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CT Evaluation of Small-Diameter Coronary Artery Stents: Effect of an Integrated Circuit Detector with Iterative
Lucas L Geyer1, G Russell Glenn1, Carlo Nicola De Cecco1
1From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
Purpose:
To use suitable objective methods of analysis to assess the influence of the combination of an integrated-circuit computed tomographic (CT) detector and iterative reconstruction (IR) algorithms on the visualization of small (≤3-mm) coronary artery stents.
Materials And Methods:
By using a moving heart phantom, 18 data sets obtained from three coronary artery stents with small diameters were investigated. A second-generation dual-source CT system equipped with an integrated-circuit detector was used. Images were reconstructed with filtered back-projection (FBP) and IR at a section thickness of 0.75 mm (FBP75 and IR75, respectively) and IR at a section thickness of 0.50 mm (IR50). Multirow intensity profiles in Hounsfield units were modeled by using a sum-of-Gaussians fit to analyze in-plane image characteristics. Out-of-plane image characteristics were analyzed with z upslope of multicolumn intensity profiles in Hounsfield units. Statistical analysis was conducted with one-way analysis of variance and the Student t test.
Results:
Independent of stent diameter and heart rate, IR75 resulted in significantly increased xy sharpness, signal-to-noise ratio, and contrast-to-noise ratio, as well as decreased blurring and noise compared with FBP75 (eg, 2.25-mm stent, 0 beats per minute; xy sharpness, 278.2 vs 252.3; signal-to-noise ratio, 46.6 vs 33.5; contrast-to-noise ratio, 26.0 vs 16.8; blurring, 1.4 vs 1.5; noise, 15.4 vs 21.2; all P < .001). In the z direction, the upslopes were substantially higher in the IR50 reconstructions (2.25-mm stent: IR50, 94.0; IR75, 53.1; and FBP75, 48.1; P < .001).
Conclusion:
The implementation of an integrated-circuit CT detector provides substantially sharper out-of-plane resolution of coronary artery stents at 0.5-mm section thickness, while the use of iterative image reconstruction mostly improves in-plane stent visualization.
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