Performance of dual source versus 256-slice multi-slice CT in the evaluation of 16 coronary artery stents. 2013

Florian André, and Grigorios Korosoglou, and Waldemar Hosch, and Evangelos Giannitsis, and Hans-Ulrich Kauczor, and Hugo A Katus, and Henning Steen
University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany. florian.andre@med.uni-heidelberg.de

BACKGROUND Invasive coronary angiography is the reference method for identification of in-stent restenosis (ISR) bearing the disadvantages of high costs and invasiveness. New approaches like dual-source CT (DSCT) and 256-multi-slice CT (256-MSCT) may potentially be the future methods of choice to reliably exclude ISR in patients with low or intermediate risk of restenosis. We sought to compare the performance of DSCT and 256-MSCT for the in vitro assessment of stent lumen diameter and basic scan parameters in stents of various diameters and designs. METHODS In 16 coronary artery stents we evaluated relative in-stent lumen diameter, attenuation, noise, attenuation-/signal-to-noise ratio (ANR/SNR) and radiation dose (CTDIvol) in an acknowledged coronary vessel in vitro phantom (iodine-filled plastic tubes) with DSCT (Siemens, SOMATOM Definition, collimation=2×64×0.6mm, pitch=0.26, current=400mAs/rot, voltage=120kV, tube-rotation-time=330ms) and 256-MSCT (Philips Brilliance, iCT, tube collimation=2×128×0.625mm, pitch=0.18, current=800mAseff, voltage=120kV, tube-rotation-time=270ms). Diameter analysis was conducted with the observer-independent full-width-at-half-maximum (FWHM) technique. RESULTS DSCT and 256-MSCT revealed similar stent lumen diameters (50.7±7.2% vs. 50.8±7.4%, p=0.98). Attenuation (-19±25HU vs. 54±29HU), ANR (-0.9±1.2 vs. 2.9±1.8) and SNR (12.1±2.4 vs. 17.4±1.9) were better in the DSCT (all p<0.001) at the expense of significantly higher radiation doses (CTDIvol=87 vs. 51mGy, p<0.01). Noise was comparable (21±2HU vs. 20±2HU, p=n.s.). Only stents with a diameter >3mm allowed sufficient stent lumen assessment in both scanners and showed a relative lumen diameter of 60-66%. CONCLUSIONS The measured stent lumen diameter and image noise were similar in both scanners. Yet the DSCT offered a more truthful stent lumen visualization at the cost of higher radiation dose. Applying the FWHM approach only stents with a diameter >3mm offered sufficient stent lumen assessment.

UI MeSH Term Description Entries
D007472 Iohexol An effective non-ionic, water-soluble contrast agent which is used in myelography, arthrography, nephroangiography, arteriography, and other radiographic procedures. Its low systemic toxicity is the combined result of low chemotoxicity and low osmolality. Compound 545,Exypaque,Iohexol 350,Nycodenz,Omnipaque
D003287 Contrast Media Substances used to allow enhanced visualization of tissues. Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent
D017023 Coronary Angiography Radiography of the vascular system of the heart muscle after injection of a contrast medium. Angiography, Coronary,Angiographies, Coronary,Coronary Angiographies
D059629 Signal-To-Noise Ratio The comparison of the quantity of meaningful data to the irrelevant or incorrect data. Ratio, Signal-To-Noise,Ratios, Signal-To-Noise,Signal To Noise Ratio,Signal-To-Noise Ratios
D019047 Phantoms, Imaging Devices or objects in various imaging techniques used to visualize or enhance visualization by simulating conditions encountered in the procedure. Phantoms are used very often in procedures employing or measuring x-irradiation or radioactive material to evaluate performance. Phantoms often have properties similar to human tissue. Water demonstrates absorbing properties similar to normal tissue, hence water-filled phantoms are used to map radiation levels. Phantoms are used also as teaching aids to simulate real conditions with x-ray or ultrasonic machines. (From Iturralde, Dictionary and Handbook of Nuclear Medicine and Clinical Imaging, 1990) Phantoms, Radiographic,Phantoms, Radiologic,Radiographic Phantoms,Radiologic Phantoms,Phantom, Radiographic,Phantom, Radiologic,Radiographic Phantom,Radiologic Phantom,Imaging Phantom,Imaging Phantoms,Phantom, Imaging
D023921 Coronary Stenosis Narrowing or constriction of a coronary artery. Coronary Artery Stenosis,Coronary Stenoses,Artery Stenoses, Coronary,Artery Stenosis, Coronary,Coronary Artery Stenoses,Stenoses, Coronary,Stenoses, Coronary Artery,Stenosis, Coronary,Stenosis, Coronary Artery
D066298 In Vitro Techniques Methods to study reactions or processes taking place in an artificial environment outside the living organism. In Vitro Test,In Vitro Testing,In Vitro Tests,In Vitro as Topic,In Vitro,In Vitro Technique,In Vitro Testings,Technique, In Vitro,Techniques, In Vitro,Test, In Vitro,Testing, In Vitro,Testings, In Vitro,Tests, In Vitro,Vitro Testing, In

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