A technical note on intra-arterial cone-beam computed tomography for the evaluation of flow-diverter stents: Image quality differences between diluted and non-diluted contrast medium

Koçer, Naci; Kandemirli, Sedat Giray; Ruijters, Daniël; Mantatzis, Michalis; Kızılkılıç, Osman; Işlak, Civan

doi:10.1177/1591019919890929

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…While the efficacy of IV CBCT is well established, 1,3,6–9 our centre felt that further refinement of the established protocol was warranted. Despite being of good diagnostic value (DV), our initial studies were somewhat subject to substantial image noise and poor iodine enhancement.…”

Section: Introductionmentioning

confidence: 99%

Optimising image quality in intravenous cerebral cone beam computed tomography

Broadley,

Erskine,

Marshall

et al. 2023

J of Medical Radiation Sci

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IntroductionThe efficacy of intravenous cerebral Cone Beam Computed Tomography (IV CBCT) is well established; however, image quality has only ever been authenticated by subjective evaluation. The aim of this study was to quantify the factors pertinent to achieving consistent and optimal image quality when performing IV CBCT.MethodsBetween 1 March 2021 and 30 October 2022, 79 patients received IV CBCT. These candidates were divided into three main acquisition field size categories (22/32, 42 and 48 cm) according to the clinical indication. The images were analysed using both a quantitative assessment and a subjective evaluation. Here, a comparison of Hounsfield units (HUs), signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR) and noise index was conducted for each study and compared relative to the acquisition field size. The subjective analysis was performed in a non‐blinded fashion where the diagnostic value (DV) of the exam was determined according to a graded scale. A phantom analysis for each of the acquisition field sizes was conducted and modulation transfer function (MTF) graphed.ResultsSignificantly higher HU, SNR, CNR and lower noise indices were achieved with the 42‐cm protocol than the 22/32 and 48‐cm protocols. Here a greater DV was also reported. The MTF demonstrates marginally improved spatial resolution for the 22‐cm protocol, but this is near equivocal for the 32‐, 42 and 48‐cm protocols.ConclusionThe use of larger acquisition field sizes provides improved image quality when performing IV CBCT as an alternative to intra‐arterial (IA) CBCT.

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Section: Introductionmentioning

confidence: 99%

Optimising image quality in intravenous cerebral cone beam computed tomography

Broadley,

Erskine,

Marshall

et al. 2023

J of Medical Radiation Sci

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Diluted contrast media combined with high-resolution C-arm CT for evaluating apposition of flow diversions in a porcine model

Long,

Yu,

Shi

et al. 2024

Interv Neuroradiol

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Background In intracranial stenting, good stent apposition is crucial, and high-resolution C-arm computer tomography (CT) is utilized to assess whether stent apposition is complete. This study was aimed at finding optimal hypertonic or isotonic contrast media injection concentration for high-resolution C-arm CT to assess apposition of flow diversion (FD) after carotid artery stenting in swine. Methods Twelve FD stents were implanted into the left carotid artery of Bama swine through the endovascular method. During high-resolution C-arm CT scanning, 6%, 8%, 10%, 12%, and 14% dilution percentages of hypertonic contrast media (iopromide 370 mg/ml) and 10%, 12%, 14%, 16%, and 18% dilution percentages of isotonic contrast media (iodixanol 320 mg/ml) were separately injected. A radiologist and a neuro-interventional specialist evaluated and qualitatively scored the post-processed images, and intravascular ultrasound (IVUS) was used to verify the accuracy of these images. Results Overall, 12 FD stents were implanted into the left common carotid artery of 12 swine, with a technical success rate of 100%. The best reconstructed images used to observe stent apposition were achieved with iopromide diluted to a concentration of 12% (all P < .05) or iodixanol diluted to a concentration of 16% (all P < .05). Malapposition was noted in one case, and good apposition was noted in 11 cases. These results were consistent with IVUS observations. Conclusion Injecting iopromide or iodixanol diluted to 12% or 16% during high-resolution C-arm CT scanning, respectively, can help evaluate FD stent apposition and obtain optimal image quality.

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A technical note on intra-arterial cone-beam computed tomography for the evaluation of flow-diverter stents: Image quality differences between diluted and non-diluted contrast medium

Cited by 2 publications

References 10 publications

Optimising image quality in intravenous cerebral cone beam computed tomography

Optimising image quality in intravenous cerebral cone beam computed tomography

Diluted contrast media combined with high-resolution C-arm CT for evaluating apposition of flow diversions in a porcine model

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