Abstract
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.
Keywords
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Article info
Publication history
Published online: August 26, 2013
Accepted:
August 16,
2013
Received in revised form:
March 1,
2013
Received:
December 24,
2012
Footnotes
Conflict of interest: T. Flohr is employee of Siemens Healthcare, Forchheim, Germany. Other authors report no conflicts of interest.
Identification
Copyright
© 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
