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Qin L, Zhou S, Dong H, Li J, Zhang R, Yang C, Liu P, Xu Z, Yan F, Yang W. Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT. Eur Radiol 2024:10.1007/s00330-024-10760-1. [PMID: 38676731 DOI: 10.1007/s00330-024-10760-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/27/2024] [Accepted: 04/07/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVES This study aimed to compare the image quality and diagnostic performance of standard-resolution (SR) and ultra-high-resolution (UHR) coronary CT angiography (CCTA) based on photon-counting detector CT (PCD-CT) of coronary stents and explore the best reconstruction kernel for stent imaging. METHODS From July 2023 to September 2023, patients were enrolled to undergo CCTA using a dual-source PCD-CT system after coronary angioplasty with stent placement. SR images with a slice thickness/increment of 0.6/0.4 mm were reconstructed using a vascular kernel (Bv48), while UHR images with a slice thickness/increment of 0.2/0.2 mm were reconstructed using vascular kernels of six sharpness levels (Bv48, Bv56, Bv60, Bv64, Bv72, and Bv76). The in-stent lumen diameters were evaluated. Subjective image quality was also evaluated by a 5-point Likert scale. Invasive coronary angiography was conducted in 12 patients (25 stents). RESULTS Sixty-nine patients (68.0 [61.0, 73.0] years, 46 males) with 131 stents were included. All UHR images had significantly larger in-stent lumen diameter than SR images (p < 0.001). Specifically, UHR-Bv72 and UHR-Bv76 for in-stent lumen diameter (2.17 [1.93, 2.63] mm versus 2.20 [1.93, 2.59] mm) ranked the two best kernels. The subjective analysis demonstrated that UHR-Bv72 images had the most pronounced effect on reducing blooming artifacts, showcasing in-stent lumen and stent demonstration, and diagnostic confidence (p < 0.001). Furthermore, SR and UHR-Bv72 images showed a diagnostic accuracy of 78.3% (95% confidence interval [CI]: 56.3%-92.5%) and 88.0% (95%CI: 68.8%-97.5%), respectively. CONCLUSION UHR CCTA by PCD-CT leads to significantly improved visualization and diagnostic performance of coronary stents, and Bv72 is the optimal reconstruction kernel showing the stent struts and in-stent lumen. CLINICAL RELEVANCE STATEMENT The significantly improved visualization of coronary stents using ultra-high resolution CCTA could increase the diagnostic accuracy for in-stent restenosis and avoid unnecessary invasive quantitative coronary angiography, thus changing the clinical management for patients after percutaneous coronary intervention. KEY POINTS Coronary stent imaging is challenging with energy-integrating detector CT due to "blooming artifacts." UHR images using a PCD-CT enhanced coronary stent visualization. UHR coronary stent imaging demonstrated improved diagnostic accuracy in clinical settings.
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Affiliation(s)
- Le Qin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Shanshui Zhou
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, No. 150 Ruijin Er Road, Shanghai, 200025, China
| | - Haipeng Dong
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Jiqiang Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Ruiyan Zhang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Chendie Yang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Peng Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Zhihan Xu
- CT Collaboration, Siemens Healthineers, 399 West Haiyang Road, Shanghai, 200126, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, No. 150 Ruijin Er Road, Shanghai, 200025, China
| | - Wenjie Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
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Kawai H, Motoyama S, Sarai M, Sato Y, Matsuyama T, Matsumoto R, Takahashi H, Katagata A, Kataoka Y, Ida Y, Muramatsu T, Ohno Y, Ozaki Y, Toyama H, Narula J, Izawa H. Coronary computed tomography angiographic detection of in-stent restenosis via deep learning reconstruction: a feasibility study. Eur Radiol 2024; 34:2647-2657. [PMID: 37672056 DOI: 10.1007/s00330-023-10110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES Evaluation of in-stent restenosis (ISR), especially for small stents, remains challenging during computed tomography (CT) angiography. We used deep learning reconstruction to quantify stent strut thickness and lumen vessel diameter at the stent and compared it with values obtained using conventional reconstruction strategies. METHODS We examined 166 stents in 85 consecutive patients who underwent CT and invasive coronary angiography (ICA) within 3 months of each other from 2019-2021 after percutaneous coronary intervention with coronary stent placement. The presence of ISR was defined as percent diameter stenosis ≥ 50% on ICA. We compared a super-resolution deep learning reconstruction, Precise IQ Engine (PIQE), and a model-based iterative reconstruction, Forward projected model-based Iterative Reconstruction SoluTion (FIRST). All images were reconstructed using PIQE and FIRST and assessed by two blinded cardiovascular radiographers. RESULTS PIQE had a larger full width at half maximum of the lumen and smaller strut than FIRST. The image quality score in PIQE was higher than that in FIRST (4.2 ± 1.1 versus 2.7 ± 1.2, p < 0.05). In addition, the specificity and accuracy of ISR detection were better in PIQE than in FIRST (p < 0.05 for both), with particularly pronounced differences for stent diameters < 3.0 mm. CONCLUSION PIQE provides superior image quality and diagnostic accuracy for ISR, even with stents measuring < 3.0 mm in diameter. CLINICAL RELEVANCE STATEMENT With improvements in the diagnostic accuracy of in-stent stenosis, CT angiography could become a gatekeeper for ICA in post-stenting cases, obviating ICA in many patients after recent stenting with infrequent ISR and allowing non-invasive ISR detection in the late phase. KEY POINTS • Despite CT technology advancements, evaluating in-stent stenosis severity, especially in small-diameter stents, remains challenging. • Compared with conventional methods, the Precise IQ Engine uses deep learning to improve spatial resolution. • Improved diagnostic accuracy of CT angiography helps avoid invasive coronary angiography after coronary artery stenting.
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Affiliation(s)
- Hideki Kawai
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Sadako Motoyama
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Masayoshi Sarai
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshihiro Sato
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Takahiro Matsuyama
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
| | - Ryota Matsumoto
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Hiroshi Takahashi
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Akio Katagata
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yumi Kataoka
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yoshihiro Ida
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Takashi Muramatsu
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University, Toyoake, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY, USA
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
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Tsuda N, Mitsui K. [Evaluation of Noise Properties at Nonuniformity Area and Resolution Properties of CT Image Using Iterative Reconstruction Method]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:809-818. [PMID: 35732411 DOI: 10.6009/jjrt.2022-1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study was to investigate the resolution property and the noise properties at the nonuniformity area in the slice plane of iterative reconstruction (IR)-CT image. METHODS CT images of a phantom with nonuniformity areas including multiple contrast (medium, high, and ultra-high contrast) signals were acquired at various scan dose conditions and reconstructed with different iterative intensity levels. The noise properties at the nonuniformity and the uniformity areas were evaluated by measuring normalized noise power spectra (nNPSs) using subtracted images from sequential scanning data under the same scan conditions. We investigated the relationship between the noise properties and the resolution properties evaluated by measuring task transfer function (TTF) using multiple contrast signals before the subtraction. RESULTS There was a correlation between the nNPS at the nonuniformity area and the TTF because the nNPS values at high spatial frequency were increased with superior TTF (higher dose, mild iterative intensity, and higher contrast level). The differences in the high spatial frequency component of the nNPSs among each task were decreased with the inferior TTF tasks. CONCLUSION We conclude that the noise properties in the slice plane at the nonuniformity area and resolution properties of the IR-CT image were correlated similar to image quality properties of the linear imaging system due to the dependence of the nNPSs curve on the TTF value under each task.
