Dual-energy computed tomography angiography: virtual calcified plaque subtraction in a vascular phantom

Jin, Kwang Nam; Chung, Jin Wook; Park, Eun‐Ah; Lee, Whal

doi:10.1177/2058460117717765

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…The focus of the study was on testing an advanced spectral algorithm under the increasingly difficult situation generated by the phantom motion toward higher heart rates. Existing literature in this context is often limited to a static evaluation or a simple spectral postprocessing 22,23 …”

Section: Highlightsmentioning

confidence: 99%

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Photon-Counting Detector CT-Based Vascular Calcium Removal Algorithm

et al. 2022

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Objectives: The diagnostic performance of coronary computed tomography angiography is known to be negatively affected by the presence of severely calcified plaques in the coronary arteries. In this article, the performance of a novel image reconstruction algorithm (PureLumen) based on spectral CT data of a firstgeneration dual-source photon-counting detector computed tomography (PCD-CT) system was assessed in a phantom study. PureLumen tries to remove only the calcified contributions from the image while leaving the rest unmodified. Materials and Methods: The study uses 2 iodine contrast filled vessel phantoms (diameter 4 mm) filled with different concentrations of iodine and equipped with calcified stenosis inserts. Each phantom features 2 separate calcified lesions of 25% and 50% percentage diameter stenosis (PDS) size. The vessel phantoms were mounted inside an anthropomorphic thorax phantom attached to an artificial motion device, simulating realistic cardiac motion at heart rates between 50 beats per minute and 100 beats per minute. Acquisitions were performed using a prospectively electrocardiogram triggered dual-source sequence mode on a PCD-CT system (NAEOTOM Alpha, Siemens Healthineers). Images were reconstructed at 80% of the RR interval with virtual monoenergetic images (Mono) and with additional calcium-removal (PureLumen), both at 65 keV. PureLumen is based on a spectral base material decomposition into iodine and calcium, which aims to reconstruct images without calcium contributions, while leaving all other material contribution unchanged. Stenosis grade was assessed individually for each vessel insert in all reconstructed image series by 2 readers. Results: The measured median PDS values for the 50% lesion were 56.0% (52.0%, 57.0%) for the Mono case and 50.0% (48.5%, 51.0%) for PureLumen. The 25% lesion median PDS values were 36.0% (29.5%, 39.5%) for Mono and 31.5% (30.5%, 34.0%) for PureLumen. Both lesion sizes demonstrate a significant difference between Mono and PureLumen in their result ( P < 0.05) with PureLumen median values being closer to the actual true stenosis size for the 50% and 25% lesion. A visual assessment of the image quality depending on the heart rate yielded good image quality up to a heart rate of 80 beats per minute in the PureLumen case. Conclusions: This phantom study shows that a novel calcium-removal image reconstruction algorithm (PureLumen) using a first-generation dual-source PCD-CT effectively decreases blooming artifacts caused by heavily calcified plaques and improves image interpretability. It also shows that PureLumen retains its performance in the presence of motion with simulated heart rates up to 80 beats per minute. Future in vivo clinical studies are needed to confirm the benefits of this type of reconstruction in terms of coronary computed tomography angiography quality and accuracy.

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Section: Highlightsmentioning

confidence: 99%

“…Existing literature in this context is often limited to a static evaluation or a simple spectral postprocessing. 22 , 23 …”

Section: Highlightsmentioning

confidence: 99%

Photon-Counting Detector CT-Based Vascular Calcium Removal Algorithm

et al. 2022

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“…Analogously, another research group [ 52 ] fabricated vascular phantoms to evaluate the accuracy of lumen area measurement using a modified dual-energy CT protocol. They investigated the effects of contrast material concentration, vessel diameter (5.7, 4.9, 3.9, 3.0, 1.9, and 1.3 mm), and thickness of calcified plaque (2.0 vs. 4.0 mm) on this measurement.…”

Section: Applications Of Biomimetic Vascular Models For Atherosclerosismentioning

confidence: 99%

“…The results indicated that extensively calcified plaques lead to an underestimated measurement of the lumen area, meaning a false diagnosis of vascular stenosis; likewise, this underestimation was as low as the vessel diameter was large. Subsequently, through preventing in vivo experimentation, this study proved that further investigation must be conducted before implementing these protocols in clinical practice [ 52 ].…”

