Improved coronary artery contrast enhancement using noise-optimised virtual monoenergetic imaging from dual-source dual-energy computed tomography. Issue 122 (January 2020)

• Record Type: Journal Article
• Authors: Arendt, Christophe T.; Czwikla, Rouben; Lenga, Lukas; Wichmann, Julian L.; Albrecht, Moritz H.; Booz, Christian; Martin, Simon S.; Leithner, Doris; Tischendorf, Patricia; Blandino, Alfredo; Vogl, Thomas J.; D'Angelo, Tommaso
• Is Part Of: European journal of radiology. Issue 122(2020)
• Publication Date: 2020-01
• Subjects: CA contrast agent -- CCTA coronary computed tomography angiography -- CNR contrast-to-noise ratio -- DE-CCTA dual-energy coronary computed tomography angiography -- DECT dual-energy computed tomography -- keV kiloelectron volt -- PACS picture archiving and communication system -- SNR signal-to-noise ratio -- VMI virtual monoenergetic imaging -- VMI+ noise-optimised virtual monoenergetic imaging; Image enhancement -- Computed tomography angiography -- Coronary artery disease; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.108666
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Objective image quality parameters peaked at 40 keV in noise-optimised VMI+ series. Vascular contrast and lesion delineation were rated best at VMI+ reconstructions. Post-processing with VMI+ may improve DE-CCTA in comparison to VMI and F_0.6 series. Abstract: Purpose: To define optimal kiloelectron volt (keV) settings for virtual monoenergetic imaging (VMI) reconstruction at dual-energy coronary computed tomography angiography (DE-CCTA). Method: Fifty-one DE-CCTA data sets (33 men; mean age, 63.9 ± 13.2 years) were reconstructed as standard linearly-blended images (F_0.6; 60% of 90 kVp, 40% of 150 kVpSn), and with traditional (VMI) and noise-optimised (VMI+) algorithms from 40 to 100 keV in 10-keV intervals. Objective image quality was assessed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements. Three observers subjectively evaluated vascular contrast, image sharpness, noise and delineation of coronary plaques. Results: Median values for objective image analysis were highest in VMI + series at 40 keV (SNR, 44.5; CNR: 33.5), significantly superior (all p < 0.001) to the best VMI series at 70 keV (SNR, 28.1; CNR, 18.4) and standard F_0.6 images (SNR, 23.2; CNR, 15.6). Overall subjective metrics achieved higher scores at 40-keV VMI+ series in comparison to 70-keV VMI series and F_0.6 images (all p < 0.001), with optimal vascular contrast (5; ICC, 0.90), good image sharpness (4; 0.88), low noise (4; 0.82), and optimal plaque delineation (5; 0.89). Conclusions: DE-CCTA image reconstruction with 40-keV VMI + allows for significant improvement of both objective and subjective image quality.