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Tytuł:
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Magic Angle in Cardiac CT: Eliminating Clinically Relevant Metal Artifacts in Pacemaker Leads with a Lead-Tip/Gantry Angle of ≤70°.
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Autorzy:
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Reinartz SD; Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwels Strasse 30, 52074 Aachen, Germany. Electronic address: .
Kuhl CK; Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwels Strasse 30, 52074 Aachen, Germany.
Fehrenbacher K; Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwels Strasse 30, 52074 Aachen, Germany.
Napp A; Department of Internal Medicine I (Cardiology, Angiology, Pneumology and Internal Intensive Care Medicine), University Hospital, RWTH Aachen University, Aachen, Germany.
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Źródło:
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Academic radiology [Acad Radiol] 2018 Jul; Vol. 25 (7), pp. 898-903. Date of Electronic Publication: 2018 Feb 13.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Reston Va : Association Of University Radiologists
Original Publication: Reston, VA : Association of University Radiologists, c1994-
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MeSH Terms:
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Artifacts*
Defibrillators, Implantable*
Pacemaker, Artificial*
Tomography, X-Ray Computed/*methods
Humans ; Metals ; Phantoms, Imaging
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Contributed Indexing:
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Keywords: Pacemakers; dual-energy CT; dual-source CT; implantable cardioverter-defibrillator (ICD); metal artifact reduction
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Substance Nomenclature:
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0 (Metals)
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Entry Date(s):
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Date Created: 20180218 Date Completed: 20190415 Latest Revision: 20190415
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Update Code:
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20240105
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DOI:
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10.1016/j.acra.2017.12.003
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PMID:
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29452741
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Rationale and Objective: To identify the influence of various parameters for reducing artifacts in computed tomography (CT) of commonly used pacemakers or implantable cardioverter-defibrillator (ICD) lead tips.
Materials and Methods: This ex vivo phantom study compared two CT techniques (Dual-Energy CT [DECT] vs. Dual-Source CT [DSCT]), as well as the influence of incremental alterations of current-time product and pacemaker lead-tip angle with respect to the gantry plane. Four pacemaker leads and one ICD lead were evaluated. The images were assessed visually on a five-point Likert scale (1 = artifact free to 5 = massive artifacts). Likert values 1-3 represent clinically relevant, diagnostic image quality.
Results: 344 of 400 total images were rated with diagnostic image quality. The DECT and dual-source DSCT technique each scored 86% diagnostic image quality. Statistically, DECT images showed significantly improved image quality (P < .05). Concerning the current-time product, no statistically significant change was found. Regarding lead-tip positioning, an angle of ≤70° yielded 100% diagnostic image quality. Pacemaker and ICD leads were assessed to have statistically significant differences.
Conclusions: Surprisingly, the lead-tip angle of 70° has been established as the key angle under which diagnostic image quality is always ensured, regardless of the imaging technique. Thus, we call 70° the "Magic angle" in CT pacemaker imaging.
(Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
