Using Photon-Counting CT to Determine In-Stent Restenosis

Images/courtesy Semmelweis University, Budapest, Hungary

Imaging Corner

Using Photon-Counting CT to Determine In-Stent Restenosis

Images/courtesy Semmelweis University, Budapest, Hungary

March 2024

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Figure 1. Left anterior descending artery (LAD) curved planar reformat (CPR). — Figure 1. Left anterior descending artery (LAD) curved planar
reformat (CPR).

The high level of spatial resolution in a diagnostic cardiac computed tomography angiography (CCTA) scan conducted using photon-counting CT can help clinicians determine whether a patient with cardiac disease also requires an invasive coronary angiography procedure. In this case, a 5’6”, 180 lb male patient with coronary artery disease was scanned on a photon-counting CT scanner (the NAEOTOM Alpha, Siemens Healthineers) for follow-up care after stenting and evaluation for in-stent restenosis. The CT scan, which used a sequential Quantum HD Cardiac CCTA acquisition and was reconstructed in the Best Diastolic phase utilizing a 1024x1024 matrix, was performed at 140 kVp with an estimated patient radiation dose of 4 mSv. The scan revealed not only multiple areas of in-stent restenosis (Figures 1-2), but also soft and hard plaque in non-stented areas (Figures 1-3).