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Hartley-Blossom ZJ, Digumarthy SR. Dual-Energy Computed Tomography Applications in Lung Cancer. Radiol Clin North Am 2023; 61:987-994. [PMID: 37758365 DOI: 10.1016/j.rcl.2023.06.001] [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] [Indexed: 10/03/2023]
Abstract
This article examines the intrathoracic applications for dual-energy computed tomography (DECT), focusing on lung cancer. The topics covered include the image data sets, methods for iodine quantification, and clinical applications. The applications of DECT are to differentiate benign and malignant lung nodules, determining the grade of lung cancer and expression of ki-67 expression. Iodine quantification has role in assessment of treatment response in both the primary tumor and nodal metastases.
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Affiliation(s)
- Zachary J Hartley-Blossom
- Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Subba R Digumarthy
- Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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2
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Abstract
Dual-energy CT has expanded the potential of thoracic imaging in both children and adults. Data processing allows material- and energy-specific reconstructions, which improve material differentiation and tissue characterization compared with single-energy CT. Material-specific reconstructions include iodine, virtual unenhanced, perfusion blood volume, and lung vessel images, which can improve assessment of vascular, mediastinal, and parenchymal abnormalities. The energy-specific reconstruction algorithm allows virtual monoenergetic reconstructions, including low-energy images to increase iodine conspicuity and high-energy images to reduce beam-hardening and metal artifacts. This review highlights dual-energy CT principles, hardware, and postprocessing algorithms; the clinical applications of dual-energy CT; and the potential benefits of photon counting (the most recently introduced iteration of spectral imaging) in pediatric thoracic imaging.
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Affiliation(s)
- Jordan B Rapp
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Marilyn J Siegel
- Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO 63110
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3
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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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Contrast-Enhanced Chest Computed Tomography (CT) Scan with Low Radiation and Total Iodine Dose for Lung Cancer Detection Using Adaptive Statistical Iterative Reconstruction. IRANIAN JOURNAL OF RADIOLOGY 2022. [DOI: 10.5812/iranjradiol-126572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Contrast-enhanced chest computed tomography (CT) is useful for the detection and follow-up of patients with lung cancer. However, reaching balance between diagnostic image quality, radiation dose, and iodixanol dose is a cause of concern. Objectives: To investigate the clinical value of adaptive statistical iterative reconstruction (ASIR) in reducing the iodixanol content and radiation dose during contrast-enhanced chest CT scan for patients diagnosed with lung masses/nodules based on the analysis of image quality. Methods: This prospective study was conducted on 80 patients diagnosed with nodules or masses, who required contrast-enhanced chest CT scans. The experimental group (n = 40) was subjected to iohexol at a high concentration (350 mgI/L) with a tube voltage of 120 kVp and a filter back projection (FBP) reconstruction algorithm. The comparison group (n = 40) was subject to iodixanol at a lower concentration (270 mgI/L) with a tube voltage of 100 kVp and ASIR (blending ratio, 40%). The radiation dose and total iodixanol content, as well as subjective and objective evaluations of image quality, were analyzed and compared. Results: The two groups obtained non-significantly different subjective scores for five structures detected in the lung window and five structures detected in the mediastinal window, as well as the overall image (P > 0.05 for all). Both the two-group images obtained diagnosis-acceptable scores (≥ 3 points) on displays of 10 structures and overall image quality. The mean CT value of vessels (100 kVp vs. 120 kVp: 314.90 ± 23.42 vs. 308.93 ± 21.40; P > 0.05), standard deviation (13.03 ± 0.88 vs.12.83 ± 0.90; P > 0.05), and contrast-to-noise ratio (20.77 ± 2.20 vs. 20.36 ± 1.94; P > 0.05) were not significantly different between two groups. However, the CT dose index, dose-length product, effective dose, and total iodine dose were reduced by 27.58%, 36.65%, 36.59%, and 22.86% in the 100-kVp group compared to the 120-kVp group. Conclusions: The ASIR showed great potential in reducing the radiation dose and iodine contrast dose, while maintaining good image quality and providing strong confidence for the diagnosis of lung cancer.
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Spectral imaging in the pediatric chest: past, present and future. Pediatr Radiol 2022; 52:1910-1920. [PMID: 35726069 DOI: 10.1007/s00247-022-05404-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/28/2022] [Accepted: 05/14/2022] [Indexed: 12/14/2022]
Abstract
Computed tomography technology continues to undergo evolution and improvement with each passing decade. From its inception in 1971, to the advent of commercially available dual-energy CT just over a decade ago, and now to the latest innovation, photon-counting detector CT, CT's utility for resolving and discriminating tissue types improves. In this review we discuss the impact of spectral imaging, including dual-energy CT and the recently available photon-counting detector CT, on the imaging of the pediatric chest. We describe the current capabilities and future directions of CT imaging, encompassing both the lungs and the surrounding tissues.
