First In-Human Results of Computed Tomography Angiography for Coronary Stent Assessment With a Spectral Photon Counting Computed Tomography

Abstract

Objectives The aim of this study is to compare the image quality of in vivo coronary stents between an energy integrating detectors dual-layer computed tomography (EID-DLCT) and a clinical prototype of spectral photon counting computed tomography (SPCCT). Materials and Methods In January to June 2021, consecutive patients with coronary stents were prospectively enrolled to undergo a coronary computed tomography (CT) with an EID-DLCT (IQon, Philips) and an SPCCT (Philips). The study was approved by the local ethical committee and patients signed an informed consent. A retrospectively electrocardiogram-gated acquisition was performed with optimized matching parameters on the 2 scanners (EID-DLCT: collimation, 64 × 0.625 mm; kVp, 120, automatic exposure control with target current at 255 mAs; rotation time, 0.27 seconds; SPCCT: collimation, 64 × 0.275 mm; kVp, 120; mAs, 255; rotation time, 0.33 seconds). The injection protocol was the same on both scanners: 65 to 75 mL of Iomeron (Bracco) at 5 mL/s. Images were reconstructed with slice thickness of 0.67 mm, 512 matrix, XCB (Xres cardiac standard) and XCD (Xres cardiac detailed) kernel, iDose 3 for EID-DLCT and 0.25-mm slice thickness, 1024 matrix, Detailed 2 and Sharp kernel, and iDose 6 for SPCCT. Two experienced observers measured the proximal and distal external and internal diameters of the stents to quantify blooming artifacts. Regions of interest were drawn in the lumen of the stent and of the upstream coronary artery. The difference (Δ S-C) between the respective attenuation values was calculated as a quantification of stent-induced artifacts on intrastent image quality. For subjective image quality, 3 experienced observers graded with a 4-point scale the image quality of different parameters: coronary wall before the stent, stent lumen, stent structure, calcifications surrounding the stent, and beam-hardening artifacts. Results Eight patients (age, 68 years [interquartile range, 8]; all men; body mass index, 26.2 kg/m 2 [interquartile range, 4.2]) with 16 stents were scanned. Five stents were not evaluable owing to motion artifacts on the SPCCT. Of the remaining, all were drug eluting stents, of which 6 were platinum-chromium, 3 were cobalt-platinum-iridium, and 1 was stainless steel. For 1 stent, no information could be retrieved. Radiation dose was lower with the SPCCT (fixed CT dose index of 25.7 mGy for SPCCT vs median CT dose index of 35.7 [IQ = 13.6] mGy; P = 0.02). For 1 stent, the internal diameter was not assessable on EID-DLCT. External diameters were smaller and internal diameters were larger with SPCCT (all P < 0.05). Consequently, blooming artifacts were reduced on SPCCT ( P < 0.05). Whereas Hounsfield unit values within the coronary arteries on the 2 scanners were similar, the Δ S-C was lower for SPCCT-Sharp as compared with EID-DLCT-XCD and SPCCT-Detailed 2 ( ...

A Spectrum of Descending Thoracic Aorta Diameter Measurement on Computerized Tomography: A Report of 500 Sudanese Patients

“…All breadths extended with age. There was no effect on weight, level, or body surface locale [25,26]. After normalization to the width at the diaphragmatic level, no truly out and out influential component could be recognized [27].…”

“…The information gathered from 500 haphazardly chosen non-neurotic patients was awarded by the SPSS program and introduced in tables and figures. One more review was directed by Boccalini et al (2022), who take a gander at the image idea of in vivo coronary stents between an energy organizing identifiers twofold layer handled tomography (EID-DLCT) and a clinical model of spooky photon-counting figured tomography. Boccalini and his partners analyzed eight patients old enough 68 years, a weilist off, 26.2 kg/m same as announced in our review.…”

Quantification of cartilage and subchondral bone cysts on knee specimens based on a spectral photon-counting computed tomography

“…The SPCCT prototype used in the present study is based on a clinical CT scanner and displayed all its characteristics with the potential to be used in a short period of time in clinics. Performances were already tested in living patients for brain, lung, heart, and to describe the anatomy of temporal bone and wrist [11][12][13][14][15][16][17], but never for osteo-articular diseases. Our results suggest that SPCCT has the potential to provide biomarkers for OA characterization for both cartilage, and bone.…”

“…They are characterized by new detectors, i.e., energy-resolving photon-counting detector, that simultaneously count photons and resolve their energy [10]. In living patients, SPCCT has, for instance, been already used to characterize kidney stones [11], coronary artery calcium scoring [12], coronary stent [13], lung cancers [14], brain [15] and anatomical structures of temporal bone and wrist [16,17]. SPCCT extends the dual energy CT approach by a multispectral approach [18].…”

Spectral Photon-Counting CT Technology in Chest Imaging

“…Photon-counting detector computed tomography (PCD-CT) technology is a new CT modality that has gained increasing interest in all areas of imaging, including musculoskeletal, digestive, cardiovascular, pulmonary, and molecular imaging [1][2][3][4][5][6]. Contrary to energy integrated detectors (EID) found in current standard CT scanners, PCD are made of compounds, such as silicon, cadmium-telluride, or cadmium-zinc-telluride, to directly convert each X-ray photon into an electric pulse, allowing resolution of the energy of the photons.…”