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Affiliation(s)
| | - Kota Mitsui
- Division of Radiology, Saga-Ken Medical Centre Koseikan
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Carrabba N, Pontone G, Andreini D, Buffa V, Cademartiri F, Carbone I, Clemente A, Guaricci AI, Guglielmo M, Indolfi C, La Grutta L, Ligabue G, Liguori C, Mercuro G, Mushtaq S, Neglia D, Palmisano A, Sciagrà R, Seitun S, Vignale D, Francone M, Esposito A. Appropriateness criteria for the use of cardiac computed tomography, SIC-SIRM part 2: acute chest pain evaluation; stent and coronary artery bypass graft patency evaluation; planning of coronary revascularization and transcatheter valve procedures; cardiomyopathies, electrophysiological applications, cardiac masses, cardio-oncology and pericardial diseases evaluation. J Cardiovasc Med (Hagerstown) 2022; 23:290-303. [PMID: 35486680 DOI: 10.2459/jcm.0000000000001303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the past 20 years, cardiac computed tomography (CCT) has become a pivotal technique for the noninvasive diagnostic workup of coronary and cardiac diseases. Continuous technical and methodological improvements, combined with fast growing scientific evidence, have progressively expanded the clinical role of CCT. Randomized clinical trials documented the value of CCT in increasing the cost-effectiveness of the management of patients with acute chest pain presenting in the emergency department, also during the pandemic. Beyond the evaluation of stents and surgical graft patency, the anatomical and functional coronary imaging have the potential to guide treatment decision-making and planning for complex left main and three-vessel coronary disease. Furthermore, there has been an increasing demand to use CCT for preinterventional planning in minimally invasive procedures, such as transcatheter valve implantation and mitral valve repair. Yet, the use of CCT as a roadmap for tailored electrophysiological procedures has gained increasing importance to assure maximum success. In the meantime, innovations and advanced postprocessing tools have generated new potential applications of CCT from the simple coronary anatomy to the complete assessment of structural, functional and pathophysiological biomarkers of cardiac disease. In this complex and revolutionary scenario, it is urgently needed to provide an updated guide for the appropriate use of CCT in different clinical settings. This manuscript, endorsed by the Italian Society of Cardiology (SIC) and the Italian Society of Medical and Interventional Radiology (SIRM), represents the second of two consensus documents collecting the expert opinion of cardiologists and radiologists about current appropriate use of CCT.
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Affiliation(s)
- Nazario Carrabba
- Department of Cardiothoracovascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence
| | | | - Daniele Andreini
- Centro Cardiologico Monzino IRCCS.,Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Vitaliano Buffa
- Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome
| | | | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, 'Sapienza' University of Rome, Rome
| | - Alberto Clemente
- Department of Radiology, CNR (National Council of Research)/Tuscany Region 'Gabriele Monasterio' Foundation (FTGM), Massa
| | - Andrea Igoren Guaricci
- University Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari
| | | | - Ciro Indolfi
- Department of Medical and Surgical Sciences, Magna Grecia University, Catanzaro
| | - Ludovico La Grutta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties-ProMISE, University of Palermo
| | - Guido Ligabue
- Department of Medical and Surgical Sciences, Modena and Raggio Emilia University.,Radiology Department, AOU of Modena, Modena
| | - Carlo Liguori
- Radiology Unit, Ospedale del Mare -A.S.L Na1- Centro, Naples
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | | | - Danilo Neglia
- Cardiovascular Department, CNR (National Council of Research)/Tuscany Region 'Gabriele Monasterio' Foundation (FTGM), Pisa
| | - Anna Palmisano
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS Ospedale San Raffaele.,Vita-Salute San Raffaele University, Milan
| | - Roberto Sciagrà
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence
| | - Sara Seitun
- Radiology Department, Ospedale Policlinico San Martino, IRCCS Per L'Oncologia e le Neuroscienze, Genoa, Italy
| | - Davide Vignale
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS Ospedale San Raffaele.,Vita-Salute San Raffaele University, Milan
| | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, 'Sapienza' University of Rome, Rome
| | - Antonio Esposito
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS Ospedale San Raffaele.,Vita-Salute San Raffaele University, Milan
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Narula J, Chandrashekhar Y, Ahmadi A, Abbara S, Berman DS, Blankstein R, Leipsic J, Newby D, Nicol ED, Nieman K, Shaw L, Villines TC, Williams M, Hecht HS. SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr 2021; 15:192-217. [PMID: 33303384 PMCID: PMC8713482 DOI: 10.1016/j.jcct.2020.11.001] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Y Chandrashekhar
- University of Minnesota and VA Medical Center, Minneapolis, MN, USA
| | - Amir Ahmadi
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suhny Abbara
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Ron Blankstein
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | | | - David Newby
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - Edward D Nicol
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | | | - Leslee Shaw
- New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Todd C Villines
- University of Virginia Health System, Charlottesville, VA, USA
| | - Michelle Williams
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - Harvey S Hecht
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Tayal U, King L, Schofield R, Castellano I, Stirrup J, Pontana F, Earls J, Nicol E. Image reconstruction in cardiovascular CT: Part 2 - Iterative reconstruction; potential and pitfalls. J Cardiovasc Comput Tomogr 2019; 13:3-10. [PMID: 31014928 DOI: 10.1016/j.jcct.2019.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 12/22/2022]
Abstract
The use of IR in CT previously has been prohibitively complicated and time consuming, however improvements in computer processing power now make it possible on almost all CT scanners. Due to its potential to allow scanning at lower doses, IR has received a lot of attention in the medical literature and has become a successful commercial product. Its use in cardiovascular CT has been driven in part due to concerns about radiation dose and image quality. This manuscript discusses the various vendor permutations of iterative reconstruction (IR) in detail and critically appraises the current clinical research available on the various IR techniques used in cardiovascular CT.
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Affiliation(s)
- U Tayal
- Department of Cardiovascular CT, Royal Brompton Hospital, London, UK.
| | - L King
- Joint Department of Physics, The Royal Marsden, London, UK.
| | - R Schofield
- Department of Cardiovascular CT, Royal Brompton Hospital, London, UK.
| | - I Castellano
- Joint Department of Physics, The Royal Marsden, London, UK.
| | - J Stirrup
- Department of Cardiology, Royal Berkshire Hospital, Reading, UK.
| | - F Pontana
- Department of Cardiovascular Imaging, Lille University Hospital, France.
| | - J Earls
- George Washington University Hospital, Washington DC, USA.
| | - E Nicol
- Department of Cardiovascular CT, Royal Brompton Hospital, London, UK.
