1
|
Yang L, Zhang H, Sheng J, Wang M, Liu Y, Xu M, Yang X, Wang B, He X, Gao L, Zheng C. Contrast enhancement boost improves the image quality of CT angiography derived from 80-kVp cerebral CT perfusion data. BMC Med Imaging 2024; 24:193. [PMID: 39080580 PMCID: PMC11290218 DOI: 10.1186/s12880-024-01373-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024] Open
Abstract
RATIONALE AND OBJECTIVE To investigate the impact of the contrast enhancement boost (CE-boost) technique on the image quality of CT angiography (CTA) derived from 80-kVp cerebral CT perfusion (CTP) data, and to compare it with conventional CTApeak as well as other currently employed methods for enhancing CTA images, such as CTAtMIP and CTAtAve extracted from CTP. MATERIALS AND METHODS The data of forty-seven patients who underwent CTP at 80 kVp were retrospectively collected. Four sets of images: CTApeak, CTAtMIP, CTAtAve, and CE-boost images. The CTApeak image represents the arterial phase at its peak value, captured as a single time point. CTAtMIP and CTAtAve are 4D CTA images that provide maximum density projection and average images from the three most prominent time points. CE-boost is a postprocessing technique used to enhance contrast in the arterial phase at its peak value. We compared the average CT value, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the internal carotid artery (ICA) and basilar artery (BA) among the four groups. Image quality was evaluated using a 5-point scale. RESULTS The CE-boost demonstrated and CNR in the ICA and BA (all p < 0.001). Compared with the other three CTA reconstructed images, the CE-boost images had the best subjective image quality, with the highest scores of 4.77 ± 0.43 and 4.87 ± 0.34 for each reader (all p < 0.001). CONCLUSION Compared with other currently used techniques,CE-boost enhances the image quality of CTA derived from 80-kVp CTP data, leading to improved visualization of intracranial arteries.
Collapse
Affiliation(s)
- Lin Yang
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China
| | - Haiwei Zhang
- Department of General Medicine, Hanzhong Central Hospital, Hanzhong, China
| | - Jiexin Sheng
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China
| | - Meng Wang
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China
| | - Yaliang Liu
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China
| | - Min Xu
- Canon Medical Systems (China), Beijing, China
| | - Xiao Yang
- Canon Medical Systems (China), Beijing, China
| | - Bo Wang
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China
| | - Xiaolong He
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China
| | - Lei Gao
- Department of Nneurology, Hanzhong Central Hospital, Hanzhong, China
| | - Chao Zheng
- Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China.
| |
Collapse
|
2
|
Du H, Sui X, Zhao R, Wang J, Ming Y, Piao S, Wang J, Ma Z, Wang Y, Song L, Song W. A comparative analysis of deep learning and hybrid iterative reconstruction algorithms with contrast-enhancement-boost post-processing on the image quality of indirect computed tomography venography of the lower extremities. BMC Med Imaging 2024; 24:163. [PMID: 38956583 PMCID: PMC11218076 DOI: 10.1186/s12880-024-01342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
PURPOSE To examine whether there is a significant difference in image quality between the deep learning reconstruction (DLR [AiCE, Advanced Intelligent Clear-IQ Engine]) and hybrid iterative reconstruction (HIR [AIDR 3D, adaptive iterative dose reduction three dimensional]) algorithms on the conventional enhanced and CE-boost (contrast-enhancement-boost) images of indirect computed tomography venography (CTV) of lower extremities. MATERIALS AND METHODS In this retrospective study, seventy patients who underwent CTV from June 2021 to October 2022 to assess deep vein thrombosis and varicose veins were included. Unenhanced and enhanced images were reconstructed for AIDR 3D and AiCE, AIDR 3D-boost and AiCE-boost images were obtained using subtraction software. Objective and subjective image qualities were assessed, and radiation doses were recorded. RESULTS The CT values of the inferior vena cava (IVC), femoral vein ( FV), and popliteal vein (PV) in the CE-boost images were approximately 1.3 (1.31-1.36) times higher than in those of the enhanced images. There were no significant differences in mean CT values of IVC, FV, and PV between AIDR 3D and AiCE, AIDR 3D-boost and AiCE-boost images. Noise in AiCE, AiCE-boost images was significantly lower than in AIDR 3D and AIDR 3D-boost images ( P < 0.05). The SNR (signal-to-noise ratio), CNR (contrast-to-noise ratio), and subjective scores of AiCE-boost images were the highest among 4 groups, surpassing AiCE, AIDR 3D, and AIDR 3D-boost images (all P < 0.05). CONCLUSION In indirect CTV of the lower extremities images, DLR with the CE-boost technique could decrease the image noise and improve the CT values, SNR, CNR, and subjective image scores. AiCE-boost images received the highest subjective image quality score and were more readily accepted by radiologists.