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Dual-source computed tomography protocols for the pediatric chest - scan optimization techniques. Pediatr Radiol 2022:10.1007/s00247-022-05468-7. [PMID: 35948645 PMCID: PMC9365683 DOI: 10.1007/s00247-022-05468-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/28/2022] [Accepted: 07/21/2022] [Indexed: 11/26/2022]
Abstract
The gold standard for pediatric chest imaging remains the CT scan. An ideal pediatric chest CT has the lowest radiation dose with the least motion degradation possible in a diagnostic scan. Because of the known inherent risks and costs of anesthesia, non-sedate options are preferred. Dual-source CTs are currently the fastest, lowest-dose CT scanners available, utilizing an ultra-high-pitch mode resulting in sub-second CTs. The dual-energy technique, available on dual-source CT scanners, gathers additional information such as pulmonary blood volume and includes relative contrast enhancement and metallic artifact reduction, features that are not available in high-pitch flash mode. In this article we discuss the benefits and tradeoffs of dual-source CT scan modes and tips on image optimization.
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Strange CD, Ahuja J, Shroff GS, Truong MT, Marom EM. Imaging Evaluation of Thymoma and Thymic Carcinoma. Front Oncol 2022; 11:810419. [PMID: 35047412 PMCID: PMC8762255 DOI: 10.3389/fonc.2021.810419] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/09/2021] [Indexed: 01/28/2023] Open
Abstract
Imaging is integral in the management of patients with thymoma and thymic carcinoma. At initial diagnosis and staging, imaging provides the clinical extent of local invasion as well as distant metastases to stratify patients for therapy and to determine prognosis. Following various modalities of therapy, imaging serves to assess treatment response and detect recurrent disease. While imaging findings overlap, a variety of CT, MRI, and PET/CT characteristics can help differentiate thymoma and thymic carcinoma, with new CT and MRI techniques currently under evaluation showing potential.
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Affiliation(s)
- Chad D Strange
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Girish S Shroff
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Mylene T Truong
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Edith M Marom
- Department of Diagnostic Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
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Araki T, Hammer M, Sodickson A. Fat content quantification using dual-energy CT for differentiation of anterior mediastinal lesions from normal or hyperplastic thymus. Curr Probl Diagn Radiol 2021; 51:334-339. [PMID: 34364734 DOI: 10.1067/j.cpradiol.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/23/2021] [Accepted: 06/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Detection of fat content in thymic lesions is crucial to differentiate thymic hyperplasia from thymic tumors or other anterior mediastinal pathologies. PURPOSE To assess the feasibility of dual-energy CT (DECT) fat content quantification for the differentiation of anterior mediastinal lesions from benign thymic lesions and the normal spectrum of the thymus. MATERIALS AND METHODS Chest DECT images of 465 patients (median 61 years, 63% female) were visually evaluated by two radiologists and semiquantitatively scored based on the degree of fatty degeneration ranging from completely fatty (score 0) to predominantly soft-tissue (score 3), and anterior mediastinal mass (score 4). A subset of scans (n =134 including all cases with scores 2-4 and 20 randomly-selected cases from scores 0 and 1) underwent quantitative DECT analysis (fat fraction, iodine density, and conventional CT value). DECT values were compared across the semiquantitative scores. RESULTS Results of visual evaluation included 35 with predominantly solid thymus (score 3) and 15 with anterior mediastinal mass (score 4). The most common clinical diagnoses of the 15 masses (including 8 with pathologic confirmation) were metastases (n = 10) and lymphoma (n = 4). CT values in the abnormal thymus were significantly higher than those in score 3 (median: 69.7 HU versus 19.9 HU, P <0.001). There was no significant difference in iodine density values (median: 1.7 mg/ml versus 1 mg/ml, P = 0.09). However, the fat fraction value was significantly lower in the abnormal thymus (score 4) than in the predominantly soft-tissue attenuation thymuses (score 3) (median: 12.8% versus 38.7%, P <0.001). ROC curve analysis showed that fat fraction had an AUC of 0.96 (P <0.001), with a cutoff of <39.2% fat fraction yielding 100% sensitivity and 85% specificity. CONCLUSION DECT fat fraction measurements of the thymus may provide additional value in distinguishing anterior mediastinal lesions from benign thymus. Use of DECT may reduce the need for subsequent imaging evaluation.
