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European Radiology

, Volume 26, Issue 6, pp 1871–1878 | Cite as

Impact of an advanced image-based monoenergetic reconstruction algorithm on coronary stent visualization using third generation dual-source dual-energy CT: a phantom study

  • Stefanie Mangold
  • Paola M. Cannaó
  • U. Joseph Schoepf
  • Julian L. Wichmann
  • Christian Canstein
  • Stephen R. Fuller
  • Giuseppe Muscogiuri
  • Akos Varga-Szemes
  • Konstantin Nikolaou
  • Carlo N. De Cecco
Computed Tomography

Abstract

Purpose

To evaluate the impact of an advanced monoenergetic (ME) reconstruction algorithm on CT coronary stent imaging in a phantom model.

Materials and methods

Three stents with lumen diameters of 2.25, 3.0 and 3.5 mm were examined with a third-generation dual-source dual-energy CT (DECT). Tube potential was set at 90/Sn150 kV for DE and 70, 90 or 120 kV for single-energy (SE) acquisitions and advanced modelled iterative reconstruction was used. Overall, 23 reconstructions were evaluated for each stent including three SE acquisitions and ten advanced and standard ME images with virtual photon energies from 40 to 130 keV, respectively. In-stent luminal diameter was measured and compared to nominal lumen diameter to determine stent lumen visibility. Contrast-to-noise ratio was calculated.

Results

Advanced ME reconstructions substantially increased lumen visibility in comparison to SE for stents ≤3 mm. 130 keV images produced the best mean lumen visibility: 86 % for the 2.25 mm stent (82 % for standard ME and 64 % for SE) and 82 % for the 3.0 mm stent (77 % for standard ME and 69 % for SE). Mean DLP for SE 120 kV and DE acquisitions were 114.4 ± 9.8 and 58.9 ± 2.2 mGy × cm, respectively.

Conclusion

DECT with advanced ME reconstructions improves the in-lumen visibility of small stents in comparison with standard ME and SE imaging.

Key Points

An advanced image-based monoenergetic reconstruction algorithm improves lumen visualization in stents ≤3.0 mm.

Application of high keV reconstructions significantly improves in-stent lumen visualization.

DECT acquisition resulted in 49 % radiation dose reduction compared with 120 kV SE.

Keywords

Dual-energy CT Coronary CT Stent Monoenergetic imaging Iterative reconstruction 

Abbreviations

CCTA

Coronary computed tomography

DECT

Dual-energy computed tomography

keV

kilo-electron volts

ME

Monoenergetic

CNR

Contrast-to-noise ratio

SE

Single-energy

ECG

Electrocardiogram

CTDIvol

Volume-based computed tomography dose index

Notes

Acknowledgments

The scientific guarantor of this publication is Carlo N. De Cecco. The authors of this manuscript declare relationships with the following companies: Dr. Schoepf is a consultant for and receives research support from Bayer, Bracco, GE, Medrad, and Siemens. Mr. Canstein is a Siemens employee. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because the study was performed by using a thoracic phantom model. No study subjects or cohorts have been previously reported. Methodology: prospective, experimental, performed at one institution.

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Stefanie Mangold
    • 1
    • 2
  • Paola M. Cannaó
    • 1
    • 3
  • U. Joseph Schoepf
    • 1
    • 4
  • Julian L. Wichmann
    • 1
    • 5
  • Christian Canstein
    • 6
  • Stephen R. Fuller
    • 1
  • Giuseppe Muscogiuri
    • 1
    • 7
  • Akos Varga-Szemes
    • 1
  • Konstantin Nikolaou
    • 2
  • Carlo N. De Cecco
    • 1
    • 7
  1. 1.Division of Cardiovascular Imaging, Department of Radiology and Radiological ScienceMedical University of South CarolinaCharlestonUSA
  2. 2.Department of Diagnostic and Interventional RadiologyEberhard-Karls University TuebingenTuebingenGermany
  3. 3.Scuola di Specializzazione in RadiodiagnosticaUniversity of MilanMilanItaly
  4. 4.Division of Cardiology, Department of MedicineMedical University of South CarolinaCharlestonUSA
  5. 5.Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurtGermany
  6. 6.Siemens Medical SolutionsMalvernUSA
  7. 7.Department of Radiological Sciences, Oncology and PathologyUniversity of Rome “Sapienza”RomeItaly

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