Impact of low-energy virtual monoenergetic imaging in photon-counting CT for pre-TAVI pelvic arteries visualization.

IF 4.8 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiologia Medica Pub Date : 2025-10-06 DOI:10.1007/s11547-025-02113-9

Leona S Alizadeh, Christian Booz, Thomas J Vogl, Ludovica R M Lanzafame, Simon S Martin, Ibrahim Yel, Leon D Gruenewald, Vitali Koch, Tommaso D'Angelo, Silvio Mazziotti, Kerstin Smolka, Grit Braunegger, Daniel Dillinger, Leonhard Kaatsch, Daniel Overhoff, Niklas Verloh, Stephan S Waldeck

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引用次数: 0

Abstract

Purpose: This study aimed to assess the impact of photon-counting computed tomography (PCCT) virtual monoenergetic images (VMI) on quantitative and qualitative parameters in abdominal and pelvic vascular imaging for transcatheter aortic valve implantation (TAVI) planning.

Material and methods: A retrospective analysis of 125 patients undergoing dual-source PCCT scans before TAVI procedures was conducted. Reconstructions included polychromatic (T3D) images, leveraging multiple photon energy levels and VMI series spanning 40-100 keV in 15 keV increments. Quantitative parameters (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) were evaluated. Qualitative assessments by three radiologists used clinically relevant five-point scales for overall image quality, TAVI access site suitability, and confidence in TAVI measurements.

Results: VMI reconstructions, particularly at 40 and 55 keV, demonstrated significantly higher SNR and CNR than T3D reconstructions (p < 0.001). T3D reconstructions had a mean noise of 12.61 ± 6.12, comparable to 100 keV VMI reconstructions (14.77 ± 8.23, p > 0.05). In qualitative evaluation, 55 keV VMI images scored highest in overall image quality and TAVI access site assessability, followed by 70 keV VMI reconstructions.

Conclusion: Low-keV PCCT VMI reconstructions provided superior quantitative and qualitative image quality for abdominal and pelvic vascular imaging in TAVI planning. Notably, 55 keV reconstructions showed an image quality reserve over T3D images, aiding confidence in TAVI-related measurements and enabling possible future reductions in contrast agent use, emphasizing the relevance of VMI techniques in optimizing TAVI imaging protocols.

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光子计数CT低能量虚拟单能成像对tavi前盆腔动脉显像的影响。

目的：本研究旨在评估光子计数计算机断层扫描（PCCT）虚拟单能图像（VMI）对经导管主动脉瓣植入术（TAVI）计划中腹部和盆腔血管成像定量和定性参数的影响。材料和方法：回顾性分析125例在TAVI手术前接受双源PCCT扫描的患者。重建包括多色（T3D）图像，利用多个光子能级和VMI系列，以15 keV的增量跨越40-100 keV。定量参数（信噪比[SNR]和噪声对比比[CNR]）进行评估。三名放射科医生使用临床相关的五分制对整体图像质量、TAVI进入地点的适用性和TAVI测量的置信度进行定性评估。结果：VMI重建，特别是在40和55 keV时，显示出明显高于T3D重建的信噪比和CNR （p 0.05）。在定性评价中，55幅keV VMI图像在整体图像质量和TAVI访问站点可评估性方面得分最高，其次是70幅keV VMI重建图像。结论：低频率PCCT VMI重建为TAVI规划中的腹部和盆腔血管成像提供了较好的定量和定性图像质量。值得注意的是，55 keV重建显示出比T3D图像更好的图像质量，这有助于对TAVI相关测量的信心，并可能在未来减少造影剂的使用，强调了VMI技术在优化TAVI成像方案中的相关性。

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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来源期刊

Radiologia Medica 医学-核医学

CiteScore

14.10

自引率

7.90%

发文量

133

审稿时长

4-8 weeks

期刊介绍： Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.