Section: Applications Of Biomimetic Vascular Models For Atherosclerosismentioning

confidence: 99%

Biomimicking Atherosclerotic Vessels: A Relevant and (Yet) Sub-Explored Topic

Henriques,

Amaro,

Piedade

2024

Biomimetics

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Atherosclerosis represents the etiologic source of several cardiovascular events, including myocardial infarction, cerebrovascular accidents, and peripheral artery disease, which remain the leading cause of mortality in the world. Numerous strategies are being delineated to revert the non-optimal projections of the World Health Organization, by both designing new diagnostic and therapeutic approaches or improving the interventional procedures performed by physicians. Deeply understanding the pathological process of atherosclerosis is, therefore, mandatory to accomplish improved results in these trials. Due to their availability, reproducibility, low expensiveness, and rapid production, biomimicking physical models are preferred over animal experimentation because they can overcome some limitations, mainly related to replicability and ethical issues. Their capability to represent any atherosclerotic stage and/or plaque type makes them valuable tools to investigate hemodynamical, pharmacodynamical, and biomechanical behaviors, as well as to optimize imaging systems and, thus, obtain meaningful prospects to improve the efficacy and effectiveness of treatment on a patient-specific basis. However, the broadness of possible applications in which these biomodels can be used is associated with a wide range of tissue-mimicking materials that are selected depending on the final purpose of the model and, consequently, prioritizing some materials’ properties over others. This review aims to summarize the progress in fabricating biomimicking atherosclerotic models, mainly focusing on using materials according to the intended application.

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“…The latter is not unique to one specific type of tissue but related to the atomic composition of the tissue. CT scanning with spectral energy, with simultaneous acquisition of datasets using two x-ray spectra of diverse energies, allows optimisation of contrast in vascular imaging, but also virtual subtraction of bone structures, calcified areas or iodine in contrast-enhanced images [1][2][3][4]. Manufacturers provide diverse technologies for acquiring spectral CT data that can potentially give different results.…”

Section: Introductionmentioning

confidence: 99%

Quantitative benchmarking of iodine imaging for two CT spectral imaging technologies: a phantom study

et al. 2021

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Background The aim of this study was to quantitatively benchmark iodine imaging across specific virtual monoenergetic energy levels, iodine maps and virtual non-contrast images with different phantom sizes and iodine concentrations, using a rapid switching dual-energy CT (DECT) and a dual source DECT, in order to investigate accuracy and potential differences between the technologies. Methods Solutions of iodine contrast (10, 20, 30, 50, and 100 mg/mL), sterile water and saline were scanned in a phantom on a rapid switching single-source and dual-source DECT scanners from two different vendors. The phantom was equipped with polyurethane rings simulating three body sizes. The datasets were reconstructed in virtual monoenergetic energy levels (70, 80, 90, 100, 110, 120, 130, and 140 keV), virtual non-contrast images and iodine maps. HU and iodine concentrations were measured by placing ROIs in the iodine solutions. Results The iodine concentrations were reproduced with a high degree of accuracy for the single-source DECT (1.8–9.0%), showing a slight dependence on phantom size. The dual source DECT technique showed deviant values (error -33.8 to 12.0%) for high concentrations. In relation to the virtual non-contrast measurements, the images from both vendors were affected by the iodine concentration and phantom size (-127.8 to 539.1 HU). Phantom size did not affect the calculated monoenergetic attenuation values, but the attenuation values varied between the scanners. Conclusions Quantitative measurements of post-processed images are dependent on the concentration of iodine, the phantom size and different technologies. However, our study indicates that the iodine maps are reliable for quantification of iodine.

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Dual-energy computed tomography angiography: virtual calcified plaque subtraction in a vascular phantom

Cited by 9 publications

References 25 publications

Photon-Counting Detector CT-Based Vascular Calcium Removal Algorithm

Photon-Counting Detector CT-Based Vascular Calcium Removal Algorithm

Biomimicking Atherosclerotic Vessels: A Relevant and (Yet) Sub-Explored Topic

Quantitative benchmarking of iodine imaging for two CT spectral imaging technologies: a phantom study

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