First in vivo head-to-head comparison of high-definition versus standard-definition stent imaging with 64-slice computed
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ORIGINAL PAPER
First in vivo head-to-head comparison of high-definition versus standard-definition stent imaging with 64-slice computed tomography Tobias A. Fuchs • Julia Stehli • Michael Fiechter • Svetlana Dougoud • Bert-Ram Sah • Cathe´rine Gebhard Sacha Bull • Oliver Gaemperli • Philipp A. Kaufmann
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Received: 15 February 2013 / Accepted: 19 April 2013 / Published online: 1 May 2013 Ó Springer Science+Business Media Dordrecht 2013
Abstract The aim of this study was to compare image quality characteristics from 64-slice high definition (HDCT) versus 64-slice standard definition CT (SDCT) for coronary stent imaging. In twenty-five stents of 14 patients, undergoing contrast-enhanced CCTA both on 64-slice SDCT (LightSpeedVCT, GE Healthcare) and HDCT (Discovery HD750, GE Healthcare), radiation dose, contrast, noise and stent characteristics were assessed. Two blinded observers graded stent image quality (score 1 = no, 2 = mild, 3 = moderate, and 4 = severe artefacts). All scans were reconstructed with increasing contributions of adaptive statistical iterative reconstruction (ASIR) blending (0, 20, 40, 60, 80 and 100 %). Image quality was significantly superior in HDCT versus SDCT (score 1.7 ± 0.5 vs. 2.7 ± 0.7; p \ 0.05). Image noise was significantly higher in HDCT compared to SDCT irrespective of ASIR contributions (p \ 0.05). Addition of 40 % ASIR or more reduced image noise significantly in both HDCT and SDCT. In HDCT in-stent luminal attenuation was significantly lower and mean measured in-stent luminal diameter was significantly larger (1.2 ± 0.4 mm vs. 0.8 ± 0.4 mm; p \ 0.05) compared to SDCT. Radiation dose from HDCT was comparable to SDCT (1.8 ± 0.7 mSv vs. 1.7 ± 0.7 mSv; p = ns). Use of
Tobias A. Fuchs and Julia Stehli contributed equally to this work. T. A. Fuchs J. Stehli M. Fiechter S. Dougoud B.-R. Sah C. Gebhard S. Bull O. Gaemperli P. A. Kaufmann (&) Department of Radiology, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, 8091 Zurich, Switzerland e-mail: [email protected] P. A. Kaufmann Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
HDCT for coronary stent imaging reduces partial volume artefacts from stents yielding improved image quality versus SDCT at a comparable radiation dose. Keywords Coronary computed tomography angiography Stent imaging High definition CT Iterative reconstruction
Introduction Coronary computed tomography angiography (CCTA) has become a well-established non-invasive tool for diagnosis of coronary artery disease (CAD). While yielding high accuracy compared to invasive coronary angiography for the detection of coronary artery stenosis [1, 2], CCTA for stent imaging is still affected by artefacts from coronary stents leading to artificial luminal narrowing, due to partial volume artefact from highly attenuated stent struts [3, 4]. Although the in-stent restenosis rate has been substantially reduced by introducing drug-eluting stents it has not been entirely eliminated [5]. Furthermore,
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