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Liu HF, Wang M, Xu YS, Shrestha MK, Lu XR, Lei JQ. Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis. Acta Radiol 2019; 60:149-159. [PMID: 29758995 DOI: 10.1177/0284185118774956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dual-source and 320-row computed tomography angiography (CTA) are increasingly used in diagnosing coronary in-stent restenosis (CISR). PURPOSE We sought to perform this meta-analysis to evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) and 320-row CTA in detecting CISR when compared to invasive coronary angiography. MATERIAL AND METHODS Five scientific databases (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were searched for research studies in which DSCTA and/or 320-row CTA were used as diagnostic tools for CISR, as recently as October 2017. Study inclusion, data extraction, systematic review, pooled meta-analysis, and subgroup analysis were conducted by two researchers independently. RESULTS Thirteen studies with 1384 assessable stents on DSCTA and five studies including 622 assessable stents on 320-row CTA were finally included. The sensitivity, specificity, and area under the curve (AUC) of DSCTA in diagnosing CISR were 0.92 (0.87-0.96), 0.91 (0.87-0.94), and 0.97 (0.95-0.98), respectively, and they were 0.91 (0.82-0.96), 0.95 (0.88-0.98), and 0.96 (0.94-0.97) for 320-row CTA. Subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥ 3 mm compared to stent diameter < 3 mm: 0.98 (0.97-0.99) vs. 0.82 (0.79-0.86) with P < 0.05. CONCLUSION Our meta-analysis indicated both DSCTA and 320-row CTA had high diagnostic accuracy in detecting CISR and may serve as alternatives for further patient evaluation with CISR, especially for stent diameters ≥ 3 mm.
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Affiliation(s)
- Hai Feng Liu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Min Wang
- Department of Anesthesia, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Yong Sheng Xu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Manish Kumar Shrestha
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Xing Ru Lu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Jun Qiang Lei
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
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Barrera CA, Otero HJ, White AM, Saul D, Biko DM. Image quality and radiation dose of ECG-triggered High-Pitch Dual-Source cardiac computed tomography angiography in children for the evaluation of central vascular stents. Int J Cardiovasc Imaging 2019; 35:367-374. [PMID: 30684082 DOI: 10.1007/s10554-019-01539-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 01/17/2019] [Indexed: 11/28/2022]
Abstract
Assess image quality and radiation dose of ECG-triggered High-Pitch Dual-Source CTA for the evaluation central vascular stents in children. We included all children ≤ 21 years old with one or more central vascular stents and available prospective ECG-triggered High-Pitch Dual-Source CTA performed at our institution between January 2015 and August 2017. Demographic and scanner information was retrieved. Two board-certified pediatric radiologists blinded to the clinical data, independently reviewed and scored each case using a four-point quality score. Scores 1, 2 and 3 were considered of diagnostic image quality. Inter-observer agreement and non-parametric test were used. 18 patients (10 girls, 8 boys) with a mean age of 9.47 ± 7.38 years (mean ± SD) met inclusion criteria. Thirty-two central vascular stents were evaluated. Mean quality score was 2.07 ± 0.94 with 12.5% (4/32) of the cases classified as unevaluable. Interobserver agreement was excellent (k = 0.86). There is no significant difference between quality score and stent location (p = 0.07). There is a significant difference with stent material as all non-diagnostic scores were only seen in covered stents made of platinum-iridium (p < 0.001). There was no association between image quality and age, height, weight, BSA, heart rate, radiation dose or stent lumen size (p > 0.05). ECG-triggered high-pitch spiral DS-CTA offers appropriate image quality for assessment of central vascular stents in children.
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Affiliation(s)
- Christian A Barrera
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ammie M White
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - David Saul
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Eckert J, Renczes-Janetzko P, Schmidt M, Magedanz A, Voigtländer T, Schmermund A. Coronary CT angiography (CCTA) using third-generation dual-source CT for ruling out in-stent restenosis. Clin Res Cardiol 2018; 108:402-410. [DOI: 10.1007/s00392-018-1369-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/03/2018] [Indexed: 12/21/2022]
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10
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Yan C, Xu J, Liang C, Wei Q, Wu Y, Xiong W, Zheng H, Xu Y. Radiation Dose Reduction by Using CT with Iterative Model Reconstruction in Patients with Pulmonary Invasive Fungal Infection. Radiology 2018; 288:285-292. [DOI: 10.1148/radiol.2018172107] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Chenggong Yan
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Jun Xu
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Chunyi Liang
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Qi Wei
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Yuankui Wu
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Wei Xiong
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Huan Zheng
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
| | - Yikai Xu
- From the Department of Medical Imaging Center (C.Y., C.L., Y.W., W.X., H.Z., Y.X.) and Department of Hematology (J.X., Q.W.), Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong, People’s Republic of China
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Cardiac CT: Technological Advances in Hardware, Software, and Machine Learning Applications. CURRENT CARDIOVASCULAR IMAGING REPORTS 2018; 11. [PMID: 31656551 DOI: 10.1007/s12410-018-9459-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose of Review Multidetector row computed tomography (CT) allows noninvasive imaging of the heart and coronary arteries. The purpose of this review is to briefly summarize recent advances in CT hardware and software technology, and machine learning applications for cardiovascular imaging. Recent Findings In the last decades, there have been significant improvements in CT hardware focusing on faster gantry rotation resulting in improved temporal resolution. Concurrent hardware improvements include improved spatial resolution and higher coverage of the patient, enabling faster acquisition. Advances in cardiac CT software include methods for measurement of noninvasive FFR, coronary plaque characterization, and adipose tissue characteristics around the heart. Machine learning approaches using cardiac CT have been shown to improve both risk of prognosis and lesion-specific ischemia. Summary Recent advances in CT hardware and software have expanded the clinical utility of CT for cardiovascular imaging. In the next decades, continued advances can be anticipated in these areas, and in machine learning applications in cardiac CT, as they are incorporated into clinical routine for image acquisition, image analysis, and prediction of patient outcomes.