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Affiliation(s)
- Tetsuro Araki
- Department of Radiology, The Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
| | - Mark Hammer
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Aaron Sodickson
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Ackman JB, Chung JH, Walker CM, Bang TJ, Carter BW, Hobbs SB, Kandathil A, Lanuti M, Madan R, Moore WH, Shah SD, Verde F, Kanne JP. ACR Appropriateness Criteria® Imaging of Mediastinal Masses. J Am Coll Radiol 2021; 18:S37-S51. [PMID: 33958117 DOI: 10.1016/j.jacr.2021.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/25/2022]
Abstract
Mediastinal masses can present with symptoms, signs, and syndromes or incidentally. Selecting the appropriate diagnostic imaging study for mediastinal mass evaluation requires awareness of the strengths and weaknesses of the various imaging modalities with regard to tissue characterization, soft tissue contrast, and surveillance. This publication expounds on the differences between chest radiography, CT, PET/CT, ultrasound, and MRI in terms of their ability to decipher and surveil mediastinal masses. Making the optimal imaging choice can yield diagnostic specificity, avert unnecessary biopsy and surgery, guide the interventionist when necessary, and serve as a means of surveillance for probably benign, but indeterminate mediastinal masses. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Jeanne B Ackman
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | | | | | - Tami J Bang
- University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Brett W Carter
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen B Hobbs
- University of Kentucky, Lexington, Kentucky, Councilor, ACR Kentucky Chapter, Vice Chair, Informatics and Integrated Clinical Operations, University of Kentucky
| | | | - Michael Lanuti
- Massachusetts General Hospital, Boston, Massachusetts, The Society of Thoracic Surgeons, Director, Thoracic Oncology, Division of Thoracic Surgery, Massachusetts General Hospital
| | - Rachna Madan
- Brigham & Women's Hospital, Boston, Massachusetts
| | - William H Moore
- New York University Langone Medical Center, New York, New York
| | - Sachin D Shah
- University of Chicago, Chicago, Illinois, Primary care physician. Associate Chief Medical Information Officer, University of Chicago Medicine
| | - Franco Verde
- Johns Hopkins University School of Medicine, Baltimore, Maryland, Director, Diagnostic Imaging, Johns Hopkins Bayview Medical Center
| | - Jeffrey P Kanne
- Specialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Birnbacher L, Braig EM, Pfeiffer D, Pfeiffer F, Herzen J. Quantitative X-ray phase contrast computed tomography with grating interferometry : Biomedical applications of quantitative X-ray grating-based phase contrast computed tomography. Eur J Nucl Med Mol Imaging 2021; 48:4171-4188. [PMID: 33846846 PMCID: PMC8566444 DOI: 10.1007/s00259-021-05259-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022]
Abstract
The ability of biomedical imaging data to be of quantitative nature is getting increasingly important with the ongoing developments in data science. In contrast to conventional attenuation-based X-ray imaging, grating-based phase contrast computed tomography (GBPC-CT) is a phase contrast micro-CT imaging technique that can provide high soft tissue contrast at high spatial resolution. While there is a variety of different phase contrast imaging techniques, GBPC-CT can be applied with laboratory X-ray sources and enables quantitative determination of electron density and effective atomic number. In this review article, we present quantitative GBPC-CT with the focus on biomedical applications.
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Affiliation(s)
- Lorenz Birnbacher
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Eva-Maria Braig
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Franz Pfeiffer
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Julia Herzen
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany.
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Siegel MJ, Bhalla S, Cullinane M. Dual-Energy CT Material Decomposition in Pediatric Thoracic Oncology. Radiol Imaging Cancer 2021; 3:e200097. [PMID: 33778757 DOI: 10.1148/rycan.2021200097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/22/2020] [Accepted: 08/27/2020] [Indexed: 11/11/2022]
Abstract
Technical advances in CT have enabled implementation of dual-energy CT into routine clinical practice. By acquiring images at two different energy spectra, dual-energy CT enables material decomposition, allowing generation of material- and energy-specific images. Material-specific images include virtual nonenhanced images and iodine-specific images (iodine maps). Energy-specific images include virtual monoenergetic images. The reconstructed images can provide unique qualitative and quantitative information about tissue composition and contrast media distribution. In thoracic oncologic imaging, dual-energy CT provides advantages in characterization of thoracic malignancies and lung nodules, determination of extent of disease, and assessment of response to therapy. An especially important feature in children is that dual-energy CT does not come at a higher radiation exposure. Keywords: CT, CT-Quantitative, Lung, Mediastinum, Neoplasms-Primary, Pediatrics, Thorax, Treatment Effects © RSNA, 2021.
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Affiliation(s)
- Marilyn J Siegel
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St Louis, MO 63110 (M.J.S., S.B.); and Siemens Healthineers, Malvern, Pa (M.C.)
| | - Sanjeev Bhalla
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St Louis, MO 63110 (M.J.S., S.B.); and Siemens Healthineers, Malvern, Pa (M.C.)
| | - Mike Cullinane
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St Louis, MO 63110 (M.J.S., S.B.); and Siemens Healthineers, Malvern, Pa (M.C.)
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12
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Heeger AP, Ackman JB. Added Value of Magnetic Resonance Imaging for the Evaluation of Mediastinal Lesions. Radiol Clin North Am 2021; 59:251-277. [PMID: 33551086 DOI: 10.1016/j.rcl.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The high soft tissue contrast and tissue characterization properties of magnetic resonance imaging allow further characterization of indeterminate mediastinal lesions on chest radiography and computed tomography, increasing diagnostic specificity, preventing unnecessary intervention, and guiding intervention or surgery when needed. The combination of its higher soft tissue contrast and ability to image dynamically during free breathing, without ionizing radiation exposure, allows more thorough and readily appreciable assessment of a lesion's invasiveness and assessment of phrenic nerve involvement, with significant implications for prognostic clinical staging and surgical management.
