Abstract
Background
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).
Methods
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.
Results
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.
Conclusion
UHR cCTA with clinical PCD-CT enables excellent in-vivo coronary stent lumen visualization.
Keywords
Abbreviations:
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)To read this article in full you will need to make a payment
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References
- 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
- CT imaging with ultra-high-resolution: opportunities for cardiovascular imaging in clinical practice.J Cardiovasc Comput Tomogr. 2022; 16: 388-396
- Spectral photon-counting CT in cardiovascular imaging.J Cardiovasc Comput Tomogr. 2021; 15: 218-225
- Ultra-high-resolution coronary CT angiography with photon-counting detector CT: feasibility and image characterization.Invest Radiol. 2022; 57: 780-788
- 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
Article info
Publication history
Published online: March 08, 2023
Accepted:
February 28,
2023
Received in revised form:
February 26,
2023
Received:
January 27,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
