Impact of an advanced image-based monoenergetic reconstruction algorithm on coronary stent visualization using third...

Area of Science:

• Medical Imaging
• Radiology
• Cardiovascular Imaging

Background:

• Coronary artery stents are crucial for treating stenosis.
• Accurate imaging of in-stent lumen is vital for assessing restenosis.
• Dual-energy CT (DECT) offers potential for improved image quality.

Purpose of the Study:

• To assess the effectiveness of an advanced monoenergetic (ME) reconstruction algorithm for CT coronary stent imaging.
• To compare the performance of advanced ME reconstructions against standard ME and single-energy (SE) imaging.
• To evaluate the impact on stent lumen visibility and radiation dose.

Main Methods:

• Three coronary stents (2.25, 3.0, 3.5 mm lumen diameters) were imaged using third-generation DECT.
• Acquisitions included DE and SE protocols with varying tube potentials.
• Advanced and standard ME reconstructions were generated across a range of virtual photon energies (40-130 keV).

Main Results:

• Advanced ME reconstructions significantly enhanced lumen visibility for stents ≤3.0 mm compared to SE.
• 130 keV ME images yielded the highest mean lumen visibility (86% for 2.25 mm, 82% for 3.0 mm stents).
• DECT with advanced ME reconstruction reduced radiation dose by 49% compared to 120 kV SE.

Conclusions:

• Advanced ME reconstruction in DECT improves in-stent lumen visualization, particularly for small coronary stents.
• High keV ME reconstructions are key to achieving superior lumen visualization.
• DECT with advanced ME algorithms provides a promising approach for enhanced stent imaging with reduced radiation exposure.