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Affiliation(s)
- Allen P Heeger
- Department of Radiology, Division of Thoracic Imaging and Intervention, Harvard Medical School, Massachusetts General Hospital, Founders House 202, 55 Fruit Street, Boston, MA 02114, USA
| | - Jeanne B Ackman
- Department of Radiology, Division of Thoracic Imaging and Intervention, Harvard Medical School, Massachusetts General Hospital, Founders House 202, 55 Fruit Street, Boston, MA 02114, USA.
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Li WX, Miao F, Xu XQ, Zhang J, Wu ZY, Chen KM, Yan FH, Lin XZ. Pancreatic Neuroendocrine Neoplasms: CT Spectral Imaging in Grading. Acad Radiol 2021; 28:208-216. [PMID: 32111466 DOI: 10.1016/j.acra.2020.01.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/26/2020] [Accepted: 01/26/2020] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to define the CT spectral imaging characteristics of pancreatic neuroendocrine neoplasms (PNENs) and evaluate their potential for differential diagnosis of nonlow grade (non-LG) PNENs from low grade (LG) PNENs. MATERIALS AND METHODS CT spectral imaging data of 54 pathologically proven PNENs were retrospectively reviewed. Patients were divided into two groups: 40 cases with grade 1 in LG PNENs group and 14 cases with grade 2 and grade 3 in non-LG PNENs group. RESULTS Gender, calcification, inhomogeneity, invasiveness, PD dilatation, lymph node enlargement, size, normalized iodine (water) concentration in arterial phase (AP) (Iodine (ap)), normalized effective-Z (Zap), slope of normalized CT spectral curves in both AP, and portal venous phase were found to be significant variables for differentiating non-LG PNENs from LG PNENs (p < 0.05). Non-LG PNENs had larger size and lower Zap and Iodine (ap) than LG PNENs. The tumor size, Zap and Iodine (ap) had fair to good diagnostic performance with the area under receiver-operating-characteristic curve (AUC) 0.843, 0.733, and 0.728, respectively. Multivariate analysis with logistic regression had higher AUC (p<0.05) than all the single parameters except for size. CONCLUSION There were significant differences in CT spectral imaging parameters between non-LG and LG PNENs. Tumor size was the most promising independent parameter and the combination of quantitative parameters with qualitative parameters is the best predictor in differentiating of non-LG PNENs from LG PNENs. CT spectral imaging can help determine the malignancy of PNENs, which can better assist in surgical planning.
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Affiliation(s)
- Wei-Xia Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fei Miao
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xue-Qin Xu
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Radiology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Jiading, Shanghai, China
| | - Zhi-Yuan Wu
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ke-Min Chen
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fu-Hua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Zhu Lin
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai, China.
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Ji X, Zhang R, Li K, Chen GH. Dual Energy Differential Phase Contrast CT (DE-DPC-CT) Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3278-3289. [PMID: 32340940 PMCID: PMC7584735 DOI: 10.1109/tmi.2020.2990347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When more than two elemental materials are present in a given object, material quantification may not be robust and accurate when the routine two-material decomposition scheme in current dual energy CT imaging is employed. In this work, we present an innovative scheme to accomplish accurate three-material decomposition with measurements from a dual energy differential phase contrast CT (DE-DPC-CT) acquisition. A DE-DPC-CT system was constructed using a grating interferometer and a photon counting CT imaging system with two energy bins. The DE-DPC-CT system can simultaneously measure both the imaginary and the real part of the complex refractive index to enable a three-material decomposition. Physical phantom with 21 material inserts were constructed and measured using DE-DPC-CT system. Results demonstrated excellent accuracy in elemental material quantification. For example, relative root-mean-square errors of 4.5% for calcium and 5.2% for iodine were achieved using the proposed three-material decomposition scheme. Biological tissues with iodine inserts were used to demonstrate the potential utility of the proposed spectral CT imaging method. Experimental results showed that the proposed method correctly differentiates the bony structure, iodine, and the soft tissue in the biological specimen samples. A triple spectra CT scan was also performed to benchmark the performance of the DE-DPC-CT scan. Results demonstrated that the material decomposition from the DE-DPC-CT has a much lower quantification noise than that from the triple spectra CT scan.
