A noise-optimized virtual monochromatic reconstruction algorithm improves stent visualization and diagnostic accuracy for detection of in-stent re-stenosis in lower extremity run-off CT angiography

Purpose To evaluate the impact of noise-optimized virtual monochromatic imaging (VMI+) on stent visualization and accuracy for in-stent re-stenosis at lower extremity dual-energy CT angiography (DE-CTA). Material and methods We evaluated third-generation dual-source DE-CTA studies in 31 patients wit...

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Bibliographic Details
Published in:European radiology 2016-12, Vol.26 (12), p.4380-4389
Main Authors: Mangold, Stefanie, De Cecco, Carlo N., Schoepf, U. Joseph, Yamada, Ricardo T., Varga-Szemes, Akos, Stubenrauch, Andrew C., Caruso, Damiano, Fuller, Stephen R., Vogl, Thomas J., Nikolaou, Konstantin, Todoran, Thomas M., Wichmann, Julian L.
Format: Article
Language:English
Subjects:
Abdomen
Accuracy
Adult
Aged
Algorithms
Computed Tomography Angiography - methods
Computer Applications
Coronary vessels
Diagnostic Radiology
Energy
Female
Graft Occlusion, Vascular - diagnostic imaging
Humans
Imaging
Internal Medicine
Interventional Radiology
Ischemia - diagnostic imaging
Ischemia - therapy
Lower Extremity - blood supply
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Radiographic Image Interpretation, Computer-Assisted - methods
Radiology
Reproducibility of Results
Sensitivity and Specificity
Sensors
Signal-To-Noise Ratio
Stents
Ultrasound
Visualization
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Summary:Purpose To evaluate the impact of noise-optimized virtual monochromatic imaging (VMI+) on stent visualization and accuracy for in-stent re-stenosis at lower extremity dual-energy CT angiography (DE-CTA). Material and methods We evaluated third-generation dual-source DE-CTA studies in 31 patients with prior stent placement. Images were reconstructed with linear blending (F_0.5) and VMI+ at 40–150 keV. In-stent luminal diameter was measured and contrast-to-noise ratio (CNR) calculated. Diagnostic confidence was determined using a five-point scale. In 21 patients with invasive catheter angiography, accuracy for significant re-stenosis (≥50 %) was assessed at F_0.5 and 80 keV-VMI+ chosen as the optimal energy level based on image-quality analysis. Results At CTA, 45 stents were present. DSA was available for 28 stents whereas 12 stents showed significant re-stenosis. CNR was significantly higher with ≤80 keV-VMI+ (17.9 ± 6.4–33.7 ± 12.3) compared to F_0.5 (16.9 ± 4.8; all p  
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-016-4304-8