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Albano D, Di Luca F, D'Angelo T, Booz C, Midiri F, Gitto S, Fusco S, Serpi F, Messina C, Sconfienza LM. Dual-energy CT in musculoskeletal imaging: technical considerations and clinical applications. LA RADIOLOGIA MEDICA 2024:10.1007/s11547-024-01827-6. [PMID: 38743319 DOI: 10.1007/s11547-024-01827-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
Dual-energy CT stands out as a robust and innovative imaging modality, which has shown impressive advancements and increasing applications in musculoskeletal imaging. It allows to obtain detailed images with novel insights that were once the exclusive prerogative of magnetic resonance imaging. Attenuation data obtained by using different energy spectra enable to provide unique information about tissue characterization in addition to the well-established strengths of CT in the evaluation of bony structures. To understand clearly the potential of this imaging modality, radiologists must be aware of the technical complexity of this imaging tool, the different ways to acquire images and the several algorithms that can be applied in daily clinical practice and for research. Concerning musculoskeletal imaging, dual-energy CT has gained more and more space for evaluating crystal arthropathy, bone marrow edema, and soft tissue structures, including tendons and ligaments. This article aims to analyze and discuss the role of dual-energy CT in musculoskeletal imaging, exploring technical aspects, applications and clinical implications and possible perspectives of this technique.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy.
| | - Filippo Di Luca
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy
| | - Tommaso D'Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Stefano Fusco
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Francesca Serpi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
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Li S, Yuan L, Lu T, Yang X, Ren W, Wang L, Zhao J, Deng J, Liu X, Xue C, Sun Q, Zhang W, Zhou J. Deep learning imaging reconstruction of reduced-dose 40 keV virtual monoenergetic imaging for early detection of colorectal cancer liver metastases. Eur J Radiol 2023; 168:111128. [PMID: 37816301 DOI: 10.1016/j.ejrad.2023.111128] [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: 04/25/2023] [Revised: 08/07/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVE To explore whether reduced-dose (RD) gemstone spectral imaging (GSI) and deep learning image reconstruction (DLIR) of 40 keV virtual monoenergetic image (VMI) enhanced the early detection and diagnosis of colorectal cancer liver metastases (CRLM). METHODS Thirty-five participants with pathologically confirmed colorectal cancer were prospectively enrolled from March to August 2022 after routine care abdominal computed tomography (CT). GSI mode was used for contrast-enhanced CT, and two portal venous phase CT images were obtained [standard-dose (SD) CT dose index (CTDIvol) = 15.51 mGy, RD CTDIvol = 7.95 mGy]. The 40 keV-VMI were reconstructed via filtered back projection (FBP) and iterative reconstruction (ASIR-V 60 %, AV60) of both SD and RD images. RD medium-strength deep learning image reconstruction (DLIR-M) and RD high-strength deep learning image reconstruction (DLIR-H) were used to reconstruct the 40 keV-VMI. The contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) of the liver and the lesions were objectively evaluated. The overall image quality, lesion conspicuity, and diagnostic confidence were subjectively evaluated, to compare the differences in evaluation results among the different images. RESULTS All 35 participants (mean age: 59.51 ± 11.01 years; 14 females) underwent SD and RD GSI portal venous-phase CT scans. The dose-length product of the RD GSI scan was reduced by 49-53 % lower than that of the SD GSI scan (420.22 ± 31.95) vs (817.58 ± 60.56). A total of 219 lesions were identified, including 55 benign lesions and 164 metastases, with an average size of 7.37 ± 4.14 mm. SD-FBP detected 207 lesions, SD-AV60 detected 201 lesions, and DLIR-M and DLIR-H detected 199 and 190 lesions, respectively. For lesions ≤ 5 mm, there was no statistical difference between SD-FBP vs DLIR-M (χ2McNemar = 1.00, P = 0.32) and SD-AV60 vs DLIR-M (χ2McNemar = 0.33, P = 0.56) in the detection rate. The CNR, SNR, and noise of DLIR-M and DLIR-H 40 keV-VMI images were better than those of SD-FBP images (P < 0.01) but did not differ significantly from those of SD-AV60 images (P > 0.05). When the lesions ≤ 5 mm, there were statistical differences in the overall diagnostic sensitivity of lesions compared with SD-FBP, SD-AV60, DLIR-M and DLIR-H (P<0.01). There were no statistical differences in the sensitivity of lesions diagnosis between SD-FBP, SD-AV60 and DLIR-M (both P>0.05). However, the DLIR-M subjective image quality and lesion diagnostic confidence were higher for SD-FBP (both P < 0.01). CONCLUSION Reduced dose DLIR-M of 40 keV-VMI can be used for routine follow-up care of colorectal cancer patients, to optimize evaluations and ensure CT image quality. Meanwhile, the detection rate and diagnostic sensitivity and specificity of small lesions, early liver metastases is not obviously reduced.