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15
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Rajiah P, Parakh A, Kay F, Baruah D, Kambadakone AR, Leng S. Update on Multienergy CT: Physics, Principles, and Applications. Radiographics 2020; 40:1284-1308. [DOI: 10.1148/rg.2020200038] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Prabhakar Rajiah
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Anushri Parakh
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Fernando Kay
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Dhiraj Baruah
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Avinash R. Kambadakone
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Shuai Leng
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
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McCollough CH, Boedeker K, Cody D, Duan X, Flohr T, Halliburton SS, Hsieh J, Layman RR, Pelc NJ. Principles and applications of multienergy CT: Report of AAPM Task Group 291. Med Phys 2020; 47:e881-e912. [DOI: 10.1002/mp.14157] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/11/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
| | - Kirsten Boedeker
- Canon (formerly Toshiba) Medical Systems Corporation 1440 Warnall Ave Los Angeles CA 90024 USA
| | - Dianna Cody
- University of Texas, M.D. Anderson Cancer Center 7163 Spanish Grant Galveston TX 77554‐7756 USA
| | - Xinhui Duan
- Southwestern Medical Center University of Texas 5323 Harry Hines Blvd Dallas TX 75390‐9071 USA
| | - Thomas Flohr
- Siemens Healthcare GmbH Siemensstr. 3 Forchheim BY 91031 Germany
| | | | - Jiang Hsieh
- GE Healthcare Technologies 3000 N. Grandview Blvd. W-1190 Waukesha WI 53188 USA
| | - Rick R. Layman
- University of Texas, M.D. Anderson Cancer Center 7163 Spanish Grant Galveston TX 77554‐7756 USA
| | - Norbert J. Pelc
- Stanford University 443 Via Ortega, Room 203 Stanford CA 94305‐4125 USA
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Yu C, Li T, Zhang R, Yang X, Yang Z, Xin L, Zhao Z. Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors. Sci Rep 2020; 10:5511. [PMID: 32218504 PMCID: PMC7098982 DOI: 10.1038/s41598-020-62466-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/13/2020] [Indexed: 11/09/2022] Open
Abstract
To evaluate the role of conventional contrast-enhanced CT (CECT) imaging and dual-energy spectral CT (DECT) perfusion imaging in differentiating the WHO histological subtypes of thymic epithelial tumours (TETs). Eighty-eight patients with TETs who underwent DECT perfusion scans (n = 51) and conventional CT enhancement scans (n = 37) using a GE Discovery CT750 HD scanner were enrolled in this study. The mean maximal contrast-enhanced range (mean CEmax) and the perfusion and spectral parameters of the lesions were analysed. Among the six WHO subtypes (Type A, AB, B1, B2, and B3 thymoma and thymic carcinoma), the mean CEmax values and most of the perfusion and spectral parameter values of Type A and Type AB were significantly higher than those of the other subtypes (all P < 0.05), and there was no difference among Type B1, B2 and B3 (all P > 0.05). The mean CEmax value was not different between Type B (including Type B1, B2, and B3) and thymic carcinoma (P = 1.000). The PS, IC, NIC and λHU values in the optimal venous phase of thymic carcinoma were higher than those of Type B (all P < 0.05). The parameters of conventional CECT imaging and DECT perfusion imaging can help identify the subtype of TETs, especially those of DECT perfusion imaging in type B thymomas and thymic carcinomas.
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Affiliation(s)
- Chunhai Yu
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Ting Li
- Department of Nephrology, Taiyuan People's Hospital, Taiyuan, Shanxi, 030001, P.R. China
| | - Ruiping Zhang
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China.
| | - Xiaotang Yang
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Zhao Yang
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Lei Xin
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Zhikai Zhao
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
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Kawahara D, Ozawa S, Yokomachi K, Fujioka C, Kimura T, Awai K, Nagata Y. Synthesized effective atomic numbers for commercially available dual-energy CT. Rep Pract Oncol Radiother 2020; 25:692-697. [PMID: 32684854 DOI: 10.1016/j.rpor.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/19/2020] [Indexed: 01/24/2023] Open
Abstract
Purpose The objective of this study was to assess synthesized effective atomic number (Zeff) values with a new developed tissue characteristic phantom and contrast material of varying iodine concentrations using single-source fast kilovoltage switching dual-energy CT (DECT) scanner. Methods A newly developed multi energy tissue characterisation CT phantom and an acrylic phantom with various iodine concentrations of were scanned using single-source fast kilovoltage switching DECT (GE-DECT) scanner. The difference between the measured and theoretical values of Zeff were evaluated. Additionally, the difference and coefficient of variation (CV) values of the theoretical and measured values were compared with values obtained with the Canon-DECT scanner that was analysed in our previous study. Results The average Zeff difference in the Multi-energy phantom was within 4.5%. The average difference of the theoretical and measured Zeff values for the acrylic phantom with variation of iodine concentration was within 3.3%. Compared to the results for the single-source Canon-DECT scanner used in our previous study, the average difference and CV of the theoretical and measured Zeff values obtained with the GE-DECT scanner were markedly smaller. Conclusions The accuracy of the synthesized Zeff values with GE-DECT had a good agreement with the theoretical Zeff values for the Multi-Energy phantom. The GE-DECT could reduce the noise and the accuracy of the Zeff values than that with Canon-DECT for the varying iodine concentrations of contrast medium. Advances in knowledge The accuracy and precision of the Zeff values of the contrast medium with the GE-DECT could be sufficient with human equivalent materials.
