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CardioVascular and Interventional Radiology

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Open Access 01-02-2018 | Technical Note

Evaluation of CT Angiography Image Quality Acquired with Single-Energy Metal Artifact Reduction (SEMAR) Algorithm in Patients After Complex Endovascular Aortic Repair

Authors: M. A. A. D. Ragusi, R. W. van der Meer, R. M. S. Joemai, J. van Schaik, C. S. P. van Rijswijk

Published in: CardioVascular and Interventional Radiology | Issue 2/2018

Abstract

Purpose

To evaluate the value of single-energy metal artifact reduction (SEMAR) algorithm on image quality in patients after complex endovascular aortic repair (EVAR) with fenestrated and branched devices.

Methods

Routine follow-up computed tomography angiography (CTA) examinations were performed between February 2016 and May 2017 in 18 patients who underwent a complex EVAR procedure at our institution. Objective analysis was performed by measuring the standard deviation (SD) of attenuation (Hounsfield Units), and the contrast-to-noise ratio (CNR) in regions of interests in the stented visceral arteries. Subjective analysis of the degree of artifacts and stent visualization was performed independently by two interventional radiologists, blinded to the image reconstruction.

Results

The SD of attenuation was significantly lower in all target visceral arteries (p < .001), the celiac artery (p = .002), the superior mesenteric artery (SMA; p = .043), and renal arteries (p < .001) in the CT images with SEMAR reconstruction. The CNR significantly increased in all SEMAR-reconstructed target visceral arteries (overall: p < .001, celiac artery: p = .009; SMA: p = .003; renal arteries: p < .001). The reviewers rated a significantly lower artifact degree in all target vessels (overall: p < .001, celiac artery: p = .001; SMA: p = .008; renal arteries: p < .001) and a significantly improved visualization of the stent patency in all target vessels (overall: p < .001, celiac artery: p = .031; SMA: p = .047; renal arteries: p < .001) in the SEMAR images. Overall preference of both reviewers was in favor of the SEMAR reconstruction in 15/18 cases (83%).

Conclusion

Reconstruction with SEMAR algorithm significantly improves CTA image quality in patients after complex EVAR.

Level of Evidence

Level 4, Case series.

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Title: Evaluation of CT Angiography Image Quality Acquired with Single-Energy Metal Artifact Reduction (SEMAR) Algorithm in Patients After Complex Endovascular Aortic Repair
Authors: M. A. A. D. Ragusi
R. W. van der Meer
R. M. S. Joemai
J. van Schaik
C. S. P. van Rijswijk
Publication date: 01-02-2018
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 2/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-017-1812-0

At a glance: The STEP trials

Springer Medicine

Evaluation of CT Angiography Image Quality Acquired with Single-Energy Metal Artifact Reduction (SEMAR) Algorithm in Patients After Complex Endovascular Aortic Repair

Abstract

Purpose

Methods

Results

Conclusion

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of Evidence

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