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Affiliation(s)
- Shenglin Li
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Long Yuan
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Ting Lu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Xinmei Yang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Wei Ren
- CT Imaging Research Center, GE Healthcare China, Beijing, 100176, China.
| | - Luotong Wang
- CT Imaging Research Center, GE Healthcare China, Beijing, 100176, China.
| | - Jun Zhao
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China.
| | - Juan Deng
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Xianwang Liu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Caiqiang Xue
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Qiu Sun
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China.
| | - Wenjuan Zhang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China.
| | - Junlin Zhou
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second clinical school, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
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Hong Y, Zhong L, Lv X, Liu Q, Fu L, Zhou D, Yu N. Application of spectral CT in diagnosis, classification and prognostic monitoring of gastrointestinal cancers: progress, limitations and prospects. Front Mol Biosci 2023; 10:1284549. [PMID: 37954980 PMCID: PMC10634296 DOI: 10.3389/fmolb.2023.1284549] [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] [Received: 08/28/2023] [Accepted: 09/26/2023] [Indexed: 11/14/2023] Open
Abstract
Gastrointestinal (GI) cancer is the leading cause of cancer-related deaths worldwide. Computed tomography (CT) is an important auxiliary tool for the diagnosis, evaluation, and prognosis prediction of gastrointestinal tumors. Spectral CT is another major CT revolution after spiral CT and multidetector CT. Compared to traditional CT which only provides single-parameter anatomical diagnostic mode imaging, spectral CT can achieve multi-parameter imaging and provide a wealth of image information to optimize disease diagnosis. In recent years, with the rapid development and application of spectral CT, more and more studies on the application of spectral CT in the characterization of GI tumors have been published. For this review, we obtained a substantial volume of literature, focusing on spectral CT imaging of gastrointestinal cancers, including esophageal, stomach, colorectal, liver, and pancreatic cancers. We found that spectral CT can not only accurately stage gastrointestinal tumors before operation but also distinguish benign and malignant GI tumors with improved image quality, and effectively evaluate the therapeutic response and prognosis of the lesions. In addition, this paper also discusses the limitations and prospects of using spectral CT in GI cancer diagnosis and treatment.
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Affiliation(s)
- Yuqin Hong
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
| | - Lijuan Zhong
- Department of Radiology, The People’s Hospital of Leshan, Leshan, China
| | - Xue Lv
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
| | - Qiao Liu
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
| | - Langzhou Fu
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
| | - Daiquan Zhou
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
| | - Na Yu
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China
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Bucolo GM, D'Angelo T, Yel I, Koch V, Gruenewald LD, Othman AE, Alizadeh LS, Overhoff DP, Waldeck S, Martin SS, Mazziotti S, Ascenti G, Blandino A, Vogl TJ, Booz C. Virtual Monoenergetic Imaging of Lower Extremities Using Dual-Energy CT Angiography in Patients with Diabetes Mellitus. Diagnostics (Basel) 2023; 13:diagnostics13101790. [PMID: 37238274 DOI: 10.3390/diagnostics13101790] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (DM) is the most common metabolic disorder in the world and an important risk factor for peripheral arterial disease (PAD). CT angiography represents the method of choice for the diagnosis, pre-operative planning, and follow-up of vascular disease. Low-energy dual-energy CT (DECT) virtual mono-energetic imaging (VMI) has been shown to improve image contrast, iodine signal, and may also lead to a reduction in contrast medium dose. In recent years, VMI has been improved with the use of a new algorithm called VMI+, able to obtain the best image contrast with the least possible image noise in low-keV reconstructions. PURPOSE To evaluate the impact of VMI+ DECT reconstructions on quantitative and qualitative image quality in the evaluation of the lower extremity runoff. MATERIALS AND METHODS We evaluated DECT angiography of lower extremities in patients suffering from diabetes who had undergone clinically indicated DECT examinations between January 2018 and January 2023. Images were reconstructed with standard linear blending (F_0.5) and low VMI+ series were generated from 40 to 100 keV, in an interval of 15 keV. Vascular attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for objective analysis. Subjective analysis was performed using five-point scales to evaluate image quality, image