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Liu WJ, Li GZ, Liu HF, Lei JQ. Diagnostic accuracy of dual-source computed tomography angiography for the detection of coronary in-stent restenosis: A systematic review and meta-analysis. Echocardiography 2018; 35:541-550. [PMID: 29569751 DOI: 10.1111/echo.13863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We sought to perform a meta-analysis to comprehensively evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) in detecting coronary in-stent restenosis (CISR) when compared to invasive coronary angiography. The stent-based research studies in which DSCTA was used as diagnostic tool for CISR, as recent as of October 2017, from several reputed scientific libraries (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were evaluated. Study inclusion, data extraction, and risk bias assessment were conducted by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under summary receiver operator characteristics (SROC) curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were also carried out. A total of 13 studies with a total of 894 patients and 1384 assessable stents were included. The pooled results of DSCTA diagnosing CISR were as follows: SEN 0.92 (95% confidence interval [CI] 0.87-0.96), SPE 0.91 (95% CI 0.87-0.94), PLR 9.83 (95% CI 6.93-13.94), NLR 0.09 (95% CI 0.05-0.15), DOR 114.73 (95% CI 64.12-205.28), and AUC 0.97 (95% CI 0.95-0.98), respectively. The subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥3 mm compared with the stent diameter <3 mm: (0.98 [0.97-0.99] vs 0.82 [0.79-0.86]) with P < .05. This study revealed that DSCTA has excellent diagnostic performance for detecting CISR and may serve as an alternative for further patient evaluation with CISR, especially for stent diameter ≥3 mm.
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Affiliation(s)
- Wen-Jun Liu
- Department of Radiology, Qingyang City Hospital of Traditional Chinese Medcine, Qingyang, Gansu, China
| | - Gui-Zhen Li
- Department of Radiology, Qingyang City Hospital of Traditional Chinese Medcine, Qingyang, Gansu, China
| | - Hai-Feng Liu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, China
| | - Jun-Qiang Lei
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, China
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Fahlenkamp UL, Diaz Ramirez I, Wagner M, Schwenke C, Huppertz A, Hamm B, Lembcke A. Image quality of low-radiation dose left atrial CT using filtered back projection and an iterative reconstruction algorithm: intra-individual comparison in unselected patients undergoing pulmonary vein isolation. Acta Radiol 2018; 59:161-169. [PMID: 28513211 DOI: 10.1177/0284185117708472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Computed tomography (CT) of the left atrium (LA) is performed prior to pulmonary vein isolation (PVI) to improve success of circumferential ablation for atrial fibrillation. The ablation procedure itself exposes patients to substantial radiation doses, therefore radiation dose reduction in pre-ablational imaging is of concern. Purpose To assess and compare diagnostic performance of low-radiation dose preprocedural CT in patients scheduled for PVI using two types of reconstruction algorithms. Material and Methods Forty-six patients (61 ± 10 years) scheduled for PVI were enrolled in this study irrespective of body-mass-index or cardiac rhythm at examination. An electrocardiographically triggered dual-source CT scan was performed. Filtered back projection (FBP) and iterative reconstruction (IR) algorithms were applied. Images were integrated into an electroanatomic mapping (EAM) system. Subjective image quality was scored independently by two readers on a five-point scale for both reconstruction algorithms (1 = excellent to 5 = non-diagnostic). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and effective radiation dose were calculated. Results Data acquisition and EAM integration were successful in all patients. Median image quality score was 1 for both FBP (quartiles = 1, 1.62; range = 1-3) and IR (quartiles = 1, 1.5; range = 1-3). Mean SNR was 7.61 ± 2.14 for FBP and 9.02 ± 2.69 for IR. Mean CNR was 5.92 ± 1.80 for FBP and 6.95 ± 2.29 for IR. Mean effective radiation dose was 0.3 ± 0.1 mSv. Conclusion At a radiation dose of 0.3 ± 0.1 mSv, high-pitch dual-source CT yields LA images of consistently high quality using both FBP and IR. IR raises SNR and CNR without significantly improving subjective image quality.
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Affiliation(s)
- Ute Lina Fahlenkamp
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Ivan Diaz Ramirez
- Department of Cardiology, Charité – Universitätsmedizin, Berlin, Germany
| | - Moritz Wagner
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Alexander Huppertz
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Present address: Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Bernd Hamm
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Lembcke
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Dai T, Wang JR, Hu PF. Diagnostic performance of computed tomography angiography in the detection of coronary artery in-stent restenosis: evidence from an updated meta-analysis. Eur Radiol 2017; 28:1373-1382. [DOI: 10.1007/s00330-017-5097-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/10/2017] [Accepted: 09/25/2017] [Indexed: 11/29/2022]
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15
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Zhang H, Ma Y, Lyu J, Yang Y, Yuan W, Song Z. Low kV and Low Concentration Contrast Agent with Iterative Reconstruction of Computed Tomography (CT) Coronary Angiography: A Preliminary Study. Med Sci Monit 2017; 23:5005-5010. [PMID: 29051477 PMCID: PMC5661743 DOI: 10.12659/msm.904251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to evaluate the image quality and radiation dose of CT coronary angiography (CTCA) with low kV, low concentration contrast agent, and iterative reconstruction. Material/Methods Ninety cases were randomly divided into 3 groups according to contrast agent concentration: group A 270 mg/ml (100 kV), group B 350 mg/ml (120 kV), and group C 370 mg/ml (120 kV), with 30 cases per group. Tube current was 200–250 mAs. Collimator width was 128×0.6 mm. Rotation speed was 0.27 s. The CT value of the left and right coronary arteries and the ascending aortic root was measured. The SNR and CNR of the images were calculated to evaluate the image quality objectively. The CTDI, DLP, and contrast injection were recorded. Results There were no significant differences in sex, age, weight, height, and BMI among the 3 groups. There was no statistically significant difference between left and right coronary artery and ascending aortic root CT value, background noise, SNR, and CNR. Compared to B and C, the ED in group A decreased by about 27.58% and 28.21%, respectively. The total amount of iodine in group A was decreased by about 21.27% and 24.83%, respectively compared with groups B and C. Conclusions Low kV and low concentration contrast agent combined with iterative reconstruction for CTCA imaging produced image quality consistent with that of conventional CTCA and significantly reduced the dosage of the radiation and injected iodine.
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Affiliation(s)
- Hong Zhang
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China (mainland)
| | - Yanhe Ma
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China (mainland)
| | - Jun Lyu
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China (mainland)
| | - Yapeng Yang
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China (mainland)
| | - Wei Yuan
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China (mainland)
| | - Zhenchun Song
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China (mainland)
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Halliburton SS, Tanabe Y, Partovi S, Rajiah P. The role of advanced reconstruction algorithms in cardiac CT. Cardiovasc Diagn Ther 2017; 7:527-538. [PMID: 29255694 DOI: 10.21037/cdt.2017.08.12] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Non-linear iterative reconstruction (IR) algorithms have been increasingly incorporated into clinical cardiac CT protocols at institutions around the world. Multiple IR algorithms are available commercially from various vendors. IR algorithms decrease image noise and are primarily used to enable lower radiation dose protocols. IR can also be used to improve image quality for imaging of obese patients, coronary atherosclerotic plaques, coronary stents, and myocardial perfusion. In this article, we will review the various applications of IR algorithms in cardiac imaging and evaluate how they have changed practice.
