Photon counting CT ultra-high resolution mode significantly improved coronary stent visualization with larger in-stent diameters and reduced blooming artifacts compared to simulated EID-CT (p<0.001).
Cross-Sectional (n=41)
Does PCCT ultra-high resolution mode improve coronary stent visualization and fat attenuation index assessment compared to simulated EID-CT in patients with prior PCI?
PCCT ultra-high resolution mode improves coronary stent visualization and provides distinct fat attenuation index cut-offs for identifying in-stent restenosis compared to standard CT reconstruction.
p-value: p=<0.001
Objectives: To investigate the effect of photon counting CT (PCCT) ultra-high resolution (UHR) mode on coronary stent visualization and fat attenuation index (FAI) assessment in individuals with percutaneous coronary intervention (PCI). Methods: Patients who underwent PCI with stent placement and following coronary CT angiography (CCTA) by using a PCCT system were enrolled during January to August 2024. Simulated energy integrating detector CT (EID-CT) images (0.8 mm) were reconstructed with kernel Bv48, while UHR images (0.2 mm) were reconstructed using kernel Bv60 and Bv72. Objective and subjective image quality, stent-specific FAI and peri-stent FAI was evaluated. Results: A total of 41 patients with 51 isolated stents (69.76 ± 8.75 years; 34 men) were included. Compared to simulated EID-CT, 0.2 mm Bv72 images showed larger in-stent diameters and reduced blooming artifacts (all p < 0.001). Subjective image quality scores for 0.2 mm UHR images were superior to those for simulated EID-CT (all p < 0.01). The stent-specific FAI and peri-stent FAI of 51 isolated stents was lower in the 0.2 mm UHR images than in simulated EID-CT (all p < 0.05). The reconstruction mode of 0.2 mm Bv72 showed the ability of stent-specific FAI and peri-stent FAI to distinguish stents with in-stent restenosis (ISR) < 50 % in diameter from stents without ISR, with cut-off value of -98HU and -99.5HU, respectively. Conclusions: PCCT UHR mode improved the image quality of coronary stents, reduced the FAI values and provided cut-off values based on stent-specific FAI and peri-stent FAI.
Gao et al. (Wed,) conducted a cross-sectional in Percutaneous coronary intervention with stent placement (n=41). Photon counting CT ultra-high resolution mode (0.2 mm) vs. Simulated energy integrating detector CT (0.8 mm) was evaluated on Coronary stent visualization (in-stent diameters and blooming artifacts) and fat attenuation index (p=<0.001). Photon counting CT ultra-high resolution mode significantly improved coronary stent visualization with larger in-stent diameters and reduced blooming artifacts compared to simulated EID-CT (p<0.001).