noise, and diagnostic assessability of vessel contrast. RESULTS Our final study cohort consisted of 77 patients (41 males). Attenuation values, CNR, and SNR were higher in 40-keV VMI+ reconstructions compared to the remaining VMI+ and standard F_0.5 series (HU: 1180.41 ± 45.09; SNR: 29.91 ± 0.99; CNR: 28.60 ± 1.03 vs. HU 251.32 ± 7.13; SNR: 13.22 ± 0.44; CNR: 10.57 ± 0.39 in standard F_0.5 series) (p < 0.0001). Subjective image rating was significantly higher in 55-keV VMI+ images compared to the other VMI+ and standard F_0.5 series in terms of image quality (mean score: 4.77), image noise (mean score: 4.39), and assessability of vessel contrast (mean value: 4.57) (p < 0.001). CONCLUSIONS DECT 40-keV and 55-keV VMI+ showed the highest objective and subjective parameters of image quality, respectively. These specific energy levels for VMI+ reconstructions could be recommended in clinical practice, providing high-quality images with greater diagnostic suitability for the evaluation of lower extremity runoff, and potentially needing a lower amount of contrast medium, which is particularly advantageous for diabetic patients.
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Affiliation(s)
- Giuseppe Mauro Bucolo
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Ibrahim Yel
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
| | - Vitali Koch
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
| | - Leon D Gruenewald
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
| | - Ahmed E Othman
- Department of Neuroradiology, University Hospital Mainz, 55131 Mainz, Germany
| | - Leona Soraja Alizadeh
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, 56072 Koblenz, Germany
| | - Daniel P Overhoff
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, 56072 Koblenz, Germany
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Stephan Waldeck
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, 56072 Koblenz, Germany
- Institute of Neuroradiology, University Medical Centre, Johannes Gutenberg University Mainz, 55099 Mainz, Germany
| | - Simon S Martin
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy
| | - Thomas J Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
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Estler A, Nikolaou K, Schönberg SO, Bamberg F, Froelich MF, Tollens F, Verloh N, Weiss J, Horger M, Hagen F. Is There Still a Role for Two-Phase Contrast-Enhanced CT and Virtual Monoenergetic Images in the Era of Photon-Counting Detector CT? Diagnostics (Basel) 2023; 13:diagnostics13081454. [PMID: 37189555 DOI: 10.3390/diagnostics13081454] [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: 01/30/2023] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND To compare the diagnostic characteristics between arterial phase imaging versus portal venous phase imaging, applying polychromatic T3D images and low keV virtual monochromatic images using a 1st generation photon-counting CT detector, of CT in patients with hepatocellular carcinoma (HCC). METHODS Consecutive patients with HCC, with a clinical indication for CT imaging, were prospectively enrolled. Virtual monoenergetic images (VMI) were reconstructed at 40 to 70 keV for the PCD-CT. Two independent, blinded radiologists counted all hepatic lesions and quantified their size. The lesion-to-background ratio was quantified for both phases. SNR and CNR were determined for T3D and low VMI images; non-parametric statistics were used. RESULTS Among 49 oncologic patients (mean age 66.9 ± 11.2 years, eight females), HCC was detected in both arterial and portal venous scans. The signal-to-noise ratio, the CNR liver-to-muscle, the CNR tumor-to-liver, and CNR tumor-to-muscle were 6.58 ± 2.86, 1.40 ± 0.42, 1.13 ± 0.49, and 1.53 ± 0.76 in the arterial phase and 5.93 ± 2.97, 1.73 ± 0.38, 0.79 ± 0.30, and 1.36 ± 0.60 in the portal venous phase with PCD-CT, respectively. There was no significant difference in SNR between the arterial and portal venous phases, including between "T3D" and low keV images (p > 0.05). CNRtumor-to-liver differed significantly between arterial and portal venous contrast phases (p < 0.005) for both "T3D" and all reconstructed keV levels. CNRliver-to-muscle and CNRtumor-to-muscle did not differ in either the arterial or portal venous contrast phases. CNRtumor-to-liver increased in the arterial contrast phase with lower keV in addition to SD. In the portal venous contrast phase, CNRtumor-to-liver decreased with lower keV; whereas, CNRtumor-to-muscle increased with lower keV in both arterial and portal venous contrast phases. CTDI and DLP mean values for the arterial upper abdomen phase were 9.03 ± 3.59 and 275 ± 133, respectively. CTDI and DLP mean values for the abdominal portal venous phase were 8.75 ± 2.99 and 448 ± 157 with PCD-CT, respectively. No statistically significant differences were found concerning the inter-reader agreement for any of the (calculated) keV levels in either the arterial or portal-venous contrast phases. CONCLUSIONS The arterial contrast phase imaging provides higher lesion-to-background ratios of HCC lesions using a PCD-CT; especially, at 40 keV. However, the difference was not subjectively perceived as significant.
