Correspondence|Articles in Press

First in-vivo coronary stent imaging with clinical ultra high resolution photon-counting CT

Published:March 08, 2023DOI:



      Coronary stent imaging remains limited with conventional CT. In this patient study we evaluated the quality of coronary stent imaging and determined the optimal reconstruction settings for ultra-high-resolution (UHR) coronary CT angiography (cCTA) with clinical photon-counting-detector CT (PCD-CT).


      In this retrospective dual-center study, 22 patients with 36 coronary stents who underwent UHR cCTA with PCD-CT were included. Images with a slice thickness of 0.6mm and Bv40 kernel and UHR images at a slice thickness of 0.2mm with kernels of eight sharpness levels (Bv40, Bv44, Bv56, Bv60, Bv64, Bv72, Bv80, and Bv89) and adapted matrix-sizes and field-of-views were reconstructed. Image noise, contrast-to-noise-ratio (CNR), in-stent diameters, and differences of in-stent attenuation compared with adjacent segments were measured. Stent strut sharpness was quantified using data derived from line profiles. Subjective in-stent lumen visualization was rated by two blinded, independent readers. In-vitro stent diameters were taken as reference standard.


      At increasing kernel sharpness, CNR decreased, in-stent diameter increased (1.8 ​± ​0.5mm for 0.6mm/Bv40 to 2.5 ​± ​0.5mm for 0.2mm/Bv89), and stent strut sharpness increased. Differences of in-stent attenuation decreased from 0.6mm/Bv40 to 0.2 mm/Bv60-Bv80 kernels, being not different from zero for the latter kernels (p ​> ​0.05). Percentage (absolute) differences of measured to in-vitro diameters decreased from 40.1 ​± ​11.1% (1.2 ​± ​0.4mm) for 0.6mm/Bv40 to 16.6 ​± ​8% (0.5 ​± ​0.3mm) for 0.2mm/Bv89. There were no associations between stent angulation and in-stent diameter or attenuation differences (p ​> ​0.05). Qualitative scores increased from suboptimal/good for 0.6mm/Bv40 to very good/excellent for 0.2mm/Bv64 and 0.2mm/Bv72.


      UHR cCTA with clinical PCD-CT enables excellent in-vivo coronary stent lumen visualization.



      CNR (Contrast-to-noise ratio), CT (Computed tomography), cCTA (Coronary computed tomography angiography), ECG (Electrocardiography), FoV (Field-of-View), HU (Hounsfield Unit), ISL (In-stent-lumen), PCD (Photon-counting detector), UHR (Ultra high resolution)
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        • Taylor A.J.
        • Cerqueira M.
        • Hodgson J.M.
        • et al.
        ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography.
        J Cardiovasc Comput Tomogr. 2010; 4 (e401-433): 407
        • Schuijf J.D.
        • Lima J.A.C.
        • Boedeker K.L.
        • et al.
        CT imaging with ultra-high-resolution: opportunities for cardiovascular imaging in clinical practice.
        J Cardiovasc Comput Tomogr. 2022; 16: 388-396
        • Sandfort V.
        • Persson M.
        • Pourmorteza A.
        • Noel P.B.
        • Fleischmann D.
        • Willemink M.J.
        Spectral photon-counting CT in cardiovascular imaging.
        J Cardiovasc Comput Tomogr. 2021; 15: 218-225
        • Mergen V.
        • Sartoretti T.
        • Baer-Beck M.
        • et al.
        Ultra-high-resolution coronary CT angiography with photon-counting detector CT: feasibility and image characterization.
        Invest Radiol. 2022; 57: 780-788
        • Boccalini S.
        • Si-Mohamed S.A.
        • Lacombe H.
        • et al.
        First in-human results of computed tomography angiography for coronary stent assessment with a spectral photon counting computed tomography.
        Invest Radiol. 2022; 57: 212-221