title: CT Evaluation of Small-Diameter Coronary Artery Stents: Effect of an Integrated Circuit Detector with Iterative Reconstruction.
abstract: OBJECTIVE
  To use suitable objective methods of analysis to assess the influence of the combination of an integrated-circuit computed tomographic (CT) detector and iterative reconstruction (IR) algorithms on the visualization of small (≤3-mm) coronary artery stents.
  
  
  METHODS
  By using a moving heart phantom, 18 data sets obtained from three coronary artery stents with small diameters were investigated. A second-generation dual-source CT system equipped with an integrated-circuit detector was used. Images were reconstructed with filtered back-projection (FBP) and IR at a section thickness of 0.75 mm (FBP75 and IR75, respectively) and IR at a section thickness of 0.50 mm (IR50). Multirow intensity profiles in Hounsfield units were modeled by using a sum-of-Gaussians fit to analyze in-plane image characteristics. Out-of-plane image characteristics were analyzed with z upslope of multicolumn intensity profiles in Hounsfield units. Statistical analysis was conducted with one-way analysis of variance and the Student t test.
  
  
  RESULTS
  Independent of stent diameter and heart rate, IR75 resulted in significantly increased xy sharpness, signal-to-noise ratio, and contrast-to-noise ratio, as well as decreased blurring and noise compared with FBP75 (eg, 2.25-mm stent, 0 beats per minute; xy sharpness, 278.2 vs 252.3; signal-to-noise ratio, 46.6 vs 33.5; contrast-to-noise ratio, 26.0 vs 16.8; blurring, 1.4 vs 1.5; noise, 15.4 vs 21.2; all P < .001). In the z direction, the upslopes were substantially higher in the IR50 reconstructions (2.25-mm stent: IR50, 94.0; IR75, 53.1; and FBP75, 48.1; P < .001).
  
  
  CONCLUSIONS
  The implementation of an integrated-circuit CT detector provides substantially sharper out-of-plane resolution of coronary artery stents at 0.5-mm section thickness, while the use of iterative image reconstruction mostly improves in-plane stent visualization.
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Lucas L
authors.initials: LL
authors.lastname: Geyer
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: G Russell
authors.initials: GR
authors.lastname: Glenn
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Carlo Nicola
authors.initials: CN
authors.lastname: De Cecco
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Mark
authors.initials: M
authors.lastname: Van Horn
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Christian
authors.initials: C
authors.lastname: Canstein
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Justin R
authors.initials: JR
authors.lastname: Silverman
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Aleksander W
authors.initials: AW
authors.lastname: Krazinski
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Jenny M
authors.initials: JM
authors.lastname: Kemper
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Andreas
authors.initials: A
authors.lastname: Bucher
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Ullrich
authors.initials: U
authors.lastname: Ebersberger
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Philip
authors.initials: P
authors.lastname: Costello
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: Fabian
authors.initials: F
authors.lastname: Bamberg
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (L.L.G., G.R.G., C.N.D.C., M.V.H., J.R.S., A.W.K., J.M.K., A.B., U.E., P.C., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Heart & Vascular Center, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Clinical Radiology, University Hospitals LMU Munich, Munich, Germany (L.L.G., F.B.); Siemens Medical Solutions, CT Division, Malvern, Pa (C.C.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (U.E.); and Department of Radiology, University of Tuebingen, Tuebingen, Germany (F.B.).
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
mesh_terms: D000465:Algorithms; D003331:Coronary Vessels; D007091:Image Processing, Computer-Assisted; D019047:Phantoms, Imaging; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed