title: Coronary artery stent imaging with CT using an integrated electronics detector and iterative reconstructions: first in vitro experience.
abstract: BACKGROUND
  Despite continuous improvements in CT technology, accurate stent lumen delineation remains challenging.
  
  
  OBJECTIVE
  The aim was to evaluate the quality of coronary stent lumen delineation with CT using a detector with integrated electronics.
  
  
  METHODS
  Twelve coronary stents placed in plastic tubes and filled with contrast agent (CT number 250 HU) were imaged with either a 128-section dual-source CT machine equipped with conventional detector or with integrated electronics. On both scanners, images were reconstructed with filtered back projection (slice thickness 0.6 mm; increment 0.4 mm) and sinogram-affirmed iterative reconstruction (slice thickness 0.6 mm; increment 0.4 mm), and with iterative reconstruction (slice thickness 0.5 mm; increment 0.3 mm) on the integrated scanner. Two blinded, independent readers assessed image quality, noise, in-stent diameter, in-stent attenuation, and image sharpness by using signal intensity profiles across stents.
  
  
  RESULTS
  Interreader agreement for image quality assessment was substantial (κ = 0.798). Both readers rated best image quality in data sets from integrated detector at highest spatial resolution (86 or 72% of stents rated best quality). Image noise was significantly lower in data sets scanned with integrated detector, being lowest at 0.6 mm slice thickness (14.3 vs 21.0 HU; P < .001). Differences between measured and true in-stent diameters and differences in attenuation across stents were smallest, and average/maximum image sharpness was highest in data sets from the integrated detector using iterative reconstructions.
  
  
  CONCLUSIONS
  CT coronary stent imaging is significantly improved by using a detector with integrated electronics combined with iterative reconstructions.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: Jochen
authors.initials: J
authors.lastname: von Spiczak
authors.forename: Fabian
authors.initials: F
authors.lastname: Morsbach
authors.forename: Sebastian
authors.initials: S
authors.lastname: Winklhofer
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.forename: Thomas
authors.initials: T
authors.lastname: Flohr
authors.forename: David
authors.initials: D
authors.lastname: Maintz
authors.forename: Harald
authors.initials: H
authors.lastname: Seifarth
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Bunck
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
mesh_terms: D016477:Artifacts; D017023:Coronary Angiography / Q000295:instrumentation* / Q000379:methods; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004867:Equipment Design; D008955:Models, Cardiovascular; D061330:Multidetector Computed Tomography / Q000295:instrumentation*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D015607:Stents; D015898:Tomography Scanners, X-Ray Computed
keywords: Computed tomography; Coronary artery; Detector; Iterative reconstruction; Stent