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Multislice CT angiography in post-aortic stent grafting: optimization of scanning protocols for virtual intravascular endoscopy

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Objective

The aim of this study is to investigate the optimal 64-slice CT scanning protocols of 3D virtual intravascular endoscopy (VIE) visualization in abdominal aortic aneurysm treated with suprarenal stent grafts, based on an in vitro phantom study.

Materials and methods

The study was performed on a human aorta phantom with a commercially available stent graft in situ. The contrast medium was diluted to produce CT attenuation similar to that used in routine abdominal aortic CT angiography. A series of scans was performed on a 64-slice CT scanner with the scanning protocols being section thickness of 0.5, 1.0, 2.0, 3.0 and 5.0 mm, pitch of 0.9, 1.2 and 1.4 with reconstruction interval of 50% overlap. Quantitative assessment of image quality was performed by measuring the standard deviation (SD) on surfaced rendered VIE images at three anatomic locations, superior mesenteric artery, right renal artery and aortic aneurysm. This aims to determine the degree of stair-step artifacts present on VIE images using a line profile. The thickness of suprarenal stent wires was measured corresponding with each scanning protocol at above same three locations. Subjective assessment of image quality was focused to evaluate the configuration of aortic ostium visualized on VIE images.

Results

Our results showed that the SD was independent of section thickness and pitch value, although thinner section thickness of 0.5 and 1.0 mm produced better image quality with fewer artifacts. The aortic ostium became irregular or distorted when the section thickness increased to 3.0 and 5.0 mm. Radiation dose was inversely proportional to the pitch values.

Conclusion

We recommend a scanning protocol of 1.0 mm and pitch 1.4 with reconstruction interval of 0.5 mm as the optimal one of VIE in post-aortic stent grafting as it allows for generation of acceptable images, with fewer artifacts and less radiation dose.

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References

  1. Cao P, Verzini F, Parlani G, Romano L, De Rango P, Pagliuca V, Iacono G (2004) Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair. J Vasc Surg 40(5): 841–848

    Article  PubMed  Google Scholar 

  2. Prinssen M, Verhoeven EL, Buth J, Cuypers PW, Sambeek MR, Balm R, Buskens E, Grobbee DE, Blankensteijn JD, Dutch Randomized Endovascular Aneurysm Management (DREAM) Trial Group (2004) A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med14 351(16): 1607–1618

    Google Scholar 

  3. Malina M, Brunkall J, Ivancev K, Lindh M, Lindblad B, Risberg B (1997) The effects of endovascular aortic stents placed across the renal arteries. Eur J Vasc Endovasc Surg 13: 207–213

    Article  PubMed  CAS  Google Scholar 

  4. Ferko A, Krajina A, Jon B, Lesko M, Voboril Z, Zizka J, Eliás P (1997) Juxtarenal aortic aneurysm: Endoluminal transfemoral repair. Eur Radiol 7(5): 703–707

    Article  PubMed  CAS  Google Scholar 

  5. Rydberg J, Kopecky KK, Lalka SG, Johnson MS, Dalsing MC, Persohn SA (2001) Stent grafting of abdominal aortic aneurysms: pre-and postoperative evaluation with multislice helical CT. J Comput Assist Tomogr 25(4): 580–586

    Article  PubMed  CAS  Google Scholar 

  6. Armerding MD, Rubin GD, Beaulieu CF, Slonim SM, Olcott EW, Samuels SL, Jorgensen MJ, Semba CP, Jeffrey RB Jr, Dake MD (2000) Aortic aneurysmal disease: assessment of stent-grafted treatment-CT versus conventional angiography. Radiology 215(1): 138–146

    PubMed  CAS  Google Scholar 

  7. Fleischmann D, Rubin GD, Pair DS, Yen SY, Hilfiker PR, Beaulieu CF, Napel S (2000) Stair-step artifacts with single versus multiple detector-row helical CT. Radiology 216(1): 185–196

    PubMed  CAS  Google Scholar 

  8. Sun Z, Winder J, Kelly B, Ellis P, Kennedy P, Hirst D (2004) Diagnostic value of CT virtual intravascular endoscopy in aortic stent-grafting. J Endovas Ther 11(1): 13–25