Collapse
Affiliation(s)
- Huayang Du
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xin Sui
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Ruijie Zhao
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Jiaru Wang
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Ying Ming
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Sirong Piao
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Jinhua Wang
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zhuangfei Ma
- Canon Medical Systems (China), No.3, Xinyuan South Road, Chaoyang District, Beijing, 100027, China
| | - Yun Wang
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Lan Song
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Wei Song
- Department of Radiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| |
Collapse
|
3
|
Li J, Zhang Y, Hou J, Li Y, Zhao Z, Xu M, Liu W. Clinical Application of Dark-blood Imaging in Head and Neck CT Angiography: Effect on Image Quality and Plaque Visibility. Acad Radiol 2024; 31:2478-2487. [PMID: 38042623 DOI: 10.1016/j.acra.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 12/04/2023]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to explore the potential of a newly developed dark-blood imaging technique to improve image quality and plaque visibility in head and neck computed tomography (CT) angiography. MATERIALS AND METHODS Patients who underwent triphasic head and neck CT angiography scans from August 2021 to March 2023 were retrospectively enrolled (mean age 67.23 ± 10.81 [SD] years, range 43-85 years, 64.7% male). The CT protocol consists of pre-contrast, arterial and delayed phases. Dark-blood images were postprocessed with the contrast-enhancement boost (CE-boost) technique. The quantitative assessment involved evaluating the CT value, image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of calcified plaque and non-calcified plaque. The plaque CNR relative to the vessel lumen (CNRplaque-lumen), vessel wall (CNRplaque-wall), and adjacent muscle (CNRplaque-muscle) was respectively calculated. Two experienced radiologists independently evaluated the CT images (5, best; 1, worst) by four characteristics including calcified plaque visibility, non-calcified plaque visibility, diagnostic confidence, and overall image quality. Inter-rater variability was also evaluated. The artery stenosis rate and plaque burden on dark-blood images were measured and compared with arterial phases. The intraclass correlation coefficient (ICC) was used for consistency analysis. The diagnostic accuracy of dark-blood images for the stenosis rate was evaluated by the area under the curve (AUC). RESULTS A total of 43 patients with 54 calcified plaques and 34 non-calcified plaques were assessed in this study. When compared with pre-contrast and delayed phase, dark-blood images yielded significantly higher CNRplaque-lumen and CNRplaque-muscle of calcified (219.79 ± 159.20 and 181.23 ± 112.12, respectively) and non-calcified (30.30 ± 29.11 and 6.28 ± 4.75, respectively) plaques (all p < 0.001). Calcified plaque SNR of dark-blood showed equal or slightly lower than other phases (p > 0.05 or p = 0.02). A major increase was observed in the non-calcified plaque SNR of dark-blood compared to the arterial phase (5.56 ± 3.71 vs. 4.23 ± 3.56, p = 0.02), although there were no apparent differences compared to pre-contrast and delayed phases (p > 0.05). In subjective analyzes, the calcified plaque visibility (4.99 ± 0.07), non-calcified plaque visibility (4.62 ± 0.48), overall image quality (4.81 ± 0.34), and diagnostic confidence (4.74 ± 0.36) in dark-blood images dominated the highest scores (p < 0.001). The subjective scores of radiologists exhibited good consistency (all kappa value>0.7). The dark-blood image and the arterial phase image exhibited good consistency in identifying the stenosis rate (p < 0.001). In the evaluation of plaque burden, the interobserver agreement for dark-blood images was higher compared to arterial phase images (ICC = 0.870 vs. 0.729). CONCLUSIONS Compared to conventional triphasic head and neck CT angiography, the CE-boost derived dark-blood imaging demonstrated a significant improvement in image quality and visibility for both calcified and non-calcified plaque assessment.
