Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

Wolf, Florian; Leschka, Sebastian; Loewe, Christian; Homolka, Peter; Plank, Christina; Schernthaner, Rüdiger; Bercaczy, Dominik; Goetti, Robert; Lämmer, Johannes; Friedrich, Guy; Marinček, Borut; Alkadhi, Hatem; Feuchtner, Gudrun

doi:10.1007/s00330-010-1792-9

Cited by 25 publications

(14 citation statements)

References 26 publications

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“…Previous reports concluded that the stents less than 3 mm in diameter couldn't be interpretated by 64-MDCT, 256-slice MDCT, even with dual source CT [9,[18][19][20]. In the present study, with an improved spatial resolution of 0.23 mm, we were able to observe the stents lumen with 2.75 mm and more in diameter clearly.…”

Section: Discussioncontrasting

confidence: 51%

“…Previous studies using standard resolution CT have shown that the stent lumen is limited by blooming artifacts, which are more significant in stents ≤3 mm in diameter, even in novel 64-slice multi-detector single-and dual-source CT systems, which offer isotropic voxel resolution up to 0.4 mm [5][6][7][8][9]. Therefore, the spatial resolution is a key factor in the imaging of coronary artery stent and needs to be further improved from the standard resolution CT system for the stent lumen visualization.…”

Section: Introductionmentioning

confidence: 99%

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High-definition computed tomography for coronary artery stents imaging: Initial evaluation of the optimal reconstruction algorithm

Cui

et al. 2015

European Journal of Radiology

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Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

High-definition computed tomography for coronary artery stents imaging: Initial evaluation of the optimal reconstruction algorithm

Cui

et al. 2015

European Journal of Radiology

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“…Potentially, CTP may solve another limitation of CTA, the detection of in-stent restenosis 19 (Figure 2), which has a sensitivity and specificity of 79% and 81%, respectively, 19 because of artifacts from stent struts causing variable (44% to 48%) artificial luminal narrowing. 20 Second, in patients presenting with intermediate stenosis of 50% to 70% on coronary CTA, an MPI study (CMR, SPECT, or ECG-treadmill) is required to determine whether a post-IA is necessary. In these patients, the addition of an adenosine stress CTP examination may provide this information while adding only little time and efforts for the patient and physician.…”

Section: Discussionmentioning

confidence: 99%

Adenosine Stress High-Pitch 128-Slice Dual-Source Myocardial Computed Tomography Perfusion for Imaging of Reversible Myocardial Ischemia

Feuchtner

Goetti

Plass

et al. 2011

Circ: Cardiovascular Imaging

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146

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Background-Coronary computed tomography angiography (CTA) enables accurate anatomic evaluation of coronary artery stenosis but lacks information about hemodynamic significance. The aim of this study was to evaluate 128-slice myocardial CT perfusion (CTP) imaging with adenosine stress using a high-pitch mode, in comparison with cardiac MRI (CMR). Methods and Results-Thirty-nine patients with intermediate to high coronary risk profile underwent adenosine stress 128-slice dual source CTP (128ϫ0.6 mm, 0.28 seconds). Among those, 30 patients (64Ϯ10 years, 6% women) also underwent adenosine stress CMR (1.5T). The 2-step CTP protocol consisted of (1) adenosine stress-CTP using a high-pitch factor (3.4) ECG-synchronized spiral mode and (2) rest-CTP/coronary-CTA using either high-pitch (heart rate Ͻ63 bpm) or prospective ECG-triggering (heart rate Ͼ63 bpm). Results were compared with CMR and with invasive angiography in 25 patients. The performance of stress-CTP for detection of myocardial perfusion defects compared with CMR was sensitivity, 96%; specificity, 88%; positive predictive value (PPV), 93%; negative predictive value (NPV), 94% (per vessel); and sensitivity, 78%; specificity, 87%; PPV, 83%; NPV, 84% (per segment). The accuracy of stress-CTP for imaging of reversible ischemia compared with CMR was sensitivity, 95%; specificity, 96%; PPV, 95%; and NPV, 96% (per vessel). In 25 patients who underwent invasive angiography, the accuracy of CTA for detection of stenosis Ͼ70% was (per segment): sensitivity, 96%; specificity, 88%; PPV, 67%; and NPV, 98.9%. The accuracy improved from 84% to 95% after adding stress CTP to CTA. Radiation exposure of the entire stress/rest CT protocol was only 2.5 mSv. Conclusions-Adenosine-induced stress 128-slice dual-source high-pitch myocardial CTP allows for simultaneously assessment of reversible myocardial ischemia and coronary stenosis, with good diagnostic accuracy as compared with CMR and invasive angiography, at a very low radiation exposure. (Circ Cardiovasc Imaging. 2011;4:540-549.)

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“…Considerable problems continue to be present for the CT imaging of coronary artery stents. While CT stent imaging can be now performed -similar to the imaging of the native coronary arteries -at a low radiation dose, the in-stent visualization still is limited [30,31], and a routine application of CT for the follow-up of coronary stent patency cannot be recommended so far.…”

Section: Outlook and Conclusionmentioning

confidence: 99%

Radiation dose of cardiac computed tomography – what has been achieved and what needs to be done

Alkadhi

Leschka

2010

Eur Radiol

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This review highlights the recently introduced techniques by manufacturers and various research workers to reduce radiation dose in coronary CT. It discusses in detail the development of ECG-based tube current modulation, the application of low tube voltage protocols and prospective ECG-gating. It also briefly discusses two further methods of dose reduction, namely minimisation of the x-y anatomical coverage and adaptive statistical iterative reconstruction.

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Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

Cited by 25 publications

References 26 publications

High-definition computed tomography for coronary artery stents imaging: Initial evaluation of the optimal reconstruction algorithm

High-definition computed tomography for coronary artery stents imaging: Initial evaluation of the optimal reconstruction algorithm

Adenosine Stress High-Pitch 128-Slice Dual-Source Myocardial Computed Tomography Perfusion for Imaging of Reversible Myocardial Ischemia

Radiation dose of cardiac computed tomography – what has been achieved and what needs to be done

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