Photon-Counting Detector CT Angiography Versus Digital Subtraction Angiography in Patients with Peripheral Arterial Disease.
Acad Radiol
; 31(7): 2973-2986, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38403477
ABSTRACT
RATIONALE AND OBJECTIVES:
This study aims to compare the diagnostic confidence of photon-counting detector CT angiography (PCD-CTA) depending on the used vascular reformatting kernels with digital subtraction angiography (DSA) as diagnostic reference standard in peripheral arterial occlusive disease (PAOD). MATERIAL ANDMETHODS:
In 39 patients, 45 lower extremity PCD-CTA with subsequent DSA were analyzed. Advanced PAOD (Fontaine stage 4) was ascertained in 77.8% of patients. CTA post-processing comprised three vascular kernels (Bv36/48/56). Objective image quality assessment included vessel attenuation, image noise, contrast-to-noise (CNR) and signal-to-noise ratios (SNR). Subjective evaluation of calcium blooming, vessel sharpness, luminal attenuation and image noise was performed by three radiologists. Diagnostic performance and concordance to DSA were assessed.RESULTS:
The luminal attenuation remained kernel-independent constant. With sharper kernels, image noise increased substantially, while SNR and CNR decreased. Subjective reduction of calcium blooming and increased vessel sharpness were noted for the sharp Bv56 kernel. While sensitivity in stenosis quantification was comparable between kernels (81.6% vs. 81.5% vs. 81.0%, p = 0.797), specificity increased slightly higher sharpness (71.1% vs. 76.9% vs. 79.6%, p = 0.067). Diagnostic concordance of stenosis ratings compared to DSA increased likewise (Bv36 vs. Bv56, p = 0.002). Severe crural vessel calcifications had no influence on sensitivity, regardless of kernel selection. Contrarily, specificity was substantially worse in severely calcified tibial vessels but could be improved by using the sharp Bv56 kernel (Bv36 vs. Bv56 p = 0.024). Diagnostic confidence was highest for Bv56.CONCLUSION:
In lower leg PCD-CTA, sharp convolution kernels increase diagnostic confidence compared to DSA by improved vessel delineation and reduced calcium blooming with acceptable image noise.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Angiografía de Substracción Digital
/
Sensibilidad y Especificidad
/
Enfermedad Arterial Periférica
/
Angiografía por Tomografía Computarizada
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Acad Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2024
Tipo del documento:
Article