A noise-optimized virtual monochromatic reconstruction algorithm improves stent visualization and diagnostic accuracy for detection of in-stent re-stenosis in lower extremity run-off CT angiography

Abstract

• The impact of noise-optimized virtual monochromatic imaging on stent visualization was assessed. • Virtual monochromatic imaging significantly improves stent lumen visualization and diagnostic confidence. • At 80 keV diagnostic performance for detection of in-stent restenosis was increased. • 80 keV virtual monochromatic images are recommended for stent evaluation of lower extremity vasculature.

Dual energy CT angiography in peripheral arterial stents: optimal scanning protocols with regard to image quality and radiation dose

“…However, a recent study found 70 and 80 keV achieved optimal image quality with the use of DECTA in 31 patients with 45 stents. It was stated that increasing keV to over 80 (90-150 keV) did not show any improvement in either image quality or diagnostic confidence (5). Studies that have evaluated lower extremities with DECT found that optimal image quality falls between 55 to 70 keV (13,19,20).…”

“…Huang et al reported an improvement of correction with DECT (4). In a recent study by Mangold et al, reduction of blooming artifacts in imaging peripheral arterial stents with improved image quality was achieved when 70 or 80 keV was used (5). Stent lumen visibility for small stents was reported in a phantom study at high keV when the third generation of dual-source CT and DECT was used (6).…”

“…Creation of different kiloelectron volt (keV) as monochromatic images may allow optimization of image quality. To the best of our knowledge, only a few studies have been published on the role of DECT angiography (DECTA) in peripheral arterial stents (5,6,11,12), and evidence of optimal scanning protocols of DECTA in peripheral arterial stents as compared to conventional CTA is lacking. Thus, the aim of this study was to determine the optimal scanning protocols of DECTA in terms of radiation dose and image quality assessment at different keV levels in comparison to conventional CTA in patients treated with peripheral arterial stents.…”

Feasibility of low-dose contrast media in run-off CT angiography on dual-layer spectral detector CT

“…As a convenient, safe, accurate, and economical tool, computed tomography angiography (CTA) is broadly utilized in clinical practice, and has become a predominant substitute for digital subtraction angiography in preoperative diagnosis and postoperative assessment of peripheral arterial disease (1)(2)(3). Iodinated contrast media (CM) can enhance the visualization of vessels and improve the contrast of the region of interest against adjacent tissue, which is especially necessary for CTA (4).…”

“…2 -test. Analysis of variance was applied in the analysis of the vascular attenuation, noise, SNR, and CNR of A1 and B1-B10.…”