进支架内狭窄的成像。
目的:冠状动脉 CT 血管造影 (CCTA) 在冠状动脉疾病的检查中越来越重要。支架和支架内狭窄的成像仍然是一项挑战。这项研究利用超高分辨率(UHR)成像和优化重建核对光子计数 CT(PCCT)中支架内狭窄的可评估性:方法:在一个已建立的模型中,使用临床 PCCT 扫描仪(NAEOTOM Alpha,德国西门子 Healthineers 公司)以标准分辨率(SRM)和超高分辨率(UHR)扫描了 6 个插入低密度狭窄的支架。使用临床确定的内核和优化的内核进行重建。对可见支架管腔和狭窄程度进行定量测量,并与血管造影参考标准进行比较。此外,还进行了基于感兴趣区(ROI)的测量和图像质量定性评估:结果:与 SRM 相比,UHR 能更精确地测量可见支架管腔和狭窄程度(0.11 ± 0.19 vs 0.41 ± 0.22 mm,P P 结论:利用 UHR 成像和优化的内核,光子计数 CCTA 可以改进模型中支架内狭窄的成像。这些结果支持在临床实践和进一步研究中使用 UHR 和优化的内核:UHR 成像和优化重建内核应在存在心脏支架的 CCTA 中使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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