Collapse
Affiliation(s)
- Junchao Li
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, PR China (J.L., J.H., Y.L., W.L.)
| | - Yuan Zhang
- Imaging Center, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, PR China (Y.Z.)
| | - Juan Hou
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, PR China (J.L., J.H., Y.L., W.L.)
| | - YuXiang Li
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, PR China (J.L., J.H., Y.L., W.L.)
| | - Zicheng Zhao
- Canon Medical Systems (China), Beijing 100015, China (Z.Z., M.X.)
| | - Min Xu
- Canon Medical Systems (China), Beijing 100015, China (Z.Z., M.X.)
| | - Wenya Liu
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, PR China (J.L., J.H., Y.L., W.L.).
| |
Collapse
|
4
|
Added value of contrast enhancement boost images in routine multiphasic contrast-enhanced CT for the diagnosis of small (<20 mm) hypervascular hepatocellular carcinoma. Eur J Radiol 2023; 160:110696. [PMID: 36680909 DOI: 10.1016/j.ejrad.2023.110696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/30/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE To investigate the added value of contrast enhancement boost (CE-boost) images in multiphasic contrast-enhanced CT (CE-CT) for diagnosing small (<20 mm) hypervascular hepatocellular carcinoma (HCC). MATERIALS AND METHODS This retrospective study included 69 patients (age, 74 ± 8 years; 52 men) with 70 hypervascular HCCs (<20 mm) who underwent multiphasic CE-CT (pre-contrast, late arterial phase [LAP], portal venous phase [PVP], and equilibrium phase). Two types of CE-boost images were generated by subtracting PVP from LAP (LA-PV) images and LAP from PVP (PV-LA) images to enhance the contrast effect of hepatic arterial and portal venous perfusion more selectively. Tumor-to-liver contrast-to-noise ratios (CNRs) in CE-boost images were compared with those in CE-CT images using the Wilcoxon signed-rank test. Two independent readers reviewed the imaging datasets: CE-CT alone and CE-CT with CE-boost images. The diagnostic performance of each dataset was compared using jackknife alternative free-response receiver operating characteristics (JAFROC-1). RESULTS The tumor-to-liver CNRs in the LA-PV (6.4 ± 3.0) and PV-LA (-3.3 ± 2.1) images were greater than those in the LAP (3.2 ± 1.7) and PVP images (-1.1 ± 1.4) (p <.001 for both). The reader-averaged figures of merit were 0.751 for CE-CT alone and 0.807 for CE-CT with CE-boost images (p <.001). Sensitivities increased by adding CE-boost images for both readers (p <.001 and = 0.03), while positive predictive values were equivalent (p >.99). CONCLUSION Adding CE-boost images to multiphasic CE-CT can improve the diagnostic accuracy and sensitivity for small hypervascular HCC by increasing the tumor-to-liver CNR.
