First experience with monochromatic coronary computed tomography angiography from a 64-slice CT scanner with Gemstone Spectral Imaging (GSI)

Fuchs, Tobias A.; Stehli, Julia; Fiechter, Michael; Dougoud, Svetlana; Gebhard, Cathérine; Ghadri, Jelena R.; Husmann, Lars; Gaemperli, Oliver; Kaufmann, Philipp A.

doi:10.1016/j.jcct.2013.01.004

Cited by 56 publications

(44 citation statements)

References 20 publications

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“…The availability of multidetector-row computed tomography (MDCT) plays an important role in characterizing pulmonary masses noninvasively according to the morphology, interfaces, inner densities, and enhancement of masses (2). However, the nonspecific CT image appearance and the high degree of enhancement of inflammatory masses are similar to lung cancers, making it difficult to differentiate between the two common lesions in lungs by conventional scanning methods.Recently a new dual-energy spectral computed tomography (DESCT) imaging mode based on the rapid switching between high-and low-energy data sets from view to view during a single rotation on the high-definition GE Discovery CT750 HD scanner was introduced, which could produce both the monochromatic spectral images at energy levels ranging from 40 to 140 keV and the material decomposition images for quantitative iodine concentration measurement (3)(4)(5). This spectral CT imaging mode was also named Gemstone Spectral Imaging (GSI) mode by the manufacturer.…”

mentioning

confidence: 99%

Differentiation of Lung Cancers From Inflammatory Masses with Dual-Energy Spectral CT Imaging

Hou

Yin

et al. 2015

Academic Radiology

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mentioning

confidence: 99%

Differentiation of Lung Cancers From Inflammatory Masses with Dual-Energy Spectral CT Imaging

Hou

Yin

et al. 2015

Academic Radiology

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“…Only a few studies have used DECT and monochromatic imaging in the evaluation of peripheral arterial stents, and most of these evaluate imaging of coronary stents (16)(17)(18). Their results vary in the identification of the optimal keV, ranging from as low as 55 keV to >80 keV.…”

Section: Almutairi Et Al Dual Energy Ct Angiography In Peripheral Armentioning

confidence: 99%

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

Almutairi

Safran

AlZaabi

et al. 2017

Quant. Imaging Med. Surg.

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Background: To determine the optimal scanning protocols of dual energy computed tomography angiography (DECTA) in terms of radiation dose and image quality assessment at different keV levels, and compare it with conventional computed tomography angiography (CTA) in patients treated with peripheral arterial stents.Methods: Twenty-nine patients with previous stent placement in peripheral arteries were evaluated with DECTA. Images were reconstructed with virtual monochromatic spectral imaging (VMS) at 65, 68, 70 and 72 keV and adaptive statistical iterative reconstruction (ASIR) at 50% compared with CTA. Image quality comprising image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed, and radiation dose was compared. Effects of different type of peripheral arterial stents on image quality were also evaluated. Fifty-six uniquely identified stents that were located in common iliac arteries (CIA), external iliac arteries (EIA) and superficial femoral arteries (SFA) were evaluated.Results: Within subjects, the results showed that DECTA images (VMS) had less noise than the CTA images for CIA, EIA and SFA stents, with the lowest noise at 72 keV. Also, the VMS images had greater SNR than the CTA images for the EIA stents (P<0.05); and the VMS images had greater CNR than the CTA images for CIA, EIA, and SFA stents (P<0.001). Also, on CT attenuation, VMS continued to outperform CTA, but to a lesser extent. Between subjects, average VMS noise varied significantly with the type of the stent used (P=0.025) for CIA stents. Radiation dose was highly significant between DECTA and conventional CTA scans (6.98 vs. 7.40 mSv, P=0.047). Conclusions:We conclude that an optimal scanning protocol consisting of 72 keV and 50% ASIR leads to better image quality for DECTA in peripheral arterial stenting when compared to conventional CTA. Quant Imaging Med Surg 2017;7(5):520-531 qims.amegroups.com few motion artifacts, and generation of 3D visualizations (3). Despite these benefits, it has its own limitation, such as the potential risk of contrast medium-induced nephrotoxicity, the presence of blooming artifacts caused by stent struts, and high radiation dose. Further, MDCT has difficulty in differentiating different materials related to peripheral arterial stents. As assessment of in-stent restenosis is closely related to stent materials, this may lead to an overestimation of the lesion severity. Blooming and beam hardening artifacts which are commonly seen in the conventional CT angiography (CTA) hamper the accurate assessment of instent restenosis (4), but these artifacts can be eliminated in dual-energy CT (DECT) applications. 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 wa...