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Affiliation(s)
- Arne Estler
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Stefan O Schönberg
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, 79106 Freiburg, Germany
| | - Matthias F Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Fabian Tollens
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Niklas Verloh
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, 79106 Freiburg, Germany
| | - Jakob Weiss
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, 79106 Freiburg, Germany
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Florian Hagen
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
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Racine D, Mergen V, Viry A, Eberhard M, Becce F, Rotzinger DC, Alkadhi H, Euler A. Photon-Counting Detector CT With Quantum Iterative Reconstruction: Impact on Liver Lesion Detection and Radiation Dose Reduction. Invest Radiol 2023; 58:245-252. [PMID: 36094810 DOI: 10.1097/rli.0000000000000925] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess image noise, diagnostic performance, and potential for radiation dose reduction of photon-counting detector (PCD) computed tomography (CT) with quantum iterative reconstruction (QIR) in the detection of hypoattenuating and hyperattenuating focal liver lesions compared with energy-integrating detector (EID) CT. MATERIALS AND METHODS A medium-sized anthropomorphic abdominal phantom with liver parenchyma and lesions (diameter, 5-10 mm; hypoattenuating and hyperattenuating from -30 HU to +90 HU at 120 kVp) was used. The phantom was imaged on ( a ) a third-generation dual-source EID-CT (SOMATOM Force, Siemens Healthineers) in the dual-energy mode at 100 and 150 kVp with tin filtration and ( b ) a clinical dual-source PCD-CT at 120 kVp (NAEOTOM Alpha, Siemens). Scans were repeated 10 times for each of 3 different radiation doses of 5, 2.5, and 1.25 mGy. Datasets were reconstructed as virtual monoenergetic images (VMIs) at 60 keV for both scanners and as linear-blended images (LBIs) for EID-CT. For PCD-CT, VMIs were reconstructed with different strength levels of QIR (QIR 1-4) and without QIR (QIR-off). For EID-CT, VMIs and LBIs were reconstructed using advanced modeled iterative reconstruction at a strength level of 3. Noise power spectrum was measured to compare image noise magnitude and texture. A channelized Hotelling model observer was used to assess diagnostic accuracy for lesion detection. The potential for radiation dose reduction using PCD-CT was estimated for the QIR strength level with the highest area under the curve compared with EID-CT for each radiation dose. RESULTS Image noise decreased with increasing QIR level at all radiation doses. Using QIR-4, noise reduction was 41%, 45%, and 59% compared with EID-CT VMIs and 12%, 18%, and 33% compared with EID-CT LBIs at 5, 2.5, and 1.25 mGy, respectively. The peak spatial frequency shifted slightly to lower frequencies at higher QIR levels. Lesion detection accuracy increased at higher QIR levels and was higher for PCD-CT compared with EID-CT VMIs. The improvement in detection with PCD-CT was strongest at the lowest radiation dose, with an area under the receiver operating curve of 0.917 for QIR-4 versus 0.677 for EID-CT VMIs for hyperattenuating lesions, and 0.900 for QIR-4 versus 0.726 for EID-CT VMIs for hypoattenuating lesions. Compared with EID-CT LBIs, detection was higher for QIR 1-4 at 2.5 mGy and for QIR 2-4 at 1.25 mGy (eg, 0.900 for QIR-4 compared with 0.854 for EID-CT LBIs at 1.25 mGy). Radiation dose reduction potential of PCD-CT with QIR-4 was 54% at 5 mGy compared with VMIs and 39% at 2.5 mGy compared with LBIs. CONCLUSIONS Compared with EID-CT, PCD-CT with QIR substantially improved focal liver lesion detection, especially at low radiation dose. This enables substantial radiation dose reduction while maintaining diagnostic accuracy.
