UHR dual-source PCCT delivered at least good image quality in 94% of coronary segments and very good or excellent quality in 85%, despite relatively high heart rates.
Image quality for coronary stents was particularly strong, with 92% of stented segments rated excellent.
Only limited motion, stack, and metal artifacts were observed, supporting the clinical feasibility of UHR PCCT for coronary and stent assessment at moderate radiation dose.
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Figure 5. Ultra high resolution CT images of a patient with multiple stents in the left main, left anterior descending and left circumflex coronary arteries. A. Curved multiplanar reconstruction of the left anterior descending artery depicting the coronary stent with in-stent restenosis due to calcifications compression on the stent (arrowheads). B. Curved multiplanar reconstruction of the left circumflex artery (LCX) showing patent stents in the proximal and distal LCX. C. Multiplanar reconstruction depicting the patent stent in the left main. D. Zoomed in multiplanar reconstruction of the LCX showing the two overlapping stents in the distal LCX. Notice the clear depiction of the individual stent struts as well as the area where the two stents overlap (arrowheads). All reconstructions with 0.2 mm slice thickness and Bv56 kernel.
Source: van der Bie et al., European Journal of Radiology, 2024, Open access
Protocol
Detail | Value |
|---|
Scanner | NAEOTOM Alpha |
Software | VA50 |
Scan area | Heart |
Scan protocol | Non-contrast calcium scoring scan followed by UHR CCTA |
Scan mode | Quantum HD Prospective ECG-triggered UHR CCTA |
Tube voltage [kV] | 120 or 140 |
IQ level | 65 |
Dose modulation | CARE Dose4D |
CTDIvol [mGy] | 19 (mean) |
DLP [mGy*cm] | 243 (mean) |
Rotation time [s] | 0.25 |
Pitch | n.a. |
Matrix | 512 × 512, 768 × 768, or 1024 × 1024, auto-selected |
Slice collimation [mm] | 120 × 0.2 |
Slice width [mm] | 0.2 |
Reconstruction increment [mm] | 0.15 |
Reconstruction kernels | Bv40, Bv44, Bv48, Bv56 |
Iterative reconstruction | QIR 4 |
Contrast agent | Visipaque 320 mg iodine/mL |
Contrast protocol | 15 mL test bolus + 85 mL main bolus + 40 mL saline |
Flow rate | 5 mL/s |
ECG pulsing window | 35%–60% if HR ≤75 bpm; 67%–83% if HR >75 bpm |
Arrhythmia handling | Retrospective gating or wide padding in AF/arrhythmia |
Patient preparation | Beta-blockers if indicated or HR >90 bpm; nitroglycerin only if requested and not contraindicated |
Heart rate during scan | 71 ± 11 bpm |
van der Bie J, Sharma SP, van Straten M, et al. Image quality assessment of coronary artery segments using ultra-high resolution dual source photon-counting detector computed tomography. Eur J Radiol. 2024;171:111282.