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“…CCTA CCTA images were acquired on a 64-slice CT system (Lightspeed VCT or Discovery HD750; GE Healthcare) (12,13). Contrast-enhanced prospective electrocardiography-triggered CCTA was performed with inspiration breath-hold at 75% of the R-R interval as previously reported (12).…”

Section: Spect Quantitative Analysismentioning

confidence: 99%

Automatic Valve Plane Localization in Myocardial Perfusion SPECT/CT by Machine Learning: Anatomic and Clinical Validation

et al. 2016

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Precise definition of the mitral valve plane (VP) during segmentation of the left ventricle for SPECT myocardial perfusion imaging (MPI) quantification often requires manual adjustment, which affects the quantification of perfusion. We developed a machine learning approach using support vector machines (SVM) for automatic VP placement. Methods: A total of 392 consecutive patients undergoing 99m Tc-tetrofosmin stress (5 min; mean 6 SD, 350 6 54 MBq) and rest (5 min; 1,024 6 153 MBq) fast SPECT MPI attenuation corrected (AC) by CT and same-day coronary CT angiography were studied; included in the 392 patients were 48 patients who underwent invasive coronary angiography and had no known coronary artery disease. The left ventricle was segmented with standard clinical software (quantitative perfusion SPECT) by 2 experts, adjusting the VP if needed. Two-class SVM models were computed from the expert placements with 10-fold cross validation to separate the patients used for training and those used for validation. SVM probability estimates were used to compute the best VP position. Automatic VP localizations on AC and non-AC images were compared with expert placement on coronary CT angiography. Stress and rest total perfusion deficits and detection of per-vessel obstructive stenosis by invasive coronary angiography were also compared. Results: Bland-Altman 95% confidence intervals (CIs) for VP localization by SVM and experts for AC stress images (bias, 1; 95% CI, 25 to 7 mm) and AC rest images (bias, 1; 95% CI, 27 to 10 mm) were narrower than interexpert 95% CIs for AC stress images (bias, 0; 95% CI, 28 to 8 mm) and AC rest images (bias, 0; 95% CI, 210 to 10 mm) (P , 0.01). Bland-Altman 95% CIs for VP localization by SVM and experts for non-AC stress images (bias, 1; 95% CI, 24 to 6 mm) and non-AC rest images (bias, 2; 95% CI, 27 to 10 mm) were similar to interexpert 95% CIs for non-AC stress images (bias, 0; 95% CI, 26 to 5 mm) and non-AC rest images (bias, 21; 95% CI, 29 to 7 mm) (P was not significant [NS]). For regional detection of obstructive stenosis, ischemic total perfusion deficit areas under the receiver operating characteristic curve for the 2 experts (AUC, 0. SPECTmyocar dial perfusion imaging (MPI) is widely used for the detection and quantification of cardiac ischemia (1). Relative perfusion deficit quantification at stress and rest on the basis of total perfusion deficits (TPD) (2) allows the quantitative estimation of ischemia. Recently, specialized cardiac SPECT scanners dramatically improved count sensitivity and image resolution, enabling lower patient radiation doses and faster acquisitions (3). However, the imaging geometry and reconstruction techniques are often different from those used with the conventional Anger camera, resulting in a somewhat different appearance of images (4) and new image artifacts (5). In this context, MPI software analysis packages may need to be updated for accurate quantification with the new camera systems.Successful software-based analysis of MPI requires accurate segm...

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First experience with monochromatic coronary computed tomography angiography from a 64-slice CT scanner with Gemstone Spectral Imaging (GSI)

Cited by 56 publications

References 20 publications

Differentiation of Lung Cancers From Inflammatory Masses with Dual-Energy Spectral CT Imaging

Differentiation of Lung Cancers From Inflammatory Masses with Dual-Energy Spectral CT Imaging

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

Automatic Valve Plane Localization in Myocardial Perfusion SPECT/CT by Machine Learning: Anatomic and Clinical Validation

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