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Affiliation(s)
- Damien Racine
- From the Institute of Radiation Physics (IRA), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne
| | - Victor Mergen
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich
| | - Anaïs Viry
- From the Institute of Radiation Physics (IRA), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne
| | - Matthias Eberhard
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - David C Rotzinger
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich
| | - André Euler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich
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Nota T, Kageyama K, Yamamoto A, Kakehashi A, Yonezawa H, Jogo A, Sohgawa E, Murai K, Ogawa S, Miki Y. Safety and Feasibility of Contrast-Enhanced Computed Tomography with a Nanoparticle Contrast Agent for Evaluation of Diethylnitrosamine-Induced Liver Tumors in a Rat Model. Acad Radiol 2023; 30:30-39. [PMID: 35680546 DOI: 10.1016/j.acra.2022.03.027] [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: 01/24/2022] [Revised: 03/23/2022] [Accepted: 03/27/2022] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES Safety and feasibility of contrast-enhanced computed tomography (CECT) with a nanoparticulate contrast agent, ExiTron nano 12000, was evaluated in a rat liver tumor model. MATERIALS AND METHODS This study employed eighteen 8-week-old male F344 rats. Six rats given tap water for 8 weeks further divided into two: Control group and Normal Liver with CECT group. Six rats each were given tap water containing diethylnitrosamine (DEN) at 100 ppm for 8 or 14 weeks; Adenoma group and Hepatocellular carcinoma (HCC) group, respectively. Biochemical marker values and adverse events were evaluated after CT imaging. ExiTron nano 12000 was evaluated for the hepatic contrast enhancement, and the detection and measurement of liver nodules by CECT after 8- and 14-weeks administration of DEN. Post-mortem liver specimens were evaluated by hematoxylin-eosin (HE) staining, and the number and size of liver nodules were measured. The HCC group was evaluated for diagnostic concordance between HE-stained and CECT-detected nodules. RESULTS The contrast agent enhanced liver and was tolerated after CECT in 15 rats. Biochemical parameter values did not differ significantly between the Control and Normal Liver groups. The numbers of CECT-detected nodules in the Adenoma and HCC groups were 14.8 ± 5.1, and 32.4 ± 8.1, respectively. The HCC group had 3.6 ± 2.7 of pathological HCCs, which were identified by CECT. The size of CECT-detected HCCs correlated significantly with that of pathological HCCs (r = 0.966, p < 0.0001). CONCLUSION CECT with ExiTron nano 12000 is a safe and feasible method to measure tumors in a rat liver tumor model.
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Affiliation(s)
- Takehito Nota
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan.
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Anna Kakehashi
- Department of Molecular Pathology (A.K.), Graduate School of Medicine, Osaka City University (currently Osaka Metropolitan University), Abenoku, Osaka, Japan
| | - Hiroki Yonezawa
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Etsuji Sohgawa
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Kazuki Murai
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Satoyuki Ogawa
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine (T.N., K.K., A.Y., H.Y., A.J., E.S., K.M., S.O., Y.M.), Osaka City University (currently Osaka Metropolitan University), 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
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8
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Multi-Energy CT Applications. Radiol Clin North Am 2023; 61:1-21. [DOI: 10.1016/j.rcl.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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9
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Koch V, Albrecht MH, Gruenewald LD, Yel I, Eichler K, Gruber-Rouh T, Hammerstingl RM, Burck I, Wichmann JL, Alizadeh LS, Vogl TJ, Lenga L, Wesarg S, Martin SS, Mader C, Dimitrova M, D'Angelo T, Booz C. Impact of Intravenously Injected Contrast Agent on Bone Mineral Density Measurement in Dual-Source Dual-Energy CT. Acad Radiol 2022; 29:880-887. [PMID: 34266738 DOI: 10.1016/j.acra.2021.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the influence of intravenously injected contrast agent on bone mineral density (BMD) assessment in dual-source dual-energy CT. METHODS This retrospective study included 1,031 patients (mean age, 53 ± 7 years; 519 women) who had undergone third-generation dual-source dual-energy CT in context of tumor staging between January 2019 and December 2019. Dedicated postprocessing software based on material decomposition was used for phantomless volumetric BMD assessment of trabecular bone of the lumbar spine. Volumetric trabecular BMD values derived from unenhanced and contrast-enhanced portal venous phase were compared by calculating correlation and agreement analyses using Pearson product-moment correlation, linear regression, and Bland-Altman plots. RESULTS Mean BMD values were 115.53 ± 37.23 and 116.10 ± 37.78 mg/cm3 in unenhanced and contrast-enhanced dual-energy CT series, respectively. Values from contrast-enhanced portal venous phase differed not significantly from those of the unenhanced phase (p = 0.44) and showed high correlation (r = 0.971 [95% CI, 0.969-0.973]) with excellent agreement in Bland-Altman plots. Mean difference of the two phases was 0.61 mg/cm3 (95% limits of agreement, -17.14 and 18.36 mg/cm3). CONCLUSION Portal venous phase dual-source dual-energy CT allows for accurate opportunistic BMD assessment of trabecular bone of the lumbar spine compared to unenhanced imaging. Therefore, dual-source CT may provide greater flexibility regarding BMD assessment in clinical routine and reduce radiation exposure by avoiding additional osteodensitometry examinations, as contrast-enhanced CT scans in context of tumor staging are increasingly performed in dual-energy mode.
