Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb;27(2):705-714.
doi: 10.1007/s00330-016-4422-3. Epub 2016 May 28.

Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement

Simon S Martin  1 , Moritz H Albrecht  1 , Julian L Wichmann  2 , Kristina Hüsers  1 , Jan-Erik Scholtz  1 , Christian Booz  1 , Boris Bodelle  1 , Ralf W Bauer  1 , Sarah C Metzger  1 , Thomas J Vogl  1 , Thomas Lehnert  1
Affiliations

Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement

Simon S Martin et al. Eur Radiol. 2017 Feb.

Abstract

Objectives: 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).

Methods: 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.

Results: 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).

Conclusions: 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.

Key points: • 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.

Keywords: Aortic valve stenosis; Image enhancement; Multidetector-row computed tomography; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement.

PubMed Disclaimer

References

    1. Eur J Radiol. 2013 Oct;82(10 ):e574-81 - PubMed
    1. Invest Radiol. 2014 Nov;49(11):735-41 - PubMed
    1. Int J Cardiovasc Imaging. 2016 Jan;32(1):137-44 - PubMed
    1. J Cardiovasc Comput Tomogr. 2015 Sep-Oct;9(5):422-7 - PubMed
    1. Eur Radiol. 2012 Dec;22(12 ):2662-9 - PubMed

MeSH terms

LinkOut - more resources