Improved Coronary Artery Visualization Using Virtual Monoenergetic Imaging from Dual-Layer Spectral Detector CT Angiography
Tommaso D’Angelo,
Ludovica R. M. Lanzafame,
Antonino Micari,
Alfredo Blandino,
Ibrahim Yel,
Vitali Koch,
Leon D. Gruenewald,
Thomas J. Vogl,
Christian Booz,
Giuseppe M. Bucolo,
Maria Teresa Cannizzaro,
Giorgio Ascenti,
Silvio Mazziotti
Affiliations
Tommaso D’Angelo
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Ludovica R. M. Lanzafame
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Antonino Micari
Department of Clinical and Experimental Medicine, DIMED, University Hospital Messina, 98124 Messina, Italy
Alfredo Blandino
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Ibrahim Yel
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Vitali Koch
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Leon D. Gruenewald
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Thomas J. Vogl
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Christian Booz
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Giuseppe M. Bucolo
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Maria Teresa Cannizzaro
Radiology Unit (CAST), University Hospital Catania, “Policlinico G. Rodolico–San Marco”, 95123 Catania, Italy
Giorgio Ascenti
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Silvio Mazziotti
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Background: To evaluate if coronary CT angiography (CCTA) monoenergetic reconstructions, obtained with a dual-layer spectral detector computed tomography (DLCT) system, offer improved image quality compared with 120 kVp conventional images without affecting the quantitative assessment of coronary stenoses. Methods: Fifty CCTA datasets (30 men; mean age: 61.6 ± 12.3 years) acquired with a DLCT system were reconstructed using virtual monoenergetic images (VMI) from 40 to 100 keV with 10 keV increment and compared with conventional images. An analysis of objective image quality was performed, evaluating the signal- and contrast-to-noise ratio. For the subjective assessment, two readers used a 5-point Likert scoring system to evaluate sharpness, noise, demarcation of coronary plaques, vascular contrast, and an overall score. Furthermore, coronary stenoses were analyzed for each vessel to describe the diagnostic agreement between monoenergetic images and conventional images. Results: The objective image analysis showed that all reconstructions from 70 keV to 40 keV show higher SNR (from 61.33 ± 12.46 to 154.22 ± 42.91, respectively) and CNR (from 51.45 ± 11.19 to 135.63 ± 39.38, respectively) compared with conventional images (all p p Conclusions: The 40 keV virtual monoenergetic images obtained with a DLCT system allow the objective and subjective image quality of coronary CT angiography to be improved.