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Affiliation(s)
| | - Yuki Tanabe
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA
| | - Sasan Partovi
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Prabhakar Rajiah
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA
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Iterative reconstruction improves detection of in-stent restenosis by high-pitch dual-source coronary CT angiography. Sci Rep 2017; 7:6956. [PMID: 28761180 PMCID: PMC5537291 DOI: 10.1038/s41598-017-07499-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/27/2017] [Indexed: 01/13/2023] Open
Abstract
Recent studies demonstrated that sinogram affirmed iterative reconstructions (SAFIRE) can produce higher-resolution images with greater robustness for the reduction of various imaging artefacts. Eighty-five patients were prospectively evaluated and underwent a high-pitch spiral acquisition CT scan. In-stent noise, signal-to-noise ratio(SNR), stent-lumen attenuation increase ratio (SAIR), and subjective image quality score were measured and compared between the SAFIRE and Filter back projection (FBP) reconstructions. Conventional coronary angiography served as the standard of reference. In 159 evaluated stents, SAFIRE was superior to FBP with regards to in-stent noise, SNR, SAIR, and image quality score. On per-stent analysis, SAFIRE vs. FBP reconstruction yielded 85% vs. 85%sensitivity, 89% vs. 78%specificity, 73% vs. 57%positive predictive value, 95% vs. 94%negative predictive value, and 0.87 vs. 0.82 area under curve, although these improvements did not reach statistical significance (P > 0.05). However, in the subgroup of small diameter stents (≤3 mm; n = 95), specificity(82% vs. 62%), positive predictive value(66% vs. 50%) and area under curve (0.81 vs. 0.70) improved significantly (P < 0.05) with SAFIRE. SAFIRE image reconstruction can thus improve the evaluation for ISR, especially in smaller stents.
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18
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Chen GZ, Fang XK, Zhou CS, Zhang LJ, Lu GM. Cerebral CT angiography with iterative reconstruction at 70 kVp and 30 mL iodinated contrast agent: Initial experience. Eur J Radiol 2017; 88:102-108. [DOI: 10.1016/j.ejrad.2016.12.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 11/10/2016] [Accepted: 12/30/2016] [Indexed: 01/07/2023]
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Gassenmaier T, Petri N, Allmendinger T, Flohr T, Weng AM, Kunz AS, Petritsch B, Voelker W, Bley TA. In Vitro Comparison of Second- and Third-generation Dual-source CT for Coronary Stent Visualization at Different Tube Potentials. Acad Radiol 2016; 23:961-8. [PMID: 27236611 DOI: 10.1016/j.acra.2016.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 11/14/2015] [Accepted: 03/14/2016] [Indexed: 12/22/2022]
Abstract
RATIONALE AND OBJECTIVES The study aimed to evaluate in vitro stent lumen visibility of coronary stents in a second- and third-generation dual-source computed tomography (CT) system at 100 and 120 kVp tube potential. MATERIALS AND METHODS Twenty-six coronary stents ranging from 2.25 to 4.0 mm in diameter were implanted in a coronary vessel phantom. Scans were performed at 100 and 120 kVp tube potential. Evaluation was performed using a medium-sharp kernel in both systems (B46f in the second-generation and Bv49 in the third-generation model) and a sharp (Bv59) convolution kernel optimized for vascular imaging in the third-generation CT. RESULTS The median visible stent lumen diameter in the second-generation system was higher at 120 kVp with a median of 62.0% compared to 56.3% at 100 kVp (P < 0.001). The median visible diameter in the third-generation system was significantly higher applying the Bv49 kernel with 66.7% at 120 kVp and 61.1% at 100 kVp (both P < 0.001). When applying the Bv59 kernel, visible stent lumen further increased to 69.3% at 120 kVp and 66.7% at 100 kVp. Additionally, stent lumen was assessed using full width at half maximum, resulting in a comparable increase in luminal diameter at corresponding tube potential. CONCLUSIONS Third-generation dual-source CT provides superior stent lumen visibility at equivalent tube potential and at reduced tube potential of 100 kVp when compared to 120 kVp in a second-generation system, at least when manually assessed.
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Affiliation(s)
- Tobias Gassenmaier
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany.
| | - Nils Petri
- Department of Internal Medicine I, University Hospital of Würzburg, Würzburg, Germany
| | | | | | - Andreas M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Andreas S Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Bernhard Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Wolfram Voelker
- Department of Internal Medicine I, University Hospital of Würzburg, Würzburg, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
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20
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Tan S, Soulez G, Diez Martinez P, Larrivée S, Stevens LM, Goussard Y, Mansour S, Chartrand-Lefebvre C. Coronary Stent Artifact Reduction with an Edge-Enhancing Reconstruction Kernel - A Prospective Cross-Sectional Study with 256-Slice CT. PLoS One 2016; 11:e0154292. [PMID: 27128507 PMCID: PMC4851391 DOI: 10.1371/journal.pone.0154292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/12/2016] [Indexed: 11/23/2022] Open
Abstract
Purpose Metallic artifacts can result in an artificial thickening of the coronary stent wall which can significantly impair computed tomography (CT) imaging in patients with coronary stents. The objective of this study is to assess in vivo visualization of coronary stent wall and lumen with an edge-enhancing CT reconstruction kernel, as compared to a standard kernel. Methods This is a prospective cross-sectional study involving the assessment of 71 coronary stents (24 patients), with blinded observers. After 256-slice CT angiography, image reconstruction was done with medium-smooth and edge-enhancing kernels. Stent wall thickness was measured with both orthogonal and circumference methods, averaging thickness from diameter and circumference measurements, respectively. Image quality was assessed quantitatively using objective parameters (noise, signal to noise (SNR) and contrast to noise (CNR) ratios), as well as visually using a 5-point Likert scale. Results Stent wall thickness was decreased with the edge-enhancing kernel in comparison to the standard kernel, either with the orthogonal (0.97 ± 0.02 versus 1.09 ± 0.03 mm, respectively; p<0.001) or the circumference method (1.13 ± 0.02 versus 1.21 ± 0.02 mm, respectively; p = 0.001). The edge-enhancing kernel generated less overestimation from nominal thickness compared to the standard kernel, both with the orthogonal (0.89 ± 0.19 versus 1.00 ± 0.26 mm, respectively; p<0.001) and the circumference (1.06 ± 0.26 versus 1.13 ± 0.31 mm, respectively; p = 0.005) methods. The edge-enhancing kernel was associated with lower SNR and CNR, as well as higher background noise (all p < 0.001), in comparison to the medium-smooth kernel. Stent visual scores were higher with the edge-enhancing kernel (p<0.001). Conclusion In vivo 256-slice CT assessment of coronary stents shows that the edge-enhancing CT reconstruction kernel generates thinner stent walls, less overestimation from nominal thickness, and better image quality scores than the standard kernel.
