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- Title
Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement.
- Authors
Martin, Simon; Albrecht, Moritz; Wichmann, Julian; Hüsers, Kristina; Scholtz, Jan-Erik; Booz, Christian; Bodelle, Boris; Bauer, Ralf; Metzger, Sarah; Vogl, Thomas; Lehnert, Thomas; Martin, Simon S; Albrecht, Moritz H; Wichmann, Julian L; Bauer, Ralf W; Metzger, Sarah C; Vogl, Thomas J
- Abstract
<bold>Objectives: </bold>To evaluate objective and subjective image quality of a noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique in dual-energy computed tomography (DECT) angiography prior to transcatheter aortic valve replacement (TAVR).<bold>Methods: </bold>Datasets of 47 patients (35 men; 64.1 ± 10.9 years) who underwent DECT angiography of heart and vascular access prior to TAVR were reconstructed with standard linear blending (F_0.5), VMI+, and traditional monoenergetic (VMI) algorithms in 10-keV intervals from 40-100 keV. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of 564 arterial segments were evaluated. Subjective analysis was rated by three blinded observers using a Likert scale.<bold>Results: </bold>Mean SNR and CNR were highest in 40 keV VMI+ series (SNR, 27.8 ± 13.0; CNR, 26.3 ± 12.7), significantly (all p < 0.001) superior to all VMI series, which showed highest values at 70 keV (SNR, 18.5 ± 7.6; CNR, 16.0 ± 7.4), as well as linearly-blended F_0.5 series (SNR, 16.8 ± 7.3; CNR, 13.6 ± 6.9). Highest subjective image quality scores were observed for 40, 50, and 60 keV VMI+ reconstructions (all p > 0.05), significantly superior to all VMI and standard linearly-blended images (all p < 0.01).<bold>Conclusions: </bold>Low-keV VMI+ reconstructions significantly increase CNR and SNR compared to VMI and standard linear-blending image reconstruction and improve subjective image quality in preprocedural DECT angiography in the context of TAVR planning.<bold>Key Points: </bold>• VMI+ combines increased contrast with reduced image noise. • VMI+ shows substantially less image noise than traditional VMI. • 40-keV reconstructions show highest SNR/CNR of the aortic and iliofemoral access route. • Observers overall prefer 60 keV VMI+ images. • VMI+ DECT imaging helps improve image quality for TAVR planning.
- Subjects
CARDIAC imaging; TOMOGRAPHY; IMAGE quality in medical radiography; BLOOD vessels; SIGNAL-to-noise ratio
- Publication
European Radiology, 2017, Vol 27, Issue 2, p705
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4422-3