Usefulness of 64-Slice Multidetector Computed Tomography for Detecting Drug Eluting In-Stent Restenosis

Carrabba, Nazario; Bamoshmoosh, Mohamed; Carusi, Luca Maria; Parodi, Guido; Valenti, Renato; Migliorini, Angela; Fanfani, F; Antoniucci, David

doi:10.1016/j.amjcard.2007.07.038

Cited by 38 publications

(19 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The new data represent a completion to the catalogue of the CT appearance of most currently available coronary stents that was published in 2006. In the meantime, a couple of studies were reported that confirm the clinical use of cardiac CT for the assessment of coronary stents with 64-slice CT [15][16][17][18][19]24] and dualsource CT [25]. The number of positive reports reflects the importance of the topic, and the updated catalogue of the CT appearance of coronary stents may be advantageous when interpreting a cardiac CT examination of a patient with previous stent treatment or to select patients with specific stent types for noninvasive follow-up.…”

Section: Discussionmentioning

confidence: 91%

Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT

et al. 2008

View full text Add to dashboard Cite

The aim of this study was to test a large sample of the latest coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in dual-source multidetector row CT (DSCT) in vitro and to provide a CT catalogue of currently used coronary artery stents. Twenty-nine different coronary artery stents (19 steel, 6 cobalt-chromium, 2 tantalum, 1 iron, 1 magnesium) were examined in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70 HU). Stents were imaged in axial orientation with standard parameters: 32 x 0.6 collimation, pitch 0.24, 400 mAs, 120 kV, rotation time 0.33 s. Image reconstructions were obtained with four different convolution kernels (soft, medium-soft, standard high-resolution, stent-dedicated). To evaluate visualization characteristics of the stent, the lumen diameter, intraluminal density, and noise were measured. The stent-dedicated kernel offered best average lumen visualization (54 +/- 8.3%) and most realistic lumen attenuation (222 +/- 44 HU) at the expense of increased noise (23.9 +/- 1.9 HU) compared with standard CTA protocols (p < 0.001 for all). The magnesium stent showed the least artifacts with a lumen visibility of 90%. The majority of stents (79%) exhibited a lumen visibility of 50-59%. Less than half of the stent lumen was visible in only six stents. Stent lumen visibility largely varies depending on the stent type. Magnesium is by far more favorable a stent material with regard to CT imaging when compared with the more common materials steel, cobalt-chromium, or tantalum. The magnesium stent exhibits a lumen visibility of 90%, whereas the majority of the other stents exhibit a lumen visibility of 50-59%.

show abstract

Section: Discussionmentioning

confidence: 91%

Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT

et al. 2008

View full text Add to dashboard Cite

show abstract

“…However, if the in-stent lumen was deemed to have sufficient image quality, a good diagnostic accuracy for the detection of greater than 50% in-stent restenosis could be achieved, with a sensitivity and specificity of 86-97% and 88-98% [16,17,[22][23][24][25], respectively. For drugeluting stents, in vivo sensitivity to diagnosing significant stenosis was 84% [26]. Magnesium stents have shown the best lumen visibility of 90% [7].…”

Section: Discussionmentioning

confidence: 98%

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

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Routine follow-up angiography in these patients has not been recommended [1]. Previous studies suggest supporting the clinical indications for 64-slice coronary CTA as a gatekeeper for the exclusion of in-stent restenosis, owing to its high negative predictive value [2][3][4][5][6][7]. However, the substantial numbers of unassessable stents, up to 14% [3], limit the usefulness of this approach.…”

Section: Introductionmentioning

confidence: 98%

Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT

et al. 2009

View full text Add to dashboard Cite

The purpose of this study was to compare coronary 64-slice CT angiography (CTA) protocols, specifically prospective electrocardiograph (ECG)-triggered and retrospective ECG-gated CT acquisition performed using a tube voltage of 140 kV and 120 kV, regarding intracoronary stent imaging. Coronary artery stents (n = 12) with artificial in-stent restenosis (50% luminal reduction, 40 HU) on a cardiac phantom were examined by CT at heart rates of 50-75 beats per minute (bpm). The subjective visibility of in-stent restenosis was evaluated with a three-point scale (1 clearly visible, 2 visible, and 3 not visible), and artificial lumen narrowing [(inner stent diameter - measured lumen diameter)/inner stent diameter], lumen attenuation increase ratio [(in-stent attenuation - coronary lumen attenuation)/coronary lumen attenuation], and signal-to-noise ratio of in-stent lumen were determined. The effective dose was estimated. The artificial lumen narrowing (mean 43%), the increase of lumen attenuation (mean 46%), and signal-to-noise ratio (mean 7.8) were not different between CT acquisitions (p = 0.12-0.91). However, the visibility scores of in-stent restenosis were different (p < 0.05) between ECG-gated CTA techniques: (a) 140-kV prospective (effective dose 4.6 mSv), 1.6; (b) 120-kV prospective (3.3 mSv), 1.8; (c) 140-kV retrospective (16.4-18.8 mSv), 1.9; and (d) 120-kV retrospective (11.0-13.4 mSv), 1.9. Thus, 140-kV prospective ECG-triggered CTA improves coronary in-stent restenosis visibility at a lower radiation dose compared with retrospective ECG-gated CTA.

show abstract

Usefulness of 64-Slice Multidetector Computed Tomography for Detecting Drug Eluting In-Stent Restenosis

Cited by 38 publications

References 14 publications

Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT

Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT

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

Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT

Contact Info

Product

Resources

About