Collapse
|
5
|
Otgonbaatar C, Ryu JK, Shin J, Kim HM, Seo JW, Shim H, Hwang DH. Deep learning reconstruction allows for usage of contrast agent of lower concentration for coronary CTA than filtered back projection and hybrid iterative reconstruction. Acta Radiol 2023; 64:1007-1017. [PMID: 35979586 DOI: 10.1177/02841851221118476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The demand for homogeneous and higher vascular contrast enhancement is critical to provide an appropriate interpretation of abnormal vascular findings in coronary computed tomography angiography (CTA). PURPOSE To evaluate the effect of various contrast media concentrations (Iohexol-370, Iohexol-300, Iohexol-240) and image reconstructions (filtered back projection [FBP], hybrid iterative reconstruction [IR], and deep learning reconstruction [DLR]) on coronary CTA. MATERIAL AND METHODS A total of 63 patients referred for coronary CTA between July and October 2021 were enrolled in this prospective study, and they randomly received one of three contrast media. CTA images were reconstructed with FBP, hybrid IR, and DLR. The CT attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for all three images. The images were subjectively evaluated by two radiologists in terms of overall image quality, artifacts, image noise, and vessel wall delineation on a 5-point Likert scale. RESULTS The application of DLR resulted in significantly lower image noise; higher CT attenuation, SNR, and CNR; and better subjective analysis among the three different concentrations of contrast media groups (P < 0.001). There was no significant difference in the CT attenuation of the left ventricle (P = 0.089) and coronary arteries (P = 0.072) between hybrid IR at Iohexol-300 and DLR at Iohexol-240. Furthermore, application of DLR to the Iohexol-240 significantly improved SNR and CNR; it achieved higher subjective scores compared with hybrid IR at Iohexol-300 (P < 0.001). CONCLUSION We suggest that using DLR with Iohexol-240 contrast media is preferable to hybrid IR with Iohexol-300 contrast media in coronary CTA.
Collapse
Affiliation(s)
- Chuluunbaatar Otgonbaatar
- Department of Radiology, 26725Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Kyun Ryu
- Medical Imaging AI Research Center, 496517Canon Medical Systems Korea, Seoul, Republic of Korea
| | - Jaemin Shin
- Department of Neurology, 58934Korea University Guro Hospital, Seoul, Republic of Korea
| | - Han Myun Kim
- Department of Radiology, 65521Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jung Wook Seo
- Department of Radiology, 119750Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Hackjoon Shim
- Medical Imaging AI Research Center, 496517Canon Medical Systems Korea, Seoul, Republic of Korea
- ConnectAI Research Center, 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae Hyun Hwang
- Department of Radiology, 65521Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
6
|
Hou J, Zhang Y, Yan J, Zhang T, Xia W, Zhu Y, Liu W. Clinical application of the contrast-enhancement boost technique in computed tomography angiography of the portal vein. Abdom Radiol (NY) 2023; 48:806-815. [PMID: 36471003 PMCID: PMC9902311 DOI: 10.1007/s00261-022-03754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this study was to explore the improved image quality of the portal vein using the contrast-enhancement boost (CE-boost) technique for the improved visibility of abdominal-enhanced computed tomography (CT) scans in clinical practice. METHODS This retrospective study included 50 patients in Group A who underwent routine abdominal-enhanced CT and 50 patients in Group B who underwent abdominal computed tomography angiography (CTA) with matched body mass index, age, and sex. Images in Group A were postprocessed with the CE-boost technique for further enhanced visibility of the portal vein. Both subjective and objective assessments of different branches of the portal vein in three types of images (i.e., Group A with CE-boost and without CE-boost, Group B) were statistically analyzed. RESULTS The subjective scores of two experienced radiologists showed good consistency (kappa value > 0.624, p < 0.001), and the score of Group A with CE-boost (mean, 4.64) was significantly higher than that of the others (p < 0.001). The liver parenchyma and most target veins in Group A with CE-boost showed the highest CT, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) values and the lowest standard deviation (SD), while the CNR of most portal veins in Group A without CE-boost had the lowest CNR (p < 0.001). There were no differences in the SNR of the portal vein in Group A without CE-Boost and Group B (p > 0.05). CONCLUSION CE-boost can significantly improve image quality in portal vein imaging without any additional scanning settings or changes in the clinical workflow.