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Affiliation(s)
- Stéphanie Tan
- Radiology, University of Montreal Medical Center (CHUM), Montreal, Canada
| | - Gilles Soulez
- Radiology, University of Montreal Medical Center (CHUM), Montreal, Canada
- University of Montreal Medical Center Research Center, Montreal, Canada
| | | | - Sandra Larrivée
- University of Montreal Medical Center Research Center, Montreal, Canada
- Biostatistics, Pennington Biomedical Research Center, Bâton Rouge, Louisiana, United States of America
| | - Louis-Mathieu Stevens
- University of Montreal Medical Center Research Center, Montreal, Canada
- Cardiac Surgery, University of Montreal Medical Center (CHUM), Montreal, Canada
| | - Yves Goussard
- Electrical Engineering, Ecole Polytechnique de Montréal, Montreal, Canada
| | - Samer Mansour
- University of Montreal Medical Center Research Center, Montreal, Canada
- Cardiology, University of Montreal Medical Center (CHUM), Montreal, Canada
| | - Carl Chartrand-Lefebvre
- Radiology, University of Montreal Medical Center (CHUM), Montreal, Canada
- University of Montreal Medical Center Research Center, Montreal, Canada
- * E-mail:
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Mangold S, De Cecco CN, Schoepf UJ, Yamada RT, Varga-Szemes A, Stubenrauch AC, Caruso D, Fuller SR, Vogl TJ, Nikolaou K, Todoran TM, Wichmann JL. A noise-optimized virtual monochromatic reconstruction algorithm improves stent visualization and diagnostic accuracy for detection of in-stent re-stenosis in lower extremity run-off CT angiography. Eur Radiol 2016; 26:4380-4389. [DOI: 10.1007/s00330-016-4304-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/14/2015] [Accepted: 02/23/2016] [Indexed: 11/30/2022]
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Armstrong I, Trevor M, Widdowfield M. Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Iterative Reconstruction Leads to Increased Subjective and Objective Image Quality in Cranial CT in Patients With Stroke. AJR Am J Roentgenol 2015; 205:618-22. [PMID: 26295650 DOI: 10.2214/ajr.15.14389] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether iterative reconstruction improves the quality of cranial CT (CCT) images of stroke patients. MATERIALS AND METHODS Fifty-one CCT studies of patients with infarction performed with either a low (260 mAs; n = 21) or standard (340 mAs; n = 30) dose were reconstructed with both filtered back projection (FBP) and sinogram-affirmed iterative reconstruction (SAFIRE) with five strength levels (S1-S5). The resulting six image sets (one FBP and one each for SAFIRE levels S1-S5) were rated separately by two blinded radiologists in terms of conspicuity of infarcted areas on a 5-point scale. Noise and infarct-to-normal brain as well as medullary-to-cortical contrast-to-noise ratios (CNRs) were measured. Ratings, noise, and CNRs were intraindividually compared within the same dose group (Fisher exact test) and interindividually between the different dose groups (Wilcoxon-Mann-Whitney U test). RESULTS The strength level S4 showed the best conspicuity of infarcted areas. Compared with FBP, SAFIRE S4 statistically significantly (p < 0.01) reduced noise and improved CNRs without statistically significant differences in all subjective and objective criteria (p > 0.01) when the dose was reduced. Patients examined with a 260-mAs low-dose were exposed to a statistically significantly lower dose (1.77 vs 2.33 mSv; p < 0.01). CONCLUSION Iterative reconstruction (SAFIRE at strength level S4) leads to increased subjective and objective image quality in CCT and allows dose reduction (-24%) without losses in the demarcation of ischemic lesions.
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Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT). J Cardiovasc Comput Tomogr 2015; 9:475-92. [DOI: 10.1016/j.jcct.2015.07.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/17/2015] [Indexed: 12/16/2022]
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Bodelle B, Isler S, Scholtz JE, Frellesen C, Luboldt W, Vogl TJ, Beeres M. Benefits of sinogram-affirmed iterative reconstruction in 0.4 mSv ultra-low-dose CT of the upper abdomen following transarterial chemoembolisation: comparison to low-dose and standard-dose CT and filtered back projection technique. Clin Radiol 2015; 71:e11-5. [PMID: 26521185 DOI: 10.1016/j.crad.2015.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 12/16/2022]
Abstract
AIM To evaluate the advantage of sinogram-affirmed iterative reconstruction (SIR) compared to filtered back projection (FBP) in upper abdomen computed tomography (CT) after transarterial chemoembolisation (TACE) at different tube currents. MATERIALS AND METHODS The study was approved by the institutional review board. Written informed consent was obtained from all patients. Post-TACE CT was performed with different tube currents successively varied in four steps (180, 90, 45 and 23 mAs) with 40 patients per group (mean age: 60±12 years, range: 23-85 years, sex: 70 female, 90 male). The data were reconstructed with standard FBP and five different SIR strengths. Image quality was independently rated by two readers on a five-point scale. High (Lipiodol-to-liver) as well as low (liver-to-fat) contrast-to-noise ratios (CNRs) were intra-individually compared within one dose to determine the optimal strength (S1-S5) and inter-individually between different doses to determine the possibility of dose reduction using the Kruskal-Wallis test. RESULTS Subjective image quality and objective CNR analysis were concordant: intra-individually, SIR was significantly (p<0.001) superior to FBP. Inter-individually, regarding different doses (180 versus 23 ref mAs), there was no significant (p=1.00) difference when using S5 SIR at 23 mAs instead of FBP. CONCLUSION SIR allows for an 88% dose reduction from 3.43 to 0.4 mSv in unenhanced CT of the liver following TACE without subjective or objective loss in image quality.
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Affiliation(s)
- B Bodelle
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
| | - S Isler
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - J-E Scholtz
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - C Frellesen
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - W Luboldt
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - T J Vogl
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - M Beeres
- Department of Diagnostic and Interventional Radiology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
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Impact of an advanced image-based monoenergetic reconstruction algorithm on coronary stent visualization using third generation dual-source dual-energy CT: a phantom study. Eur Radiol 2015; 26:1871-8. [PMID: 26373752 DOI: 10.1007/s00330-015-3997-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/18/2015] [Accepted: 09/01/2015] [Indexed: 01/08/2023]
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.
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Geyer LL, Schoepf UJ, Meinel FG, Nance JW, Bastarrika G, Leipsic JA, Paul NS, Rengo M, Laghi A, De Cecco CN. State of the Art: Iterative CT Reconstruction Techniques. Radiology 2015. [PMID: 26203706 DOI: 10.1148/radiol.2015132766] [Citation(s) in RCA: 395] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Lucas L Geyer
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - U Joseph Schoepf
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Felix G Meinel
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - John W Nance
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Gorka Bastarrika
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Jonathon A Leipsic
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Narinder S Paul
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Marco Rengo
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Andrea Laghi
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
| | - Carlo N De Cecco
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC 29425 (L.L.G., U.J.S., F.G.M., J.W.N., C.N.D.); Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada (G.B.); Department of Radiology, University of British Columbia, Vancouver, BC, Canada (J.A.L.); Department of Radiology, Toronto General Hospital, University of Toronto, Toronto, Ont, Canada (N.S.P.); and Department of Radiological Sciences, Oncology and Pathology, University of Rome Sapienza-Polo Pontino, Latina, Italy (M.R., A.L., C.N.D.)