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Affiliation(s)
- Daisuke Kawahara
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Shuichi Ozawa
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Japan.,Hiroshima High-Precision Radiotherapy Cancer Center, Japan
| | - Kazushi Yokomachi
- Radiation Therapy Section, Division of Clinical Support, Hiroshima University Hospital, Japan
| | - Chikako Fujioka
- Radiation Therapy Section, Division of Clinical Support, Hiroshima University Hospital, Japan
| | - Tomoki Kimura
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Kazuo Awai
- Department of Radiation Oncology, Graduate School of Medicine, Hiroshima University, Japan
| | - Yasushi Nagata
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Japan.,Hiroshima High-Precision Radiotherapy Cancer Center, Japan
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Cicero G, Ascenti G, Albrecht MH, Blandino A, Cavallaro M, D'Angelo T, Carerj ML, Vogl TJ, Mazziotti S. Extra-abdominal dual-energy CT applications: a comprehensive overview. Radiol Med 2020; 125:384-397. [PMID: 31925704 DOI: 10.1007/s11547-019-01126-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
Abstract
Unlike conventional computed tomography, dual-energy computed tomography is a relatively novel technique that exploits ionizing radiations at different energy levels. The separate radiation sets can be achieved through different technologies, such as dual source, dual layers or rapid switching voltage. Body tissue molecules vary for their specific atomic numbers and electron density, and the interaction with different sets of radiations results in different attenuations, allowing to their final distinction. In particular, iodine recognition and quantification have led to important information about intravenous contrast medium delivery within the body. Over the years, useful post-processing algorithms have also been validated for improving tissue characterization. For instance, contrast resolution improvement and metal artifact reduction can be obtained through virtual monoenergetic images, dose reduction by virtual non-contrast reconstructions and iodine distribution highlighting through iodine overlay maps. Beyond the evaluation of the abdominal organs, dual-energy computed tomography has also been successfully employed in other anatomical districts. Although lung perfusion is one of the most investigated, this evaluation has been extended to narrowly fields of application, such as musculoskeletal, head and neck, vascular and cardiac. The potential pool of information provided by dual-energy technology is already wide and not completely explored, yet. Therefore, its performance continues to raise increasing interest from both radiologists and clinicians.
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Affiliation(s)
- Giuseppe Cicero
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.
| | - Giorgio Ascenti
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Alfredo Blandino
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Marco Cavallaro
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.,Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Tommaso D'Angelo
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Maria Ludovica Carerj
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Silvio Mazziotti
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
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Siegel MJ, Ramirez-Giraldo JC. Dual-Energy CT in Children: Imaging Algorithms and Clinical Applications. Radiology 2019; 291:286-297. [PMID: 30912717 DOI: 10.1148/radiol.2019182289] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Dual-energy CT enables the simultaneous acquisition of CT images at two different x-ray energy spectra. By acquiring high- and low-energy spectral data, dual-energy CT can provide unique qualitative and quantitative information about tissue composition, allowing differentiation of multiple materials including iodinated contrast agents. The two dual-energy CT postprocessing techniques that best exploit the advantages of dual-energy CT in children are the material-decomposition images (which include virtual nonenhanced, iodine, perfused lung blood volume, lung vessel, automated bone removal, and renal stone characterization images) and virtual monoenergetic images. Clinical applications include assessment of the arterial system, lung perfusion, neoplasm, bowel diseases, renal calculi, tumor response to treatment, and metal implants. Of importance, the radiation exposure level of dual-energy CT is equivalent to or less than that of conventional single-energy CT. In this review, the authors discuss the basic principles of the dual-energy CT technologies and postprocessing techniques and review current clinical applications in the pediatric chest and abdomen.
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Affiliation(s)
- Marilyn J Siegel
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, Mo 63110 (M.J.S.); and Siemens Healthineers, Malvern, Pa (J.C.R.G.)
| | - Juan Carlos Ramirez-Giraldo
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, Mo 63110 (M.J.S.); and Siemens Healthineers, Malvern, Pa (J.C.R.G.)
