Coronary stent imaging in photon counting computed tomography: improved imaging of in-stent stenoses in a phantom with optimized reconstruction kernels

Coronary stent imaging in photon counting computed tomography: improved imaging of in-stent stenoses in a phantom with optimized reconstruction kernels

Coronary CT angiography (CCTA) is becoming increasingly important in the workup of coronary artery disease. Imaging of stents and in-stent stenoses remains a challenge. This work investigates the assessability of in-stent stenoses in photon counting CT (PCCT) using ultra-high-resolution (UHR) imagin...

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Veröffentlicht in:BJR open 2024-01, Vol.6 (1), p.tzae030
Hauptverfasser: Michael, Arwed Elias, Schoenbeck, Denise, Becker-Assmann, Jendrik, Haag, Nina Pauline, Niehoff, Julius Henning, Schmidt, Bernhard, Panknin, Christoph, Baer-Beck, Matthias, Hickethier, Tilman, Maintz, David, Bunck, Alexander C, Gertz, Roman Johannes, Borggrefe, Jan, Kroeger, Jan Robert
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container_start_page tzae030
container_title BJR open
container_volume 6
creator Michael, Arwed Elias
Schoenbeck, Denise
Becker-Assmann, Jendrik
Haag, Nina Pauline
Niehoff, Julius Henning
Schmidt, Bernhard
Panknin, Christoph
Baer-Beck, Matthias
Hickethier, Tilman
Maintz, David
Bunck, Alexander C
Gertz, Roman Johannes
Borggrefe, Jan
Kroeger, Jan Robert
description Coronary CT angiography (CCTA) is becoming increasingly important in the workup of coronary artery disease. Imaging of stents and in-stent stenoses remains a challenge. This work investigates the assessability of in-stent stenoses in photon counting CT (PCCT) using ultra-high-resolution (UHR) imaging and optimized reconstruction kernels. In an established phantom, 6 stents with inserted hypodense stenoses were scanned in both standard resolution (SRM) and UHR in a clinical PCCT scanner (NAEOTOM Alpha, Siemens Healthineers, Germany). Reconstructions were made both with the clinically established and optimized kernels. The visible stent lumen and the extent of stenosis were quantitatively measured and compared with the angiographic reference standard. Also, region-of-interest (ROI)-based measurements and a qualitative assessment of image quality were performed. The visible stent lumen and the extent of stenosis were measured more precisely in UHR compared to SRM (0.11 ± 0.19 vs 0.41 ± 0.22 mm,  
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Imaging of stents and in-stent stenoses remains a challenge. This work investigates the assessability of in-stent stenoses in photon counting CT (PCCT) using ultra-high-resolution (UHR) imaging and optimized reconstruction kernels. In an established phantom, 6 stents with inserted hypodense stenoses were scanned in both standard resolution (SRM) and UHR in a clinical PCCT scanner (NAEOTOM Alpha, Siemens Healthineers, Germany). Reconstructions were made both with the clinically established and optimized kernels. The visible stent lumen and the extent of stenosis were quantitatively measured and compared with the angiographic reference standard. Also, region-of-interest (ROI)-based measurements and a qualitative assessment of image quality were performed. The visible stent lumen and the extent of stenosis were measured more precisely in UHR compared to SRM (0.11 ± 0.19 vs 0.41 ± 0.22 mm,  &lt; .001). The optimized kernel further improved the accuracy of the measurements and image quality in UHR (0.35 ± 0.23 vs 0.47 ± 0.19 mm,  &lt; .001). Compared to angiography, stenoses were overestimated in PCCT, on average with an absolute difference of 18.20% ± 4.11%. Photon counting CCTA allows improved imaging of in-stent stenoses in a phantom using UHR imaging and optimized kernels. These results support the use of UHR and optimized kernels in clinical practice and further studies. UHR imaging and optimized reconstruction kernels should be used in CCTA in the presence of cardiac stents.</description><identifier>ISSN: 2513-9878</identifier><identifier>EISSN: 2513-9878</identifier><identifier>DOI: 10.1093/bjro/tzae030</identifier><identifier>PMID: 39444459</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><ispartof>BJR open, 2024-01, Vol.6 (1), p.tzae030</ispartof><rights>The Author(s) 2024. 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Imaging of stents and in-stent stenoses remains a challenge. This work investigates the assessability of in-stent stenoses in photon counting CT (PCCT) using ultra-high-resolution (UHR) imaging and optimized reconstruction kernels. In an established phantom, 6 stents with inserted hypodense stenoses were scanned in both standard resolution (SRM) and UHR in a clinical PCCT scanner (NAEOTOM Alpha, Siemens Healthineers, Germany). Reconstructions were made both with the clinically established and optimized kernels. The visible stent lumen and the extent of stenosis were quantitatively measured and compared with the angiographic reference standard. Also, region-of-interest (ROI)-based measurements and a qualitative assessment of image quality were performed. The visible stent lumen and the extent of stenosis were measured more precisely in UHR compared to SRM (0.11 ± 0.19 vs 0.41 ± 0.22 mm,  &lt; .001). The optimized kernel further improved the accuracy of the measurements and image quality in UHR (0.35 ± 0.23 vs 0.47 ± 0.19 mm,  &lt; .001). Compared to angiography, stenoses were overestimated in PCCT, on average with an absolute difference of 18.20% ± 4.11%. Photon counting CCTA allows improved imaging of in-stent stenoses in a phantom using UHR imaging and optimized kernels. These results support the use of UHR and optimized kernels in clinical practice and further studies. 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title Coronary stent imaging in photon counting computed tomography: improved imaging of in-stent stenoses in a phantom with optimized reconstruction kernels
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