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Zhu X, Shi Z, Zhu Y, Liu W, Yang G, Yu T, Tang L, Xu Y. Individually adapted tube current selection and contrast medium injection protocol of coronary CT angiography based on test bolus parameters: a feasibility study. Acta Radiol 2015; 56:666-72. [PMID: 24938658 DOI: 10.1177/0284185114536156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/28/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Test bolus is mostly used to determine the starting point of a full cardiac scanning with respect to injection of a larger bolus of contrast material. So far there are limited data demonstrating the feasibility of using information obtained from a test bolus to adjust contrast delivery protocols and tube current individually during coronary computed tomography angiography (CCTA). PURPOSE To evaluate the feasibility of individually adapted tube current selection and contrast injection protocols of CCTA based on test bolus parameters. MATERIAL AND METHODS Test bolus followed by CCTA was performed in 93 patients at 100 kV and in 81 patients at 120 kV, respectively. Simulated attenuation of the descending aorta (SimDA) of CCTA was calculated at a fixed contrast injection rate of 4 mL/s. Univariate and multivariate comparisons were performed to identify associations of SimDA and image noise of CCTA (NoiseCCTA) with test bolus information and patient-related factors including body weight (BW), body mass index (BMI), and body surface area (BSA). RESULTS Compared with BW, BMI, and BSA, SimDA was more closely related to the peak time of left ventricle and peak enhancement of right ventricle obtained from test bolus (r = 0.495 and r = 0.642 for 100 and 120 kV protocol, respectively). Similarly, NoiseTB was much more closely related to NoiseCCTA (r = 0.740 and r = 0.630 for 100 and 120 kV protocol, respectively) when compared with BW, BMI, and BSA. CONCLUSION It is feasible to individually adapt tube current and contrast injection protocol of CCTA based on the information of test bolus.
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Affiliation(s)
- Xiaomei Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Zhaofei Shi
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Yinsu Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Wangyan Liu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Guanyu Yang
- Laboratory of Image Science & Technology, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu, PR China
| | - Tongfu Yu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Lijun Tang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Yi Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
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Lee JW, Kim CW, Lee HC, Wu MT, Hwangbo L, Choo KS, Kim JH, Lee KN, Kim JY, Jeong YJ. High-definition computed tomography for coronary artery stents: image quality and radiation doses for low voltage (100 kVp) and standard voltage (120 kVp) ECG-triggered scanning. Int J Cardiovasc Imaging 2015; 31 Suppl 1:39-49. [DOI: 10.1007/s10554-015-0686-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/21/2015] [Indexed: 01/29/2023]
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Zhao L, Plank F, Kummann M, Burghard P, Klauser A, Dichtl W, Feuchtner G. Improved non-calcified plaque delineation on coronary CT angiography by sonogram-affirmed iterative reconstruction with different filter strength and relationship with BMI. Cardiovasc Diagn Ther 2015; 5:104-12. [PMID: 25984450 DOI: 10.3978/j.issn.2223-3652.2015.03.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 03/13/2015] [Indexed: 01/25/2023]
Abstract
PURPOSE To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP). METHODS A total of 57 patients [28.1% females; body mass index (BMI) 29.2±6.5 kg/m(2)] were investigated. CCTA was performed using 128-slice dual-source CT. Images were reconstructed with standard FBP and sinogram-affirmed IR using different filter strength (IR-2, IR-3, IR-4) (SAFIRE, Siemens, Germany). Image quality of CCTA and a non-calcified plaque outer border delineation score were evaluated by using a 5-scale score: from 1= poor to 5= excellent. Image noise, contrast-to-noise ratio (CNR) of aortic root, left main (LM) and right coronary artery, and the non-calcified plaque delineation were quantified and compared among the 4 image reconstructions, and were compared between different BMI groups (BMI <28 and ≥28). Statistical analyses included one-way analysis of variance (ANOVA), least significant difference (LSD) and Kruskal-Wallis test. RESULTS There were 71.9% patients in FBP, 96.5% in IR-2, 96.5% in IR-3 and 98.2% in IR-4 who had overall CCTA image quality ≥3, and there were statistical differences in CCTA exam image quality score among those groups, respectively (P<0.001). Sixty-one non-calcified plaques were detected by IR-2 to IR-4, out of those 11 (18%) were missed by FBP. Plaque delineation score increased constantly from FBP (2.7±0.4) to IR-2 (3.2±0.3), to IR-3 (3.5±0.3) up to IR-4 (4.0±0.4), while CNRs of the non-calcifying plaque increased and image noise decreased, respectively. Similarly, CNR of aortic root, LM and right coronary artery improved and image noise declined from FBP to IR-2, IR-3 and IR-4. There were no significant differences of image quality and plaque delineation score between low and high BMI groups within same reconstruction (all P>0.05). Significant differences in image quality and plaque delineation scores among different image reconstructions both in low and high BMI groups (all P<0.001) were found. I4f revealed the highest image quality and plaque delineation score. CONCLUSIONS IR offers improved image quality and non-calcified plaque delineation as compared with FBP, especially if BMI is increasing. Importantly, 18% of non-calcified plaques were missed with FBP. IR-4 shows the best image quality score and plaque delineation score among the different IR-filter strength.
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Affiliation(s)
- Lei Zhao
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
| | - Fabian Plank
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
| | - Moritz Kummann
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
| | - Philipp Burghard
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
| | - Andrea Klauser
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
| | - Wolfgang Dichtl
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
| | - Gudrun Feuchtner
- 1 Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Chaoyang District, Beijing 100029, China ; 2 Innsbruck Medical University, Department of Radiology, 3 Innsbruck Medical University, Department of Cardiology, Innrain 52, Christoph-Probst-Platz, 6020 Innsbruck, Tyrol, Austria
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The Impact of Different Levels of Adaptive Iterative Dose Reduction 3D on Image Quality of 320-Row Coronary CT Angiography: A Clinical Trial. PLoS One 2015; 10:e0125943. [PMID: 25945924 PMCID: PMC4422621 DOI: 10.1371/journal.pone.0125943] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 03/22/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was the systematic image quality evaluation of coronary CT angiography (CTA), reconstructed with the 3 different levels of adaptive iterative dose reduction (AIDR 3D) and compared to filtered back projection (FBP) with quantum denoising software (QDS). Methods Standard-dose CTA raw data of 30 patients with mean radiation dose of 3.2 ± 2.6 mSv were reconstructed using AIDR 3D mild, standard, strong and compared to FBP/QDS. Objective image quality comparison (signal, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contour sharpness) was performed using 21 measurement points per patient, including measurements in each coronary artery from proximal to distal. Results Objective image quality parameters improved with increasing levels of AIDR 3D. Noise was lowest in AIDR 3D strong (p≤0.001 at 20/21 measurement points; compared with FBP/QDS). Signal and contour sharpness analysis showed no significant difference between the reconstruction algorithms for most measurement points. Best coronary SNR and CNR were achieved with AIDR 3D strong. No loss of SNR or CNR in distal segments was seen with AIDR 3D as compared to FBP. Conclusions On standard-dose coronary CTA images, AIDR 3D strong showed higher objective image quality than FBP/QDS without reducing contour sharpness. Trial Registration Clinicaltrials.gov NCT00967876
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Iterative reconstruction in cardiac CT. J Cardiovasc Comput Tomogr 2015; 9:255-63. [PMID: 26088375 DOI: 10.1016/j.jcct.2015.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 12/29/2022]
Abstract
Iterative reconstruction (IR) has the ability to reduce image noise in CT without compromising diagnostic quality, which permits a significant reduction in effective radiation dose. This been increasingly integrated into clinical CT practice over the past 7 years and has been particularly important in the field of cardiac CT with multiple vendors introducing cardiac CT-compatible IR algorithms. The following review will summarize the principles of IR algorithms, studies validating their noise- and dose-reducing abilities, and the specific applications of IR in cardiac CT.
