Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT
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...
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| Veröffentlicht in: | European radiology 2024-04, Vol.34 (10), p.6568-6577 |
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| creator | Qin, Le Zhou, Shanshui Dong, Haipeng Li, Jiqiang Zhang, Ruiyan Yang, Chendie Liu, Peng Xu, Zhihan Yan, Fuhua Yang, Wenjie |
| description | 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
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| doi_str_mv | 10.1007/s00330-024-10760-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3047943020</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3047943020</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-4a9ba9b59bbd56a6af82697c410420aad2835450904548f089e350e8f1265f933</originalsourceid><addsrcrecordid>eNp9kUtLxDAQx4Morq8v4EEKXrxEJ4-m7VEWXyB4Wc8h7aa7XdpkzWNBP71Z6wsPQiCZzG_-k8wfoVMClwSguPIAjAEGyjGBQgAmO-iAcEZTWPLdX-cJOvR-BQAV4cU-mrBSFKJg5AA1D8Pa2Y0etAmZbbPGOmuUe8182N5sOh9V372p0FmTRd-ZRRb74BRedosldtrbPn7k1ksbrMGNjSZsqbkOugnWZdPZMdprVe_1yed-hJ5vb2bTe_z4dPcwvX7EDaMiYK6qOq28qut5LpRQbUlFVTScAKeg1JyWLOc5VMBzXrZQVprloMuWUJG3FWNH6GLUTT96idoHOXS-0X2vjLbRSwa8qDgDCgk9_4OubHQmvU6ybbuCEMETRUeqcdZ7p1u5dt2QpiMJyK0FcrRAJgvkhwWSpKKzT-lYD3r-XfI18wSwEfApZRba_fT-R_Ydp2WRfg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3104271164</pqid></control><display><type>article</type><title>Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT</title><source>SpringerLink Journals - AutoHoldings</source><creator>Qin, Le ; Zhou, Shanshui ; Dong, Haipeng ; Li, Jiqiang ; Zhang, Ruiyan ; Yang, Chendie ; Liu, Peng ; Xu, Zhihan ; Yan, Fuhua ; Yang, Wenjie</creator><creatorcontrib>Qin, Le ; Zhou, Shanshui ; Dong, Haipeng ; Li, Jiqiang ; Zhang, Ruiyan ; Yang, Chendie ; Liu, Peng ; Xu, Zhihan ; Yan, Fuhua ; Yang, Wenjie</creatorcontrib><description>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.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-024-10760-1</identifier><identifier>PMID: 38676731</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Accuracy ; Angiography ; Angioplasty ; Cardiac ; Computed tomography ; Diagnostic Radiology ; Diagnostic systems ; Diameters ; High resolution ; Image quality ; Image reconstruction ; Image resolution ; Imaging ; Implants ; Internal Medicine ; Interventional Radiology ; Medical imaging ; Medicine ; Medicine & Public Health ; Neuroradiology ; Photons ; Radiology ; Restenosis ; Sensors ; Stents ; Struts ; Thickness ; Ultrasound ; Visualization</subject><ispartof>European radiology, 2024-04, Vol.34 (10), p.6568-6577</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-4a9ba9b59bbd56a6af82697c410420aad2835450904548f089e350e8f1265f933</cites><orcidid>0000-0002-3959-5043</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-024-10760-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-024-10760-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27928,27929,41492,42561,51323</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38676731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qin, Le</creatorcontrib><creatorcontrib>Zhou, Shanshui</creatorcontrib><creatorcontrib>Dong, Haipeng</creatorcontrib><creatorcontrib>Li, Jiqiang</creatorcontrib><creatorcontrib>Zhang, Ruiyan</creatorcontrib><creatorcontrib>Yang, Chendie</creatorcontrib><creatorcontrib>Liu, Peng</creatorcontrib><creatorcontrib>Xu, Zhihan</creatorcontrib><creatorcontrib>Yan, Fuhua</creatorcontrib><creatorcontrib>Yang, Wenjie</creatorcontrib><title>Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>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.