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

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 | Pediatric Imaging

September 29, 2022 — According to an open-access Editor’s Choice article in ARRS’ American Journal of Roentgenology (AJR ...

Time September 29, 2022
arrow
News | PET-CT

September 28, 2022 — Xoran Technologies is engaged in a ground-breaking research project to develop a PET/CT scanner for ...

Time September 28, 2022
arrow
News | Artificial Intelligence

September 22, 2022 — Medical imaging specialist Avicenna.AI announced a groundbreaking partnership with the MedTech ...

Time September 22, 2022
arrow
News | Interventional Radiology

September 21, 2022 — According to ARRS’ American Journal of Roentgenology (AJR), incorporating patient decision aids ...

Time September 21, 2022
arrow
News | MRI Breast

September 16, 2022 — According to ARRS’ American Journal of Roentgenology (AJR), the contrast-enhanced in-phase Dixon ...

Time September 16, 2022
arrow
Feature | Contrast Media | By Christine Book

The theme “Everyday progress” seems appropriate for the imaging community in 2022. What a year it’s been. Supply ...

Time September 14, 2022
arrow
News | Artificial Intelligence

September 14, 2022 — An AI tool is highly effective at detecting pancreatic cancer on CT, according to a study published ...

Time September 14, 2022
arrow
Feature | Radiology Business | By Melinda Taschetta-Millane

Here is a rundown of what you and your colleagues found to be most interesting in the field of medical imaging during ...

Time September 07, 2022
arrow
News | SPECT-CT

September 7, 2022 — The American Society of Nuclear Cardiology (ASNC) and three partner societies have come together to ...

Time September 07, 2022
arrow
News | Radiology Business

September 6, 2022 — The American College of Radiology (ACR) Computed Tomography (CT) and Magnetic Resonance Imaging (MRI ...

Time September 06, 2022
arrow
Subscribe Now