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Updated: Oct 31, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Deformable Known Component Model-Based Reconstruction for Coronary CT Angiography
1Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA 21205.
Insights
A new method, STF-dKCR, significantly improves plaque visualization in coronary CT angiography by reducing metal artifacts from cardiac implants. This technique enhances the visibility of plaque near pacemaker and defibrillator leads.
Area of Science:
- Medical imaging
- Biomedical engineering
- Radiology
Background:
- Coronary CT angiography (CCTA) is crucial for atherosclerosis detection.
- Cardiac implants like pacemakers and defibrillators cause metal artifacts in CCTA, hindering plaque visualization.
- Existing metal artifact reduction methods are insufficient for visualizing plaque near implant components.
Purpose of the Study:
- To develop and evaluate a novel reconstruction method (STF-dKCR) for reducing metal artifacts in CCTA.
- To improve the visualization of coronary artery plaque in patients with cardiac implants.
- To specifically enhance the imaging of plaque located near pacemaker or defibrillator leads.
Main Methods:
- The STF-dKCR method incorporates a deformable model for metal leads, including novel parameterization and 3D-2D preregistration.
- A polyenergetic forward model estimates x-ray propagation and spectral properties through the metal component.
- The method was validated using physical data from a cardiac phantom with a simulated vessel, metal wire, and Teflon sphere, compared against Filtered Back Projection (FBP) and FBP with metal artifact reduction (FBP-MAR).
Main Results:
- STF-dKCR significantly reduced metal artifacts compared to FBP and FBP-MAR.
- Only STF-dKCR substantially improved the visibility of a simulated plaque (Teflon sphere) near the metal wire.
- The attenuation of the Teflon bead improved with STF-dKCR, closely matching the expected value, unlike FBP and FBP-MAR.
Conclusions:
- The proposed STF-dKCR reconstruction method effectively reduces metal artifacts in CCTA.
- This technique shows significant potential for improving plaque visualization in the challenging clinical scenario of patients with cardiac implants.
- STF-dKCR offers a promising solution for enhanced atherosclerosis detection in the presence of wire-shaped metal components.
Purpose:
Atherosclerosis detection remains challenging in coronary CT angiography for patients with cardiac implants. Pacing electrodes of a pacemaker or lead components of a defibrillator can create substantial blooming and streak artifacts in the heart region, severely hindering the visualization of a plaque of interest. We present a novel reconstruction method that incorporates a deformable model for metal leads to eliminate metal artifacts and improve anatomy visualization even near the boundary of the component.
Methods:
The proposed reconstruction method, referred as STF-dKCR, includes a novel parameterization of the component that integrates deformation, a 3D-2D preregistration process that estimates component shape and position, and a polyenergetic forward model for x-ray propagation through the component where the spectral properties are jointly estimated. The methodology was tested on physical data of a cardiac phantom acquired on a CBCT testbench. The phantom included a simulated vessel, a metal wire emulating a pacing lead, and a small Teflon sphere attached to the vessel wall, mimicking a calcified plaque. The proposed method was also compared to the traditional FBP reconstruction and an interpolation-based metal correction method (FBP-MAR).
Results:
Metal artifacts presented in standard FBP reconstruction were significantly reduced in both FBP-MAR and STF-dKCR, yet only the STF-dKCR approach significantly improved the visibility of the small Teflon target (within 2 mm of the metal wire). The attenuation of the Teflon bead improved to 0.0481 mm-1 with STF-dKCR from 0.0166 mm-1 with FBP and from 0.0301 mm-1 with FBP-MAR - much closer to the expected 0.0414 mm-1.
Conclusion:
The proposed method has the potential to improve plaque visualization in coronary CT angiography in the presence of wire-shaped metal components.
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