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Affiliation(s)
- Vitali Koch
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Moritz H Albrecht
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Leon D Gruenewald
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Ibrahim Yel
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Katrin Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tatjana Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Renate M Hammerstingl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Iris Burck
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Julian L Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Leona S Alizadeh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Thomas J Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Lukas Lenga
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Stefan Wesarg
- Fraunhofer IGD, Cognitive Computing & Medical Imaging, Darmstadt, Germany
| | - Simon S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Christoph Mader
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Mirela Dimitrova
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
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10
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Bette S, Decker JA, Braun FM, Becker J, Haerting M, Haeckel T, Gebhard M, Risch F, Woźnicki P, Scheurig-Muenkler C, Kroencke TJ, Schwarz F. Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI. Diagnostics (Basel) 2022; 12:diagnostics12051231. [PMID: 35626387 PMCID: PMC9140684 DOI: 10.3390/diagnostics12051231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
In dual-energy CT datasets, the conspicuity of liver metastases can be enhanced by virtual monoenergetic imaging (VMI) reconstructions at low keV levels. Our study investigated whether this effect can be reproduced in photon-counting detector CT (PCD-CT) datasets. We analyzed 100 patients with liver metastases who had undergone contrast-enhanced CT of the abdomen on a PCD-CT (n = 50) or energy-integrating detector CT (EID-CT, single-energy mode, n = 50). PCD-VMI-reconstructions were performed at various keV levels. Identical regions of interest were positioned in metastases, normal liver, and other defined locations assessing image noise, tumor-to-liver ratio (TLR), and contrast-to-noise ratio (CNR). Patients were compared inter-individually. Subgroup analyses were performed according to BMI. On the PCD-CT, noise and CNR peaked at the low end of the keV spectrum. In comparison with the EID-CT, PCD-VMI-reconstructions exhibited lower image noise (at 70 keV) but higher CNR (for ≤70 keV), despite similar CTDIs. Comparing high- and low-BMI patients, CTDI-upregulation was more modest for the PCD-CT but still resulted in similar noise levels and preserved CNR, unlike the EID-CT. In conclusion, PCD-CT VMIs in oncologic patients demonstrated reduced image noise–compared to a standard EID-CT–and improved conspicuity of hypovascularized liver metastases at low keV values. Patients with higher BMIs especially benefited from constant image noise and preservation of lesion conspicuity, despite a more moderate upregulation of CTDI.
