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Peer-reviewedCC BY 4.0Cardiovascular Engineering and Technology

Reducing Stent-Induced Blooming Artifacts Using Virtual Monoenergetic Imaging Reconstructions in a Superficial Femoral Artery Phantom: An In-Vitro Study

  • Lisa Rutten1,2,3,4
  • Lennart van de Velde1,2
  • Cornelis H. Slump5
  • Jasper Martens6
  • Kartik Jain4
  • Michel Versluis3
  • Michel M. P. J. Reijnen1,2
6 affiliations
  1. 1Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Hallenweg 5, 7522 NH Enschede, The Netherlands
  2. 2Department of Surgery, Rijnstate, Arnhem, The Netherlands
  3. 3Physics of Fluids group, TechMed Centre, University of Twente, Enschede, The Netherlands
  4. 4Department of Thermal and Fluid Engineering, University of Twente, Enschede, The Netherlands
  5. 5Robotics and Mechatronics Group, University of Twente, Enschede, The Netherlands
  6. 6Department of Radiology and Nuclear Medicine, Rijnstate, Arnhem, The Netherlands
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Abstract

Purpose: Spectral computed tomography derived virtual monoenergetic imaging (VMI) reconstructions have been shown to reduce stent-induced blooming artifacts thus minimizing in-stent lumen underestimation. We have investigated the use of VMI reconstructions to reduce the blooming artifact for stent markers, single and double stent configurations.

Methods: Two partially overlapping covered stents were deployed in a superficial femoral artery phantom. A conventional and twelve VMI reconstructions (40–100 keV and 120–200 keV with 10 and 20 keV increments, respectively) were created. Contrast-to-noise ratio, signal-to-noise ratio, attenuation difference between native and in-stent vessel lumen and full width at half maximum (FWHM) of the stent peaks were evaluated. The in-stent lumen diameter was measured, and the stent evaluated using a 5-point scale by three interventional radiologists.

Results: The 80–100 keV VMI reconstructions for the single stent configuration and the 140 keV VMI reconstruction for the other configurations resulted in the smallest lumen underestimation and best quality score on blooming. The underestimation was reduced from 21.5–29.1% for the conventional reconstruction to 14.1–18.6% for the optimal VMI reconstructions. No significant differences were observed in FWHM between the conventional reconstruction and the 50–200 keV VMI reconstructions.

Conclusions: VMI was found to minimize stent-induced blooming artifacts and improve in-stent lumen assessment. More stent material requires higher-energy VMI reconstructions to reduce blooming. The absence of significant differences in quantitative parameters suggests that the number of pixels affected by the blooming artifact is not reduced using VMI reconstructions.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13239-026-00848-8.

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Cite

BibTeXRIS
BibTeX
@article{rutten2026reducing,
  title = {{Reducing Stent-Induced Blooming Artifacts Using Virtual Monoenergetic Imaging Reconstructions in a Superficial Femoral Artery Phantom: An In-Vitro Study}},
  author = {Lisa Rutten and Lennart van de Velde and Cornelis H. Slump and Jasper Martens and Kartik Jain and Michel Versluis and Michel M. P. J. Reijnen},
  journal = {Cardiovascular Engineering and Technology},
  year = {2026},
  month = jul,
  doi = {10.1007/s13239-026-00848-8},
  url = {https://doi.org/10.1007/s13239-026-00848-8},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Reducing Stent-Induced Blooming Artifacts Using Virtual Monoenergetic Imaging Reconstructions in a Superficial Femoral Artery Phantom: An In-Vitro Study
AU  - Lisa Rutten
AU  - Lennart van de Velde
AU  - Cornelis H. Slump
AU  - Jasper Martens
AU  - Kartik Jain
AU  - Michel Versluis
AU  - Michel M. P. J. Reijnen
PY  - 2026
DA  - 2026/07/07
JO  - Cardiovascular Engineering and Technology
DO  - 10.1007/s13239-026-00848-8
UR  - https://doi.org/10.1007/s13239-026-00848-8
AB  - Purpose: Spectral computed tomography derived virtual monoenergetic imaging (VMI) reconstructions have been shown to reduce stent-induced blooming artifacts thus minimizing in-stent lumen underestimation. We have investigated the use of VMI reconstructions to reduce the blooming artifact for stent markers, single and double stent configurations.  Methods: Two partially overlapping covered stents were deployed in a superficial femoral artery phantom. A conventional and twelve VMI reconstructions (40–100 keV and 120–200 keV with 10 and 20 keV increments, respectively) were created. Contrast-to-noise ratio, signal-to-noise ratio, attenuation difference between native and in-stent vessel lumen and full width at half maximum (FWHM) of the stent peaks were evaluated. The in-stent lumen diameter was measured, and the stent evaluated using a 5-point scale by three interventional radiologists.  Results: The 80–100 keV VMI reconstructions for the single stent configuration and the 140 keV VMI reconstruction for the other configurations resulted in the smallest lumen underestimation and best quality score on blooming. The underestimation was reduced from 21.5–29.1% for the conventional reconstruction to 14.1–18.6% for the optimal VMI reconstructions. No significant differences were observed in FWHM between the conventional reconstruction and the 50–200 keV VMI reconstructions.  Conclusions: VMI was found to minimize stent-induced blooming artifacts and improve in-stent lumen assessment. More stent material requires higher-energy VMI reconstructions to reduce blooming. The absence of significant differences in quantitative parameters suggests that the number of pixels affected by the blooming artifact is not reduced using VMI reconstructions.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13239-026-00848-8.
SN  - 1869-408X
SN  - 1869-4098
ER  -