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Computed Tomography Coronary Stent Imaging With Iterative Reconstruction: A Trade-off Study Between Medium Kernel and Sharp Kernel

Zhou, Qijing MD*; Jiang, Biao MD*; Dong, Fei MD*; Huang, Peiyu PhD*; Liu, Hongtao PhD; Zhang, Minming MD, PhD*

Journal of Computer Assisted Tomography: July/August 2014 - Volume 38 - Issue 4 - p 604–612
doi: 10.1097/RCT.0000000000000080
Thoracic Imaging

Objective To evaluate the improvement of iterative reconstruction in image space (IRIS) technique in computed tomographic (CT) coronary stent imaging with sharp kernel, and to make a trade-off analysis.

Materials and Methods Fifty-six patients with 105 stents were examined by 128-slice dual-source CT coronary angiography (CTCA). Images were reconstructed using standard filtered back projection (FBP) and IRIS with both medium kernel and sharp kernel applied. Image noise and the stent diameter were investigated. Image noise was measured both in background vessel and in-stent lumen as objective image evaluation. Image noise score and stent score were performed as subjective image evaluation.

Results The CTCA images reconstructed with IRIS were associated with significant noise reduction compared to that of CTCA images reconstructed using FBP technique in both of background vessel and in-stent lumen (the background noise decreased by approximately 25.4% ± 8.2% in medium kernel (P <C; 0.0001) and 30.3% ± 3.4% in sharp kernel (P <C; 0.0001). The in-stent lumen noise decreased by approximately 14.2% ± 19.2% in medium kernel (P <C; 0.0001) and 27.0% ± 17.8% in sharp kernel (P <C; 0.0001)). Subjective image assessment showed that the noise of the images reconstructed with IRIS decreased compared to that with FBP. Moreover, the images with sharp kernel showed better visualization of the stent struts and in-stent lumen than that with medium kernel.

Conclusions Iterative reconstruction in image space reconstruction can effectively reduce the image noise and improve image quality. The sharp kernel images constructed with iterative reconstruction are considered the optimal images to observe coronary stents in this study.

From the *Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; and †Healthcare Sector, Siemens Ltd. China, Shanghai, China.

Received for publication November 22, 2013; accepted January 22, 2014.

Reprints: Minming Zhang, MD, PhD, Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Rd, Hangzhou, 310009, China (e-mail:

The authors declare no conflict of interest.

Qijing Zhou and Biao Jiang contributed equally to this paper.

© 2014 by Lippincott Williams & Wilkins