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Affiliation(s)
- Stefanie Bette
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Josua A. Decker
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Franziska M. Braun
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Judith Becker
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Mark Haerting
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Thomas Haeckel
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Michael Gebhard
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Franka Risch
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Piotr Woźnicki
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Christian Scheurig-Muenkler
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Thomas J. Kroencke
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
- Correspondence: ; Tel.: +49-821-400-2441
| | - Florian Schwarz
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
- Medical Faculty, Ludwig Maximilian University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
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11
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Saleh M, Mujtaba B, Jensen C, Aslam R, Elsayes A, Kuchana V, Bhosale P. Feasibility of half the recommended dose of IV contrast in DECT: image quality evaluation and diagnostic acceptability in cancer patients. Clin Imaging 2022; 88:59-65. [DOI: 10.1016/j.clinimag.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022]
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12
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Higashigaito K, Euler A, Eberhard M, Flohr TG, Schmidt B, Alkadhi H. Contrast-Enhanced Abdominal CT with Clinical Photon-Counting Detector CT: Assessment of Image Quality and Comparison with Energy-Integrating Detector CT. Acad Radiol 2022; 29:689-697. [PMID: 34389259 DOI: 10.1016/j.acra.2021.06.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
RATIONALE AND OBJECTIVES To determine quantitative and qualitative image quality of contrast-enhanced abdominal photon-counting detector CT (PCD-CT) compared to energy-integrating detector CT (EID-CT) in the same patients. MATERIAL AND METHODS Thirty-nine patients (mean age 63 ± 10 years, 10 females, mean BMI 26.0 ± 5.7 kg/m2) were retrospectively included who underwent clinically indicated, contrast-enhanced abdominal CT in portal-venous phase with first-generation dual-source PCD-CT and who underwent previous abdominal CT with EID-CT. For both scan, same contrast media protocol was used. PCD-CT was performed in QuantumPlus mode (obtaining full spectral information) at 120kVp. EID-CT was performed using automated tube voltage selection (reference tube voltage 100kVp). In PCD-CT, virtual monoenergetic images (VMI) were reconstructed in 10keV intervals (40-90 keV). Tube current-time product in PCD-CT was modified in each patient to obtain same volume CT-dose-index (CTDIvol) as with EID-CT. Attenuation of organs and vascular structures were measured, noise quantified, and contrast-to-noise ratio (CNR) calculated. Two independent, blinded radiologists assessed subjective image quality using a 5-point Likert scale (overall image quality, image noise, contrast, and liver lesion conspicuity). RESULTS Median time interval between the scan was 12 months. BMI (p = 0.905) and CTDIvol (p = 0.984) were similar between scans. CNRparenchymal and CNRvascular of VMI from PCD-CT at 40 and 50keV were significantly higher than EID-CT (all, p < 0.05). Overall, inter-reader agreement for all subjective image quality readings was substantial (Krippendorff's alpha = 0.773). Overall image quality of VMI was rated similar at 50 and 60 keV compared to EID-CT (all, p > 0.05). Subjective image noise was significantly higher at 40-50 keV, contrast significantly higher at 40-60 keV (all, p < 0.05). Lesion conspicuity was rated similar on all images. CONCLUSION Our intra-individual analysis of abdominal PCD-CT indicates that VMI at 50 keV shows significantly higher CNR at similar subjective image quality as compared to EID-CT at identical radiation dose.
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13
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Freitas PS, Janicas C, Veiga J, Matos AP, Herédia V, Ramalho M. Imaging evaluation of the liver in oncology patients: A comparison of techniques. World J Hepatol 2021; 13:1936-1955. [PMID: 35069999 PMCID: PMC8727197 DOI: 10.4254/wjh.v13.i12.1936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/26/2021] [Accepted: 11/28/2021] [Indexed: 02/06/2023] Open
Abstract
The liver is commonly affected by metastatic disease. Therefore, it is essential to detect and characterize liver metastases, assuming that patient management and prognosis rely on it. The imaging techniques that allow non-invasive assessment of liver metastases include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, and PET/MRI. In this paper, we review the imaging findings of liver metastases, focusing on each imaging modality’s advantages and potential limitations. We also assess the importance of different imaging modalities for the management, follow-up, and therapy response of liver metastases. To date, both CT and MRI are the most appropriate imaging methods for initial lesion detection, follow-up, and assessment of treatment response. Multiparametric MRI is frequently used as a problem-solving technique for liver lesions and has evolved substantially over the past decade, including hardware and software developments and specific intravenous contrast agents. Several studies have shown that MRI performs better in small-sized metastases and moderate to severe liver steatosis cases. Although state-of-the-art MRI shows a greater sensitivity for detecting and characterizing liver metastases, CT remains the chosen method. We also present the controversial subject of the "economic implication" to use CT over MRI.