</description><subject>Accuracy</subject><subject>Angiography</subject><subject>Angioplasty</subject><subject>Cardiac</subject><subject>Computed tomography</subject><subject>Diagnostic Radiology</subject><subject>Diagnostic systems</subject><subject>Diameters</subject><subject>High resolution</subject><subject>Image quality</subject><subject>Image reconstruction</subject><subject>Image resolution</subject><subject>Imaging</subject><subject>Implants</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Photons</subject><subject>Radiology</subject><subject>Restenosis</subject><subject>Sensors</subject><subject>Stents</subject><subject>Struts</subject><subject>Thickness</subject><subject>Ultrasound</subject><subject>Visualization</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kUtLxDAQx4Morq8v4EEKXrxEJ4-m7VEWXyB4Wc8h7aa7XdpkzWNBP71Z6wsPQiCZzG_-k8wfoVMClwSguPIAjAEGyjGBQgAmO-iAcEZTWPLdX-cJOvR-BQAV4cU-mrBSFKJg5AA1D8Pa2Y0etAmZbbPGOmuUe8182N5sOh9V372p0FmTRd-ZRRb74BRedosldtrbPn7k1ksbrMGNjSZsqbkOugnWZdPZMdprVe_1yed-hJ5vb2bTe_z4dPcwvX7EDaMiYK6qOq28qut5LpRQbUlFVTScAKeg1JyWLOc5VMBzXrZQVprloMuWUJG3FWNH6GLUTT96idoHOXS-0X2vjLbRSwa8qDgDCgk9_4OubHQmvU6ybbuCEMETRUeqcdZ7p1u5dt2QpiMJyK0FcrRAJgvkhwWSpKKzT-lYD3r-XfI18wSwEfApZRba_fT-R_Ydp2WRfg</recordid><startdate>20240427</startdate><enddate>20240427</enddate><creator>Qin, Le</creator><creator>Zhou, Shanshui</creator><creator>Dong, Haipeng</creator><creator>Li, Jiqiang</creator><creator>Zhang, Ruiyan</creator><creator>Yang, Chendie</creator><creator>Liu, Peng</creator><creator>Xu, Zhihan</creator><creator>Yan, Fuhua</creator><creator>Yang, Wenjie</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3959-5043</orcidid></search><sort><creationdate>20240427</creationdate><title>Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT</title><author>Qin, Le ; Zhou, Shanshui ; Dong, Haipeng ; Li, Jiqiang ; Zhang, Ruiyan ; Yang, Chendie ; Liu, Peng ; Xu, Zhihan ; Yan, Fuhua ; Yang, Wenjie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-4a9ba9b59bbd56a6af82697c410420aad2835450904548f089e350e8f1265f933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Accuracy</topic><topic>Angiography</topic><topic>Angioplasty</topic><topic>Cardiac</topic><topic>Computed tomography</topic><topic>Diagnostic Radiology</topic><topic>Diagnostic systems</topic><topic>Diameters</topic><topic>High resolution</topic><topic>Image quality</topic><topic>Image reconstruction</topic><topic>Image resolution</topic><topic>Imaging</topic><topic>Implants</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Photons</topic><topic>Radiology</topic><topic>Restenosis</topic><topic>Sensors</topic><topic>Stents</topic><topic>Struts</topic><topic>Thickness</topic><topic>Ultrasound</topic><topic>Visualization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qin, Le</creatorcontrib><creatorcontrib>Zhou, Shanshui</creatorcontrib><creatorcontrib>Dong, Haipeng</creatorcontrib><creatorcontrib>Li, Jiqiang</creatorcontrib><creatorcontrib>Zhang, Ruiyan</creatorcontrib><creatorcontrib>Yang, Chendie</creatorcontrib><creatorcontrib>Liu, Peng</creatorcontrib><creatorcontrib>Xu, Zhihan</creatorcontrib><creatorcontrib>Yan, Fuhua</creatorcontrib><creatorcontrib>Yang, Wenjie</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qin, Le</au><au>Zhou, Shanshui</au><au>Dong, Haipeng</au><au>Li, Jiqiang</au><au>Zhang, Ruiyan</au><au>Yang, Chendie</au><au>Liu, Peng</au><au>Xu, Zhihan</au><au>Yan, Fuhua</au><au>Yang, Wenjie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2024-04-27</date><risdate>2024</risdate><volume>34</volume><issue>10</issue><spage>6568</spage><epage>6577</epage><pages>6568-6577</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38676731</pmid><doi>10.1007/s00330-024-10760-1</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3959-5043</orcidid></addata></record> |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Accuracy Angiography Angioplasty Cardiac Computed tomography Diagnostic Radiology Diagnostic systems Diameters High resolution Image quality Image reconstruction Image resolution Imaging Implants Internal Medicine Interventional Radiology Medical imaging Medicine Medicine & Public Health Neuroradiology Photons Radiology Restenosis Sensors Stents Struts Thickness Ultrasound Visualization |
| title | Improvement of coronary stent visualization using ultra-high-resolution photon-counting detector CT |
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