Collapse
Affiliation(s)
- Juan Hou
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Yuan Zhang
- Imaging Center, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Jing Yan
- Canon Medical Systems (China), Co., Ltd., Room 1004-1006, City Point, NO 666 West Huaihai Rd, Changning District, 200052 Shanghai China
| | - Tieliang Zhang
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Wenwen Xia
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Yucai Zhu
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Wenya Liu
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, Xinjiang, China.
| |
Collapse
|
7
|
A Novel Computed Tomography Image Reconstruction for Improving Visualization of Pulmonary Vasculature: Comparison Between Preprocessing and Postprocessing Images Using a Contrast Enhancement Boost Technique. J Comput Assist Tomogr 2022; 46:729-734. [PMID: 36103677 DOI: 10.1097/rct.0000000000001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to evaluate chest computed tomography (CT) angiography image quality using the contrast enhancement (CE)-boost technique compared with conventional images. METHODS Forty patients who underwent contrast-enhanced chest CT were included. Combined CT angiography images of the iodinated image obtained from the subtraction of nonenhanced CT images and CT angiography images were used to generate CE-boost images. Computed tomography attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) for the right and left pulmonary arteries as the central and subsegmental arteries as peripheral vessels were assessed. Subjective image quality was rated on a 5-point scale by 2 radiologists. Image quality was assessed using a paired t test. RESULTS Computed tomography attenuation in the main pulmonary artery was significantly higher for the CE-boost images (311.05 ± 91.94) than for the conventional images (221.25 ± 61.21, P < 0.001). Similarly, the CE-boost images resulted in significantly higher CT attenuation in the subsegmental arteries (right, 305.34 ± 90.13; left, 313.05 ± 97.21) than in the conventional images (right, 218.45 ± 63.16; left, 223.89 ± 74.27). The CE-boost technique demonstrated marked improvement in the visualization of the peripheral pulmonary artery without the administration of a higher iodine delivery rate. The mean SNR and CNR were also significantly higher in the central and peripheral vessels in the CE-boost images than in the conventional images (P < 0.001). In the subjective analysis, the image contrast and vascular contrast edge were significantly higher for the CE-boost images than for conventional images (P < 0.001). CONCLUSIONS The CE-boost technique increases not only the visualization of peripheral arteries by improving vascular attenuation but also the SNR and CNR.
Collapse
|
8
|
Xu J, Wang S, Wang X, Wang Y, Xue H, Yan J, Xu M, Jin Z. Effects of contrast enhancement boost postprocessing technique in combination with different reconstruction algorithms on the image quality of abdominal CT angiography. Eur J Radiol 2022; 154:110388. [DOI: 10.1016/j.ejrad.2022.110388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/22/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022]
|
9
|
Lennartz S, Laukamp KR, Tandon Y, Jordan M, Große Hokamp N, Zopfs D, Pennig L, Obmann M, Gilkeson RC, Herrmann KA, Ramaiya N, Gupta A. Abdominal vessel depiction on virtual triphasic spectral detector CT: initial clinical experience. Abdom Radiol (NY) 2021; 46:3501-3511. [PMID: 33715050 PMCID: PMC8215039 DOI: 10.1007/s00261-021-03001-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 12/19/2022]
Abstract
Purpose To evaluate vessel assessment in virtual monoenergetic images (VMI40keV) and virtual-non-contrast images (VNC) derived from venous phase spectral detector computed tomography (SDCT) acquisitions in comparison to arterial phase and true non-contrast (TNC) images. Methods Triphasic abdominal SDCT was performed in 25 patients including TNC, arterial and venous phase. VMI40keV and VNC were reconstructed from the venous phase and compared to conventional arterial-phase images (CIart), TNC and conventional venous-phase images (CIven). Vessel contrast and virtual contrast removal were analyzed with region-of-interest-based measurements and in a qualitative assessment. Results Quantitative analysis revealed no significant attenuation differences between TNC and VNC in arterial vessels (p-range 0.07–0.47) except for the renal artery (p = 0.011). For venous vessels, significant differences between TNC and VNC were found for all veins (p < 0.001) except the inferior vena cava (p = 0.26), yet these differences remained within a 10 HU range in most patients. No significant attenuation differences were found between CIart/VMI40keV in arterial vessels (p-range 0.06–0.86). Contrast-to-noise ratio provided by VMI40keV and CIart was equivalent for all arterial vessels assessed (p-range 0.14–0.91). Qualitatively, VMI40keV showed similar enhancement of abdominal and pelvic arteries as CIart and VNC were rated comparable to TNC. Conclusion Our study suggests that VNC and VMI40keV derived from single venous-phase SDCT offer comparable assessment of major abdominal vessels as provided by routine triphasic examinations, if no dynamic contrast information is required.