    Article  Google Scholar 

  9. Sun Z, Winder J, Kelly B, Ellis P, Hirst D (2003) CT virtual intravascular endoscopy of abdominal aortic aneurysms treated with suprarenal endovascular stent grafting. Abdom Imaging 28(4): 580–587

    Article  PubMed  CAS  Google Scholar 

  10. Neri E, Bonanomi C, Vignali R, Cioni R, Ferrari M, Petruzzi P, Bartolozzi C (2000) Spiral CT virtual endoscopy of abdominal arteries: clinical applications. Abdom Imaging 25(1): 59–61

    Article  PubMed  CAS  Google Scholar 

  11. O’Donnell M, Sun Z, Winder J, Lau LL, Ellis PK, Blair PH (2007) Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology. J Vasc Surg 45(4): 694–700

    Article  PubMed  Google Scholar 

  12. Sun Z, O’Donnell M, Winder R, Ellis P, Blair P (2007) Effect of suprarenal fixation of aortic stent grafts on renal ostium: Assessment of morphological changes by virtual intravascular endoscopy. J Endovasc Ther 14(5): 650–660

    Article  PubMed  Google Scholar 

  13. Sun Z, Gallagher E (2004) Multislice CT virtual intravascular endoscopy for abdominal aortic aneurysm stent grafts. J Vasc Interv Radiol 15: 961–970

    PubMed  Google Scholar 

  14. Sun Z, Winder J, Kelly B, Ellis P, Kennedy P, Hirst D (2004) Assessment of VIE image quality using helical CT angiography: in vitro phantom study. Comput Med Imaging Graph 28: 3–12

    Article  PubMed  Google Scholar 

  15. Sun Z, Ferris C (2006) Optimal Scanning protocol of multislice CT virtual intravascular endoscopy in pre-aortic stent grafting: in vitro phantom study. Eur J Radiol 58(2): 310–316

    Article  PubMed  Google Scholar 

  16. Flohr TG, McCollough CH, Bruder H, Petersilka M, Gruber K, Süss C, Grasruck M, Stierstorfer K, Krauss B, Raupach R, Primak AN, Küttner A, Achenbach S, Becker C, Kopp A, Ohnesorge BM (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16(2): 256–268

    Article  PubMed  Google Scholar 

  17. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S (2006) Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control. Eur Radiol 16(12): 2739–2749

    Article  PubMed  Google Scholar 

  18. Luboldt W, Weber R, Seemann M, Desantis M, Reiser M (1999) Influence of helical CT parameters on spatial resolution in CT angiography performed with a subsecond scanner. Invest Radiol 34: 421–426

    Article  PubMed  CAS  Google Scholar 

  19. Wessling J, Fischbach R, Ludwig K, Juergens KU, Schaller S, Fallenberg EM, Lenzen H, Heindel W (2001) Multi-slice CT of abdomen in oncologic patients: influence of table feed and detector configuration on image quality and radiation exposure. Fortschr Roentgenstr 173(4): 373–378

    Article  CAS  Google Scholar 

  20. Maintz D, Fischbach R, Juergens KU, Allkemper T, Wessling J, Heindel W (2001) Multislice CT angiography of the iliac arteries in the presence of various stents: in vitro evaluation of artefacts and lumen visibility. Invest Radiol 36: 699–704

    Article  PubMed  CAS  Google Scholar 

  21. Coles DR, Smail MA, Negus IS, Wilde P, Oberhoff M, Karsch KR, Baumbach A (2006) Comparison of radiation doses from multislice computed tomography coronary angiography and conventional diagnostic angiography. J Am Coll Cardiol 47(9): 1840–1845

    Article  PubMed  Google Scholar 

  22. Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, Kastrati A, Schömig A (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 113(10): 1305–1310

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box, U1987, Perth, Western Australia, 6845, Australia

    Zhonghua Sun

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  1. Zhonghua Sun
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Correspondence to Zhonghua Sun.

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Sun, Z. Multislice CT angiography in post-aortic stent grafting: optimization of scanning protocols for virtual intravascular endoscopy. Int J CARS 3, 19–26 (2008). https://doi.org/10.1007/s11548-008-0201-1

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  • DOI: https://doi.org/10.1007/s11548-008-0201-1

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