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Influence of cardiac motion on stent lumen visualization in third generation dual-source CT employing a pulsatile
Nils Petri1, Tobias Gassenmaier2, Thomas Allmendinger3
11 Department of Internal Medicine I, University Hospital of Würzburg, Würzburg, Germany.
Insights
Cardiac motion significantly impacts stent lumen visibility, reducing it by approximately 5%. However, a modern dual-source CT scanner maintains high visibility, crucial for detecting in-stent restenosis non-invasively.
Area of Science:
- Medical Imaging
- Cardiovascular Technology
Background:
- In-stent restenosis detection often relies on invasive coronary angiography, posing risks to patients.
- A non-invasive method for evaluating in-stent restenosis is highly desirable.
Purpose of the Study:
- To assess the effect of cardiac motion on the visibility of coronary stent lumens.
- To evaluate a third-generation dual-source CT scanner's performance in visualizing stents during simulated cardiac motion.
Main Methods:
- Coronary stents (3.0 mm diameter) were placed in plastic tubes with contrast medium within a pulsatile heart model.
- Scans were performed using a dual-source CT scanner, mimicking cardiac motion, with stents oriented parallel to the z-axis.
- A medium-sharp convolution kernel optimized for vascular imaging was used for evaluation.
Main Results:
- Mean visible stent lumen decreased from 65.6 ± 5.7% at rest to 60.8 ± 4.4% during simulated cardiac motion (p < 0.001).
- Despite a significant reduction, substantial lumen visibility was maintained.
Conclusions:
- The third-generation dual-source CT scanner demonstrates high stent lumen visibility even with cardiac motion.
- This technology shows promise for non-invasively detecting or excluding in-stent restenosis.
- Further clinical studies are needed to confirm these findings in patients.
Objective:
To detect an in-stent restenosis, an invasive coronary angiography is commonly performed. Owing to the risk associated with this procedure, a non-invasive method to detect or exclude an in-stent restenosis is desirable. The purpose of this study was to evaluate the influence of cardiac motion on stent lumen visibility in a third-generation dual-source CT scanner (SOMATOM Force; Siemens Healthcare, Forchheim, Germany), employing a pulsatile heart model (CoroSim®; Mecora, Aachen, Germany).
Methods:
13 coronary stents with a diameter of 3.0 mm were implanted in plastic tubes filled with a contrast medium and then fixed onto the pulsatile phantom heart model. The scans were performed while the heart model mimicked the heartbeat. Coronary stents were scanned in an orientation parallel to the scanner z-axis. The evaluation of the stents was performed by employing a medium sharp convolution kernel optimized for vascular imaging.
Results:
The mean visible stent lumen was reduced from 65.6 ± 5.7% for the stents at rest to 60.8 ± 4.4% for the stents in motion (p-value: <0.001).
Conclusion:
While the difference in lumen visibility between stents in motion and at rest was significant, the use of this third-generation dual-source CT scanner enabled a high stent lumen visibility under the influence of cardiac motion. Whether this translates into a clinical setting has to be evaluated in further patient studies. Advances in knowledge: The employed modern CT scanner enables a high stent lumen visibility even under the influence of cardiac motion, which is important to detect or exclude an in-stent restenosis.
