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CT evaluation of coronary artery stents with iterative image reconstruction: improvements in image quality and potential for radiation dose reduction

  • Cardiac
  • Published:
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Abstract

Objectives

Comparison of coronary artery stent assessment with cardiac CT angiography (cCTA) using traditional filtered back projection (FBP) and sinogram affirmed iterative reconstruction (SAFIRE), in both full- and half-radiation dose image data.

Methods

Dual-source cCTA studies of 37 implanted stents were reconstructed at full- and half-radiation dose with FBP and SAFIRE. Half-dose data were based on projections from one DSCT detector. In-stent noise, signal-to-noise ratio (SNR), and stent-lumen attenuation increase ratio (SAIR) were measured and image quality graded. Stent volumes were measured to gauge severity of beam hardening artefacts.

Results

Full-dose SAFIRE reconstructions were superior to full-dose FBP vis-à-vis in-stent noise (21.2 ± 6.6 vs. 35.7 ± 17.5; P < 0.05), SNR (22.1 ± 8.6 vs. 14.3 ± 6.7; P < 0.05), SAIR (19.6 ± 17.6 vs. 33.4 ± 20.4%; P < 0.05), and image quality (4.2 ± 0.86 vs. 3.5 ± 1.0; P < 0.05). Stent volumes were lower measured with SAFIRE (119.9 ± 53.7 vs. 129.8 ± 65.0 mm3; P > 0.05). Comparing half-dose SAFIRE with full-dose FBP, in-stent noise (26.7 ± 13.0 vs. 35.7 ± 17.5; P < 0.05) and SNR (18.2 ± 6.9 vs. 14.3 ± 6.7; P < 0.05) improved significantly. SAIR (31.6 ± 24.3 vs. 33.4 ± 20.4%; P > 0.05), stent volume (129.6 ± 57.3 vs. 129.8 ± 65.0 mm3; P > 0.05), and image quality (3.5 ± 1.0 vs. 3.7 ± 1.1; P > 0.05) did not differ. Radiation dose decreased from 8.7 ± 5.2 to 4.3 ± 2.6 mSv.

Conclusions

Iterative reconstruction significantly improves imaging of coronary artery stents by CT compared with FBP, even with half-radiation-dose data.

Key Points

• Computed tomography (CT) is becoming an increasingly important investigation for cardiac problems.

• Iterative CT reconstruction techniques significantly improve coronary artery stent evaluation.

• Iterative reconstruction has the potential to reduce radiation dose requirements.

• Improved stent visualisation detects complications better, further reducing the need for catheterisation.

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Acknowledgements

U.J.S. is a consultant for and receives research support from Bayer-Schering, Bracco, General Electric, Medrad, and Siemens. T.A., S.V., and B.S. are employees of Siemens Healthcare. The other authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Radiology and Radiological Science and Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Ullrich Ebersberger, U. Joseph Schoepf, Philipp Blanke, J. Reid Spears, Garrett W. Rowe, William T. Halligan, Thomas Henzler & Paul Apfaltrer

  2. Department of Cardiology and Intensive Care Medicine, Heart Centre Munich-Bogenhausen, Munich, Germany

    Ullrich Ebersberger & Ellen Hoffmann

  3. Department of Bioimaging and Radiological Sciences, Catholic University of the Sacred Heart, “A. Gemelli” Hospital, Rome, Italy

    Francesco Tricarico

  4. Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany

    Philipp Blanke

  5. Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany

    Thomas Henzler & Paul Apfaltrer

  6. Institute of Clinical Radiology, University of Munich – Grosshadern Campus, Munich, Germany

    Fabian Bamberg

  7. Institute for Cardiovascular Intervention and Imaging, Schulich Heart Center, Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada

    Alexander W. Leber

  8. Heart and Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA

    U. Joseph Schoepf

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  1. Ullrich Ebersberger
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  2. Francesco Tricarico
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  3. U. Joseph Schoepf
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  4. Philipp Blanke
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  5. J. Reid Spears
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  6. Garrett W. Rowe
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  7. William T. Halligan
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  8. Thomas Henzler
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  9. Fabian Bamberg
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  10. Alexander W. Leber
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  11. Ellen Hoffmann
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  12. Paul Apfaltrer
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Correspondence to U. Joseph Schoepf.

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Ebersberger, U., Tricarico, F., Schoepf, U.J. et al. CT evaluation of coronary artery stents with iterative image reconstruction: improvements in image quality and potential for radiation dose reduction. Eur Radiol 23, 125–132 (2013). https://doi.org/10.1007/s00330-012-2580-5

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  • DOI: https://doi.org/10.1007/s00330-012-2580-5

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