Image reconstruction and performance evaluation for ECG-gated spiral scanning with a 16-slice CT system.

We present an image reconstruction approach and a performance evaluation for ECG-gate cardiac spiral scanning with recently introduced 16-slice CT equipment. We present an extension of the Adaptive Cardio Volume (ACV) reconstruction approach for ECG-gated multislice spiral scanning. We discuss the image z reformation introduced to control the spiral slice width of the final images and give an overview of the reformation functions chosen. We investigate image quality and discuss the maximum number of slices that can be reconstructed without severe cone-beam artifacts. Slice sensitivity profiles (SSPs) and transverse resolution are evaluated as a function of the patient's heart rate. We demonstrate the influence of slice width on the visualization of stents and plaques and show the impact of reduced gantry rotation time (0.42 s) on temporal resolution. Deviating from general purpose spiral scanning cone-beam reconstruction is not required for ECG-gated cardiac CT with up to 16 slices. Using the ACV approach with image reformation, SSPs are well defined and independent of the patient's heart rate. With 0.75 mm collimated slice width, the measured full width at half-maximum (FWHM) of the smallest reconstructed slice is about 0.83 mm. Using this slice width and overlapping image reconstruction, cylindrical holes 0.6-0.7 mm in diameter can be resolved in a z-resolution phantom. Adequate visualization of the coronary arteries requires reconstruction slice widths not larger than 1.5 mm. Visualization of stents and severe calcifications is significantly improved with sub-mm slice width. Experimental evidence for the theoretically predicted temporal resolution and for the variation of temporal resolution depending on the position in the field of measurement (FOM) is presented. With 0.42 s gantry rotation temporal resolution reaches its optimum of 105 ms in the center of the FOM at 81 bpm. First scans on human subjects demonstrate the potential to expand the range of heart rates accessible to routine clinical examinations. A 16-slice platform can cover the heart with sub-mm slices within short breath-hold times, allowing for improved cardiac imaging due to isotropic sub-mm spatial resolution.