Exploring the best monochromatic energy level in dual energy spectral imaging for coronary stents after percutaneous coronary intervention

• Published in: Scientific reports Vol. 11; no. 1; p. 17576
• Main Authors: Liu, Qian, Wang, Yajuan, Qi, Haicheng, Yu, Yaohui, Xing, Yan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.09.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4019; 692/699/75; Adult; Aged; Angioplasty; China - epidemiology; Computed tomography; Computed Tomography Angiography - methods; Coronary Angiography - methods; Coronary Disease - diagnostic imaging; Coronary Disease - epidemiology; Coronary Disease - pathology; Coronary Disease - surgery; Energy; Female; Humanities and Social Sciences; Humans; Implants; Male; Middle Aged; multidisciplinary; Percutaneous Coronary Intervention - methods; Prognosis; Radiographic Image Interpretation, Computer-Assisted - methods; Retrospective Studies; Risk Factors; Science; Science (multidisciplinary); Signal-To-Noise Ratio; Stents; China
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-97035-7

In this study, the optimal monochromatic energy level in dual-energy spectral CT required for imaging coronary stents after percutaneous coronary intervention (PCI) was explored. Thirty-five consecutive patients after PCI were examined using the dual-energy spectral CT imaging mode. The original images were reconstructed at 40–140 keV (10-keV interval) monochromatic levels. The in-stent and out-stent CT values at each monochromatic level were measured to calculate the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) for the vessel and the CT value difference between the in-stent and out-stent lumen (dCT (in–out)), which reflects the artificial CT number increase due to the beam hardening effect caused by the stents. The subjective image quality of the stent and in-stent vessel was evaluated by two radiologists using a 5-point scale. With the increase in energy level, the CT value, SNR, CNR, and dCT (in–out) all decreased. At 80 keV, the mean CT value in-stent reached (345.24 ± 93.43) HU and dCT (in–out) started plateauing. In addition, the subjective image quality of the stents and vessels peaked at 80 keV. The 80 keV monochromatic images are optimal for imaging cardiac patients with stents after PCI, balancing the enhancement and SNR and CNR in the vessels while minimizing the beam hardening artifacts caused by the stents.