Along with the promise of stents comes the problem of in-stent restenosis. One solution posed by manufacturers is drug-eluting stents (DES), however, even with DES, stent apposition and stent fracture can aggravate in-stent restenosis. Multiplanar reformations (MPRs) of CT images can successfully identify stent fractures.
In our first top story, researchers showed that CT angiography (CTA) imaging could find fractures earlier than conventional angiography and early enough before restenosis becomes symptomatic. They also found that CTA yielded a higher prevalence of stent fractures, compared with conventional angiography. They suspect that the higher spatial and temporal resolution of 64-detector CT, compared with earlier generations of scanners, improves the ability of the modality to detect stent fractures.
The advanced visualization techniques can be done automatically, adding no significant time to the diagnosis.
Our second top story highlights advances in 3D optical imaging. While optical coherence tomography (OCT) has a greater spatial resolution than CT, it is invasive and cannot “see” through blood, necessitating a saline flush. The second-generation optical frequency-domain imaging (OFDI) has a higher frame rate than its predecessor and, therefore, has less interference from blood. The increased speed of OFDI enables rapid, three-dimensional imaging of longer coronary segments after a brief, non-occlusive saline purge.
Much of the promise of optical imaging lies in its ability to characterize vulnerable plaque. This next-generation product indicates that we are getting closer to the day when OCT or OFDI will become clinically routine.
I’d like to draw your attention to the article “ Advanced visualization adds new practice dimension,” from our latest issue of Cardiovascular Business. The article details how the adoption of advanced visualization techniques improves workflow and the bottom line.
Be sure to catch the comprehensive RSNA coverage by Health Imaging & IT, our sister publication, beginning November 30. On the site already are nearly 20 categories of product previews, of which Advanced Visualization is a big part.
On these or any other topics, feel free to send me your comments.
Chris P. Kaiser, Editor