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Harris BS, De Cecco CN, Schoepf UJ, Steinberg DH, Bayer RR, Krazinski AW, Dyer KT, Sandhu MK, Zile MR, Meinel FG. Dual-Source CT Imaging to Plan Transcatheter Aortic Valve Replacement: Accuracy for Diagnosis of Obstructive Coronary Artery Disease. Radiology 2015; 275:80-8. [DOI: 10.1148/radiol.14140763] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nappi C, Acampa W, Pellegrino T, Petretta M, Cuocolo A. Beyond ultrasound: advances in multimodality cardiac imaging. Intern Emerg Med 2015; 10:9-20. [PMID: 25037458 DOI: 10.1007/s11739-014-1106-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 06/27/2014] [Indexed: 11/26/2022]
Abstract
The rapid technological evolution accomplished in noninvasive cardiac imaging techniques over the past few decades has provided physicians with a large armamentarium for the evaluation of patients with known or suspected coronary heart disease. Noninvasive assessment of coronary artery calcium or noninvasive coronary angiography may be performed using computed tomography or magnetic resonance imaging. These techniques evaluate the presence of atherosclerosis rather than ischemia. Conversely, nuclear cardiology is the most widely used noninvasive approach for the assessment of myocardial perfusion and function. These techniques coupled with the development of dedicated image fusion software packages to merge data sets from different modalities have paved the way for hybrid imaging. This article provides a description of the available noninvasive imaging techniques in the assessment of coronary anatomy, myocardial perfusion, and cardiac function in patients with known or suspected coronary heart disease.
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Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
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Cardiac CT and Stent Imaging: Update 2014. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Luo S, Zhang LJ, Meinel FG, Zhou CS, Qi L, McQuiston AD, Schoepf UJ, Lu GM. Low tube voltage and low contrast material volume cerebral CT angiography. Eur Radiol 2014; 24:1677-85. [PMID: 24792591 DOI: 10.1007/s00330-014-3184-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/13/2014] [Accepted: 04/09/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the image quality, radiation dose and diagnostic accuracy of low kVp and low contrast material volume cerebral CT angiography (CTA) in intracranial aneurysm detection. METHODS One hundred twenty patients were randomly divided into three groups (n = 40 for each): Group A, 70 ml iodinated contrast agent/120 kVp; group B, 30 ml/100 kVp; group C, 30 ml/80 kVp. The CT numbers, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the internal carotid artery (ICA) and middle cerebral artery (MCA). Subjective image quality was evaluated. For patients undergoing DSA, diagnostic accuracy of CTA was calculated with DSA as reference standard and compared. RESULTS CT numbers of ICA and MCA were higher in groups B and C than in group A (P < 0.01). SNR and CNR in groups A and B were higher than in group C (both P < 0.05). There was no difference in subjective image quality among the three groups (P = 0.939). Diagnostic accuracy for aneurysm detection among these groups had no statistical difference (P = 1.00). Compared with group A, the radiation dose of groups B and C was decreased by 45% and 74%. CONCLUSION Cerebral CTA at 100 or 80 kVp using 30 ml contrast agent can obtain diagnostic image quality with a low radiation dose while maintaining the same diagnostic accuracy for aneurysm detection. KEY POINTS • Cerebral CTA is feasible using 100/80 kVp and 30 ml contrast agent. • This approach obtains diagnostic image quality with 45-74% radiation dose reduction. • Diagnostic accuracy for intracranial aneurysm detection seems not to be compromised.
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Affiliation(s)
- Song Luo
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
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Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience. Eur Radiol 2014; 24:1537-46. [PMID: 24737530 DOI: 10.1007/s00330-014-3157-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 03/03/2014] [Accepted: 03/19/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate the feasibility, image quality and radiation dose of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) with 30 mL contrast agent at 70 kVp. METHODS Fifty-eight patients with suspected coronary artery disease, a body mass index (BMI) of less than 25 kg/m(2), sinus rhythm and a heart rate (HR) of less than 70 beats per minute (bpm) were prospectively enrolled in this study. Thirty mL of 370 mg I/mL iodinated contrast agent was administrated at a flow rate of 5 mL/s. All patients underwent prospectively ECG-triggered high-pitch CCTA on a second-generation dual-source CT system at 70 kVp using automated tube current modulation. RESULTS Fifty-six patients (96.6%) had diagnostic CCTA images and two patients (3.4%) had one vessel with poor image quality each rated as non-diagnostic. No significant effects of HR, HR variability and BMI on CCTA image quality were observed (all P > 0.05). Effective dose was 0.17 ± 0.02 mSv and the size-specific dose estimate was 1.03 ± 0.13 mGy. CONCLUSION Prospectively ECG-triggered high-pitch CCTA at 70 kVp with 30 mL of contrast agent can provide diagnostic image quality at a radiation dose of less than 0.2 mSv in patients with a BMI of less than 25 kg/m(2) and an HR of less than 70 bpm. KEY POINTS • Prospectively ECG-triggered high-pitch CCTA at 70 kVp/30 mL contrast agent is feasible. • Diagnostic image quality can be obtained at a radiation dose of less than 0.2 mSv. • This protocol is suitable for normal-weight patients with slow heart rate.
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Nance JW, Schoepf UJ, Ebersberger U. The Role of Iterative Reconstruction Techniques in Cardiovascular CT. CURRENT RADIOLOGY REPORTS 2013. [DOI: 10.1007/s40134-013-0023-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wuest W, May MS, Scharf M, Layritz C, Eisentopf J, Ropers D, Pflederer T, Uder M, Achenbach S, Lell MM. Stent evaluation in low-dose coronary CT angiography: Effect of different iterative reconstruction settings. J Cardiovasc Comput Tomogr 2013; 7:319-25. [DOI: 10.1016/j.jcct.2013.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/09/2013] [Accepted: 08/16/2013] [Indexed: 11/30/2022]
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