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Affiliation(s)
- Patrícia S Freitas
- Department of Radiology, Centro Hospitalar Universitário de Lisboa Central, Lisbon 1150-199, Portugal
| | - Catarina Janicas
- Department of Radiology, Centro Hospitalar de Lisboa Ocidental, Lisbon 1449-005, Portugal
| | - José Veiga
- Department of Radiology, Centro Hospitalar Universitário de Lisboa Central, Lisbon 1150-199, Portugal
| | - António P Matos
- Department of Radiology, Hospital Garcia de Orta, EPE, Almada 2805-267, Portugal
- Department of Radiology, Hospital CUF Tejo, Lisbon 1350-352, Portugal
| | - Vasco Herédia
- Department of Radiology, Hospital Garcia de Orta, EPE, Almada 2805-267, Portugal
- Department of Radiology, Hospital Espírito Santo de Évora-EPE, Évora 7000-811, Portugal
| | - Miguel Ramalho
- Department of Radiology, Hospital Garcia de Orta, EPE, Almada 2805-267, Portugal
- Department of Radiology, Hospital da Luz, Lisbon 1500-650, Portugal
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14
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D'Angelo T, Albrecht MH, Caudo D, Mazziotti S, Vogl TJ, Wichmann JL, Martin S, Yel I, Ascenti G, Koch V, Cicero G, Blandino A, Booz C. Virtual non-calcium dual-energy CT: clinical applications. Eur Radiol Exp 2021; 5:38. [PMID: 34476640 PMCID: PMC8413416 DOI: 10.1186/s41747-021-00228-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/11/2021] [Indexed: 12/15/2022] Open
Abstract
Dual-energy CT (DECT) has emerged into clinical routine as an imaging technique with unique postprocessing utilities that improve the evaluation of different body areas. The virtual non-calcium (VNCa) reconstruction algorithm has shown beneficial effects on the depiction of bone marrow pathologies such as bone marrow edema. Its main advantage is the ability to substantially increase the image contrast of structures that are usually covered with calcium mineral, such as calcified vessels or bone marrow, and to depict a large number of traumatic, inflammatory, infiltrative, and degenerative disorders affecting either the spine or the appendicular skeleton. Therefore, VNCa imaging represents another step forward for DECT to image conditions and disorders that usually require the use of more expensive and time-consuming techniques such as magnetic resonance imaging, positron emission tomography/CT, or bone scintigraphy. The aim of this review article is to explain the technical background of VNCa imaging, showcase its applicability in the different body regions, and provide an updated outlook on the clinical impact of this technique, which goes beyond the sole improvement in image quality.
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Affiliation(s)
- Tommaso D'Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Moritz H Albrecht
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - Danilo Caudo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Thomas J Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Julian L Wichmann
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Simon Martin
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Ibrahim Yel
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Vitali Koch
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Giuseppe Cicero
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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15
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Effect of energy level on the spatial resolution and noise frequency characteristics of virtual monochromatic images: a phantom experiment using four types of CT scanners. Jpn J Radiol 2021; 40:94-102. [PMID: 34304382 DOI: 10.1007/s11604-021-01180-y] [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: 04/04/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the study is to evaluate the effect of energy level on the modulation transfer functions (MTF) and noise power spectra (NPS) of virtual monochromatic images (VMIs) obtained using four types of computed-tomographic (CT) scanners: Revolution, SOMATOM, IQon, and Aquilion. MATERIALS AND METHODS VMIs were obtained at 70, 60, and 50 kiloelectron volts (keV), and also at the lowest keV available in each scanner. We evaluated the MTF and NPS in the VMIs obtained at each keV. RESULTS No significant effect of the energy level on the MTF was observed in IQon, whereas the spatial resolution decreased as the energy level decreased in the other types of scanners. The NPS curves tended to increase as the energy levels decreased with three types of scanners other than Aquilion. CONCLUSION The spatial resolution and noise frequency characteristics of VMIs may be affected by the energy level, and the effects of energy level on these characteristics differ depending on the type of CT scanners.
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16
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Dual energy CT in clinical routine: how it works and how it adds value. Emerg Radiol 2020; 28:103-117. [PMID: 32483665 DOI: 10.1007/s10140-020-01785-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
Dual energy computed tomography (DECT), also known as spectral CT, refers to advanced CT technology that separately acquires high and low energy X-ray data to enable material characterization applications for substances that exhibit different energy-dependent x-ray absorption behavior. DECT supports a variety of post-processing applications that add value in routine clinical CT imaging, including material selective and virtual non-contrast images using two- and three-material decomposition algorithms, virtual monoenergetic imaging, and other material characterization techniques. Following a review of acquisition and post-processing techniques, we present a case-based approach to highlight the added value of DECT in common clinical scenarios. These scenarios include improved lesion detection, improved lesion characterization, improved ease of interpretation, improved prognostication, inherently more robust imaging protocols to account for unexpected pathology or suboptimal contrast opacification, length of stay reduction, reduced utilization by avoiding unnecessary follow-up examinations, and radiation dose reduction. A brief discussion of post-processing workflow approaches, challenges, and solutions is also included.
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