News | Computed Tomography (CT) | August 15, 2022

Deep Learning, Subtraction Technique Optimal for Coronary Stent Evaluation by CTA

Combo of deep-learning reconstruction and subtraction technique yielded optimal diagnostic performance for the detection of in-stent restenosis by coronary CTA 

57-year-old man who underwent coronary CTA using two-breath-hold subtraction technique to assess patency of coronary artery stent.

A. Conventional HIR image and B. conventional DLR image show blurred appearance of proximal aspect of stent (arrow). C. Subtraction HIR image and D. subtraction DLR image show discrete region of hypoattenuation at proximal aspect of stent (arrow). Both readers provided a diagnosis of in-stent restenosis only for subtraction HIR and subtraction DLR. Diagnostic confidence score for the four methods for reader 1 was 2, 2, 3, and 4, respectively, and for reader 2 was 1, 2, 3, and 3, respectively. Patient subsequently underwent invasive catheter angiography. Fluoroscopic imagines obtained (E) before and (F) after contrast media injection demonstrate in-stent restenosis of proximal aspect of stent (arrow). Image courtesy of ARRS and AJR 


August 15, 2022 — According to ARRS’ American Journal of Roentgenology (AJR), the combination of deep-learning reconstruction (DLR) and a subtraction technique yielded optimal diagnostic performance for the detection of in-stent restenosis by coronary CTA. 

Noting that these findings could guide patient selection for invasive coronary stent evaluation, combining DLR with a two-breath-hold subtraction technique “may help overcome challenges related to stent-related blooming artifact,” added corresponding author Yi-Ning Wang from the State Key Laboratory of Complex Severe and Rare Diseases at China’s Peking Union Medical College Hospital. 

Between March 2020 and August 2021, Wang and team studied 30 patients (22 men, 8 women; mean age, 63.6 years) with a total of 59 coronary stents who underwent coronary CTA using the two-breath-hold technique (i.e., noncontrast and contrast-enhanced acquisitions). Conventional and subtraction images were reconstructed for hybrid iterative reconstruction (HIR) and DLR, while maximum visible in-stent lumen diameter was measured. Two readers independently evaluated images for in-stent restenosis (≥50% stenosis). 

Ultimately, coronary CTA using DLR and subtraction technique—with a combined (conventional and subtraction images) interpretation—yielded PPV, NPV, and accuracy for in-stent restenosis for reader 1 of 73.3%, 93.2%, and 88.1%, and for reader 2 of 75.0%, 84.3%, and 83.1%, respectively. 

Acknowledging that the two-breath-hold subtraction technique requires an additional noncontrast acquisition (and thus a higher radiation dose), “DLR allows a reduction in radiation exposure, while improving image quality,” the authors of this AJR article pointed out

For more information: www.arrs.org 


Related Content

News | Stents

July 5, 2022 — A BIO-RESORT subgroup analysis of outcomes in small coronary vessels (<2,5mm) evaluated the efficacy and ...

Home July 05, 2022
Home
News | Stents

June 2, 2022 — According to the U.S. Food and Drug Administration (FDA), Atrium Medical Corporation is recalling the ...

Home June 02, 2022
Home
News | Stents

May 13, 2022 — Vascular diseases are public enemy number one: the leading killers worldwide, accounting for nearly a ...

Home May 13, 2022
Home
News | Stents

April 6, 2022 – Narrowed arteries can restrict blood flow to the heart. One treatment is inserting a stent — a small ...

Home April 06, 2022
Home
News | Stents

November 9, 2021 — Results from SUGAR trial, a randomized, controlled, multicenter trial conducted exclusively in ...

Home November 09, 2021
Home
News | Stents

June 30, 2021 — Abbott announced its Xience family of drug-eluting coronary stents received U.S. Food and Drug ...

Home June 30, 2021
Home
News | Stents

April, 14, 2021 – Elixir Medical recently announced the first patient was treated in the BIOADAPTOR randomized ...

Home April 14, 2021
Home
News | Stents

April 6, 2021 — Abbott today announced its Xience stent has received CE mark in Europe for shorter duration of dual anti ...

Home April 06, 2021
Home
News | Stents

December 21, 2020 – A proposed ASTM International standard will answer the need for a standardized test method that ...

Home December 21, 2020
Home
News | Stents

November 24, 2020 — One-year results off the PIONEER III study comparing the safety and efficacy of the Supreme HT ...

Home November 24, 2020
Home
Subscribe Now