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Chen ML, Li XT, Wei YY, Qi LP, Sun YS. Can spectral computed tomography imaging improve the differentiation between malignant and benign pulmonary lesions manifesting as solitary pure ground glass, mixed ground glass, and solid nodules? Thorac Cancer 2018; 10:234-242. [PMID: 30582292 PMCID: PMC6360238 DOI: 10.1111/1759-7714.12937] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study quantitatively assessed the efficacy of spectral computed tomography (CT) imaging parameters for differentiating the malignancy and benignity of solitary pulmonary nodules (SPNs) manifesting as ground glass nodules (GGNs) and solid nodules (SNs). METHODS The study included 114 patients with SPNs (61 GGNs, and 53 SNs) who underwent CT plain and enhanced scans in the arterial (a) and venous (v) phases using the spectral imaging mode. The spectral CT imaging parameters included: iodine concentrations (IC) of lesions in the arterial (ICLa) and venous (ICLv) phases; normalized IC (NICa/NICv, normalized to the IC in the aorta); the slope of the spectral Hounsfield unit (HU) curve (λHUa/λHUv); and monochromatic CT number (CT40keVa/v, CT70keVa/v) enhancement on 40 and 70 keV images. The two-sample Mann-Whitney U test was used to compare quantitative parameters between malignant and benign SPNs, SNs, and GGNs. RESULTS Pathology revealed 75 lung cancer cases, 3 metastatic nodules, 14 benign nodules, and 22 inflammatory nodules. Among the 53 SNs there were 37 malignant and 16 benign nodules. Among the 61 GGNs there were 41 malignant and 20 benign nodules. Overall, the CT40keVa, λHUa, CT40keVv, λHUv, and ICLv of benign SPNs were all greater than those of malignant SPNs (all P < 0.05). For GGNs, CT40keVa/v, CT70keVa/v, λHUa/λHUv, and ICLv of malignant GGNs were all lower than those of benign GGNs. CONCLUSION Spectral CT imaging is a more promising method for distinguishing malignant from benign nodules, especially in nodules manifesting as GGNs in contrast-enhanced scanning.
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Affiliation(s)
- Mai-Lin Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiao-Ting Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yi-Yuan Wei
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Li-Ping Qi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
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Yan WQ, Xin YK, Jing Y, Li GF, Wang SM, Rong WC, Xiao G, Lei XB, Li B, Hu YC, Cui GB. Iodine Quantification Using Dual-Energy Computed Tomography for Differentiating Thymic Tumors. J Comput Assist Tomogr 2018; 42:873-880. [PMID: 30339550 PMCID: PMC6250292 DOI: 10.1097/rct.0000000000000800] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/17/2018] [Indexed: 12/27/2022]
Abstract
The aim of the study was to explore the efficacy of iodine quantification with dual-energy computed tomography (DECT) in differentiating thymoma, thymic carcinoma, and thymic lymphoma. MATERIALS AND METHODS Fifty-seven patients with pathologically confirmed low-risk thymoma (n = 16), high-risk thymoma (n = 15), thymic carcinoma (n = 14), and thymic lymphoma (n = 12) underwent chest contrast-enhanced DECT scan were enrolled in this study. Tumor DECT parameters including iodine-related Hounsfield unit (IHU), iodine concentration (IC), mixed HU (MHU), and iodine ratio in dual phase, slope of energy spectral HU curve (λ), and virtual noncontrast (VNC) were compared for differences among 4 groups by one-way analysis of variance. Receiver operating characteristic curve was used to determine the efficacy for differentiating the low-risk thymoma from other thymic tumor by defined parameters. RESULTS According to quantitative analysis, dual-phase IHU, IC, and MHU values in patients with low-risk thymoma were significantly increased compared with patients with high-risk thymoma, thymic carcinoma, and thymic lymphoma (P < 0.05/4).The venous phase IHU value yielded the highest performance with area under the curve of 0.893, 75.0% sensitivity, and 89.7% specificity for differentiating the low-risk thymomas from high-risk thymomas or thymic carcinoma at the cutoff value of 34.3 HU. When differentiating low-risk thymomas from thymic lymphoma, the venous phase IC value obtained the highest diagnostic efficacy with the area under the curve of 0.969, and sensitivity, specificity, and cutoff value were 87.5%, 100.0%, and 1.25 mg/mL, respectively. CONCLUSIONS Iodine quantification with DECT may be useful for differentiating the low-risk thymomas from other thymic tumors.
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Affiliation(s)
- Wei-Qiang Yan
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Yong-Kang Xin
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Yong Jing
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Gang-Feng Li
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Shu-Mei Wang
- Department of Pathology, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University), Shaanxi, PR China
| | - Wei-Cheng Rong
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Gang Xiao
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Xue-Bin Lei
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Bo Li
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Yu-Chuan Hu
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
| | - Guang-Bin Cui
- From the Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, and
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Abstract
The present study aimed to evaluate the application of gemstone spectral imaging (GSI) for multi-parameter quantitative measurement in lung cancer.The study retrospectively enrolled 30 patients with lung cancer who underwent chest contrast enhanced CT scan with GSI mode. The GSI viewer was used for image display and data analysis. Optimal energy value, CT values at 40 keV, 70 keV and optimal energy level, spectral curve slope, effective atomic number (Zeff), iodine concentration (IC), and water concentration (WC) at the region of interest were measured and analyzed by statistical methods.The optimal energy value for optimal contrast-to-noise ratio on plain scan, arterial phase and venous phase was 62.2 ± 5.38 keV, 50.63 ± 3.84 keV, and 52.5 ± 3.7 keV, respectively. There were significant differences in CT values at different energy levels on each scan phase (P = .033). The spectral curve slope values among 40 to 70 keV, 40 to 100 keV, and 40 to 140 keV were significantly different (P < .001). No significant difference with the slope between arterial phase and venous phase at each energy level interval was observed. Zeff on plain scan, arterial phase, and venous phase was 7.75 ± 0.15, 8.38 ± 0.37, and 8.38 ± 0.30, respectively. Positive correlation was observed among IC, normalized IC, and Zeff on enhanced scan.Multiparameter of GSI can be used for lung tumor lesion evaluation. Different parameters were correlated and provide multiple qualitative and quantitative information together.
