Decker Josua A, Bette Stefanie, Scheurig-Muenkler Christian, Jehs Bertram, Risch Franka, Woźnicki Piotr, Braun Franziska M, Haerting Mark, Wollny Claudia, Kroencke Thomas J, Schwarz Florian
Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
Faculty of Medicine, Ludwig Maximilian University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany.
Diagnostics (Basel). 2022 Feb 22;12(3):558. doi: 10.3390/diagnostics12030558.
The purpose of this study was to evaluate virtual-non contrast reconstructions of Photon-Counting Detector (PCD) CT-angiography datasets using a novel calcium-preserving algorithm (VNCPC) vs. the standard algorithm (VNCConv) for their potential to replace unenhanced acquisitions (TNC) in patients after endovascular aneurysm repair (EVAR). 20 EVAR patients who had undergone CTA (unenhanced and arterial phase) on a novel PCD-CT were included. VNCConv- and VNCPC-series were derived from CTA-datasets and intraluminal signal and noise compared. Three readers evaluated image quality, contrast removal, and removal of calcifications/stent parts and assessed all VNC-series for their suitability to replace TNC-series. Image noise was higher in VNC- than in TNC-series (18.6 ± 5.3 HU, 16.7 ± 7.1 HU, and 14.9 ± 7.1 HU for VNCConv-, VNCPC-, and TNC-series, p = 0.006). Subjective image quality was substantially higher in VNCPC- than VNCConv-series (4.2 ± 0.9 vs. 2.5 ± 0.6; p < 0.001). Aortic contrast removal was complete in all VNC-series. Unlike in VNCConv-reconstructions, only minuscule parts of stents or calcifications were erroneously subtracted in VNCPC-reconstructions. Readers considered 95% of VNCPC-series fully or mostly suited to replace TNC-series; for VNCConv-reconstructions, however, only 75% were considered mostly (and none fully) suited for TNC-replacement. VNCPC-reconstructions of PCD-CT-angiography datasets have excellent image quality with complete contrast removal and only minimal erroneous subtractions of stent parts/calcifications. They could replace TNC-series in almost all cases.
本研究的目的是评估使用一种新型保钙算法（VNCPC）的光子计数探测器（PCD）CT血管造影数据集的虚拟非增强重建与标准算法（VNCConv）相比，在血管内动脉瘤修复（EVAR）术后患者中替代未增强采集（TNC）的潜力。纳入了20例在新型PCD-CT上进行过CTA（未增强和动脉期）检查的EVAR患者。从CTA数据集中生成VNCConv和VNCPC系列，并比较管腔内信号和噪声。三位阅片者评估图像质量、对比剂去除情况以及钙化/支架部分的去除情况，并评估所有VNC系列替代TNC系列的适用性。VNC系列的图像噪声高于TNC系列（VNCConv系列、VNCPC系列和TNC系列的图像噪声分别为18.6±5.3 HU、16.7±7.1 HU和14.9±7.1 HU，p = 0.006）。VNCPC系列的主观图像质量显著高于VNCConv系列（4.2±0.9对2.5±0.6；p<0.001）。所有VNC系列的主动脉对比剂去除均完全。与VNCConv重建不同，VNCPC重建中仅错误减去了极少量的支架或钙化部分。阅片者认为95%的VNCPC系列完全或大部分适合替代TNC系列；然而，对于VNCConv重建，只有75%被认为大部分（且无完全）适合替代TNC系列。PCD-CT血管造影数据集的VNCPC重建具有出色的图像质量，对比剂完全去除，支架部分/钙化的错误减法极少。它们几乎可以在所有情况下替代TNC系列。
