Reducing Stent-Induced Blooming Artifacts Using Virtual Monoenergetic Imaging Reconstructions in a Superficial...

Area of Science:

• Medical Imaging
• Radiology
• Biomedical Engineering

Background:

• Stent placement is crucial for treating vascular occlusions.
• Stent-induced blooming artifacts in computed tomography (CT) can obscure lumen assessment.
• Virtual monoenergetic imaging (VMI) offers potential to mitigate these artifacts.

Purpose of the Study:

• To evaluate the efficacy of VMI reconstructions in reducing stent blooming artifacts.
• To assess the impact of VMI on in-stent lumen underestimation.
• To investigate optimal VMI energy levels for different stent configurations.

Main Methods:

• Covered stents were deployed in a superficial femoral artery phantom.
• Conventional and VMI reconstructions (40-200 keV) were generated.
• Quantitative metrics (CNR, SNR, lumen diameter, FWHM) and qualitative scores were assessed.

Main Results:

• VMI reconstructions, particularly at 80-100 keV and 140 keV, significantly reduced lumen underestimation (from 21.5-29.1% to 14.1-18.6%).
• Optimal VMI energy levels varied with stent configuration and material density.
• No significant difference in Full Width at Half Maximum (FWHM) was observed across VMI energies.

Conclusions:

• VMI effectively minimizes stent blooming artifacts and improves in-stent lumen assessment.
• Higher energy VMI reconstructions are necessary for denser stent materials.
• While VMI reduces artifact severity, it may not decrease the affected pixel count.