Journal Article

DKFZ-2023-01856

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Photon-counting computed tomography of coronary and peripheral artery stents: a phantom study.

Stein, T. ; Taron, J. ; Verloh, N. ; Doppler, M. ; Rau, A. ; Hagar, M. T. ; Faby, S. ; Baltas, D.DKFZ* ; Westermann, D. ; Ayx, I. ; Schönberg, S. O. ; Nikolaou, K. ; Schlett, C. L. ; Bamberg, F. ; Weiss, J.

2023
Macmillan Publishers Limited, part of Springer Nature [London]

Abstract: Accurate small vessel stent visualization using CT remains challenging. Photon-counting CT (PCD-CT) may help to overcome this issue. We systematically investigate PCD-CT impact on small vessel stent assessment compared to energy-integrating-CT (EID). 12 water-contrast agent filled stents (3.0-8 mm) were scanned with patient-equivalent phantom using clinical PCD-CT and EID-CT. Images were reconstructed using dedicated vascular kernels. Subjective image quality was evaluated by 5 radiologists independently (5-point Likert-scale; 5 = excellent). Objective image quality was evaluated by calculating multi-row intensity profiles including edge rise slope (ERS) and coefficient-of-variation (CV). Highest overall reading scores were found for PCD-CT-Bv56 (3.6[3.3-4.3]). In pairwise comparison, differences were significant for PCD-CT-Bv56 vs. EID-CT-Bv40 (p ≤ 0.04), for sharpness and blooming respectively (all p < 0.05). Highest diagnostic confidence was found for PCD-CT-Bv56 (p ≤ 0.2). ANOVA revealed a significant effect of kernel strength on ERS (p < 0.001). CV decreased with stronger PCD-CT kernels, reaching its lowest in PCD-CT-Bv56 and highest in EID-CT reconstruction (p ≤ 0.05). We are the first study to verify, by phantom setup adapted to real patient settings, PCD-CT with a sharp vascular kernel provides the most favorable image quality for small vessel stent imaging. PCD-CT may reduce the number of invasive coronary angiograms, however, more studies needed to apply our results in clinical practice.

Keyword(s): Humans (MeSH) ; Tomography, X-Ray Computed (MeSH) ; Phantoms, Imaging (MeSH) ; Coronary Angiography (MeSH) ; Stents (MeSH) ; Arteries (MeSH)

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Freiburg (FR01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2023

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