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European Radiology
Published in: European Radiology 2/2017

01-02-2017 | Cardiac

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

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

Published in: European Radiology | Issue 2/2017

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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.
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Metadata
Title
Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement
Authors
Simon S. Martin
Moritz H. Albrecht
Julian L. Wichmann
Kristina Hüsers
Jan-Erik Scholtz
Christian Booz
Boris Bodelle
Ralf W. Bauer
Sarah C. Metzger
Thomas J. Vogl
Thomas Lehnert
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4422-3

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