title: Image quality of volume rendering of the bronchial tree: Kymogram-gated versus retrospectively ECG-gated and non-gated multi-row detector CT.
abstract: OBJECTIVE
  To compare the image quality of three different heart-cycle-synchronized computed tomography (CT) reconstruction algorithms for volume-rendered (VR) 3D visualization of the bronchial tree.
  
  
  METHODS
  Kymogram-gated, retrospectively ECG-gated, and non-ECG-gated reconstructions of the bronchial tree were performed from 4-detector-row CT data in 10 subjects. The raw data were reconstructed in 10 phases of the cardiac cycle using ECG-gated and kymogram-gated technique, respectively. For both reconstructions, the optimal artifact-free diastolic phase was determined. VR reconstructions of the bronchial tree were generated from these two data sets and from the non-gated data. Stairstep artifacts of the main bronchi, artifacts in the lung parenchyma, and the extent of bronchial tree visualization were rated by two blinded, independent readers.
  
  
  RESULTS
  Kymogram-gated reconstruction showed stairstep artifacts in the main bronchi to the same extent as non-gated reconstruction, but less compared to ECG-gated reconstruction (P < .001). Artifacts in the lung parenchyma were similar with kymogram-gated and non-gated reconstruction, but less compared to ECG-gated reconstruction (P < 0.01). Kymogram-gated reconstruction showed no differences in visualization of segmental and subsegmental bronchi compared to ECG-gated reconstruction, but was inferior to the non-gated reconstruction (P < 0.05).
  
  
  CONCLUSIONS
  Kymogram-gated reconstruction of CT data results in fewer artifacts when compared to the ECG-gated algorithm. Best visualization of the bronchial tree at a low artifact level is obtained with non-gated CT data. It remains therefore the method of choice for VR 3D data post-processing of the bronchial tree.
authors.affiliation: Department of Radiology, Spitäler Chur AG, Loestrasse 170, CH-7000 Chur, Switzerland. Thomas_Boehm@gmz.net
authors.forename: Thomas
authors.initials: T
authors.lastname: Boehm
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Dirk-Alexander
authors.initials: DA
authors.lastname: Sennst
authors.forename: Thomas
authors.initials: T
authors.lastname: Schertler
authors.forename: M
authors.initials: M
authors.lastname: Kachelriess
authors.forename: Willi
authors.initials: W
authors.lastname: Kalender
authors.forename: Borut
authors.initials: B
authors.lastname: Marincek
authors.forename: Simon
authors.initials: S
authors.lastname: Wildermuth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D001995:Bronchography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*