Collapse
Affiliation(s)
- Simon Lennartz
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
- Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne, Weyertal 115b, 50931, Cologne, Germany
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Kai Roman Laukamp
- Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA.
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University Cologne, Kerpener Straße, 62, 50937, Cologne, Germany.
| | - Yasmeen Tandon
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Michelle Jordan
- Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| | - Nils Große Hokamp
- Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
| | - David Zopfs
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
| | - Lenhard Pennig
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
| | - Markus Obmann
- Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Robert C Gilkeson
- Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| | - Karin A Herrmann
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| | - Nikhil Ramaiya
- Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Amit Gupta
- Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
10
|
Sultan S, Acharya Y, Atteia E, Hynes N. Management of Concealed Type IV Endoleak and Aortic Sac Hygroma by Prone ContrASt EnHancement Computed Tomography Angiography. Ann Vasc Surg 2020; 72:647-661. [PMID: 33385530 DOI: 10.1016/j.avsg.2020.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aortic sac hygroma and concealed endoleaks (EL) after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm needs particular attention with aggressive management as they are associated with rapid sac expansion and rupture risk. However, they can be erroneously reported as type IV or V EL with supine computed tomography (CT) scans, leading to delay in management. Therefore, we describe a novel diagnostic technique, 'Prone contrASt enHanced computed tomography Angiography' (PASHA), to document concealed EL METHODS: We present eight case descriptions with continuous sac expansion after primary EVAR. Management began with diagnosis using the PASHA imaging technique. PASHA is a multiphase CTA positional technique for increasing the accuracy of detecting EL after EVAR. Furthermore, the PASHA imaging technique also guides whether the open or endovascular intervention could be used effectively to manage the sac expansion. In synchrony with the PASHA technique, "EVAR GORE SalvAge FAbric Technique" (ARAFAT) was to salvage previous EVAR. RESULTS The PASHA technique diagnosed all cases of type IIIb EL, as it enhanced the degree of contrast infiltration into the aortic sac when microleaks were present. ARAFAT was effectively used in five elderly patients. Another three had an open conversion; two with double breasting of the aortic sac and one EVAR explantation. CONCLUSIONS The PASHA protocol helped classify and localize the concealed EL (type IV, V), which were not appropriately diagnosed by supine CT protocols. PASHA and ARAFAT were used as a fully functioning protocol to overcome apparent challenges in accurate diagnosis and subsequent concealed EL management in high-risk patients.
Collapse
Affiliation(s)
- Sherif Sultan
- Department of Vascular and Endovascular Surgery, Western Vascular Institute, University Hospital Galway, National University of Ireland Galway, Galway, Ireland; Department of Vascular and Endovascular Surgery, Galway Clinic, Royal College of Surgeons in Ireland Affiliated Hospitals, Galway, Ireland.
| | - Yogesh Acharya
- Department of Vascular and Endovascular Surgery, Western Vascular Institute, University Hospital Galway, National University of Ireland Galway, Galway, Ireland; Department of Vascular and Endovascular Surgery, Galway Clinic, Royal College of Surgeons in Ireland Affiliated Hospitals, Galway, Ireland
| | - Emad Atteia
- Department of Vascular and Endovascular Surgery, Western Vascular Institute, University Hospital Galway, National University of Ireland Galway, Galway, Ireland
| | - Niamh Hynes
- Department of Vascular and Endovascular Surgery, Galway Clinic, Royal College of Surgeons in Ireland Affiliated Hospitals, Galway, Ireland
| |
Collapse
|
11
|
Stein EB, Williams DM. CT Boost, an Important Step in Endoleak Diagnosis. Acad Radiol 2019; 26:1441-1442. [PMID: 31494002 DOI: 10.1016/j.acra.2019.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Erica B Stein
- Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Drive, UH B1 D502, Ann Arbor, MI 48109.
| | - David M Williams
- Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Drive, UH B1 D502, Ann Arbor, MI 48109
| |
Collapse
|