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Affiliation(s)
- Yulin Jia
- Department of Imaging and Nuclear Medicine
| | - Xigang Xiao
- Department of Radiology, the First Affiliated Hospital
| | - Qiulian Sun
- Department of Radiology, the First Affiliated Hospital
| | - Huijie Jiang
- Department of Radiology, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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Kawahara D, Ozawa S, Yokomachi K, Tanaka S, Higaki T, Fujioka C, Suzuki T, Tsuneda M, Nakashima T, Ohno Y, Nagata Y. Accuracy of the raw-data-based effective atomic numbers and monochromatic CT numbers for contrast medium with a dual-energy CT technique. Br J Radiol 2017; 91:20170524. [PMID: 29161881 DOI: 10.1259/bjr.20170524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of raw-data-based effective atomic number (Zeff) values and monochromatic CT numbers for contrast material of varying iodine concentrations, obtained using dual-energy CT. METHODS We used a tissue characterization phantom and varying concentrations of iodinated contrast medium. A comparison between the theoretical values of Zeff and that provided by the manufacturer was performed. The measured and theoretical monochromatic CT numbers at 40-130 keV were compared. RESULTS The average difference between the Zeff values of lung (inhale) inserts in the tissue characterization phantom was 81.3% and the average Zeff difference was within 8.4%. The average difference between the Zeff values of the varying concentrations of iodinated contrast medium was within 11.2%. For the varying concentrations of iodinated contrast medium, the differences between the measured and theoretical monochromatic CT values increased with decreasing monochromatic energy. The Zeff and monochromatic CT numbers in the tissue characterization phantom were reasonably accurate. CONCLUSION The accuracy of the raw-data-based Zeff values was higher than that of image-based Zeff values in the tissue-equivalent phantom. The accuracy of Zeff values in the contrast medium was in good agreement within the maximum SD found in the iodine concentration range of clinical dynamic CT imaging. Moreover, the optimum monochromatic energy for human tissue and iodinated contrast medium was found to be 70 keV. Advances in knowledge: The accuracy of the Zeff values and monochromatic CT numbers of the contrast medium created by raw-data-based, dual-energy CT could be sufficient in clinical conditions.
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Affiliation(s)
- Daisuke Kawahara
- 1 Division of Clinical Support, Radiation Therapy Section, Hiroshima University Hospital , Radiation Therapy Section, Hiroshima University Hospital , Hiroshima , Japan.,2 Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University , Hiroshima , Japan
| | - Shuichi Ozawa
- 3 Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University , Institute of Biomedical & Health Sciences, Hiroshima University , Hiroshima , Japan.,4 Hiroshima High-Precision Radiotherapy Cancer Center , Hiroshima , Japan
| | - Kazushi Yokomachi
- 1 Division of Clinical Support, Radiation Therapy Section, Hiroshima University Hospital , Radiation Therapy Section, Hiroshima University Hospital , Hiroshima , Japan
| | - Sodai Tanaka
- 5 Department of Nuclear Engineering and Management, School of Engineering, University of Tokyo , School of Engineering, University of Tokyo , Tokyo , Japan
| | - Toru Higaki
- 6 Departments of Diagnostic Radiology and Radiology, Hiroshima University , Hiroshima University , Hiroshima , Japan
| | - Chikako Fujioka
- 1 Division of Clinical Support, Radiation Therapy Section, Hiroshima University Hospital , Radiation Therapy Section, Hiroshima University Hospital , Hiroshima , Japan
| | - Tatsuhiko Suzuki
- 2 Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University , Hiroshima , Japan
| | - Masato Tsuneda
- 2 Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University , Hiroshima , Japan
| | - Takeo Nakashima
- 1 Division of Clinical Support, Radiation Therapy Section, Hiroshima University Hospital , Radiation Therapy Section, Hiroshima University Hospital , Hiroshima , Japan
| | - Yoshimi Ohno
- 1 Division of Clinical Support, Radiation Therapy Section, Hiroshima University Hospital , Radiation Therapy Section, Hiroshima University Hospital , Hiroshima , Japan
| | - Yasushi Nagata
- 3 Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University , Institute of Biomedical & Health Sciences, Hiroshima University , Hiroshima , Japan.,4 Hiroshima High-Precision Radiotherapy Cancer Center , Hiroshima , Japan
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Assessment of 70-keV virtual monoenergetic spectral images in abdominal CT imaging: A comparison study to conventional polychromatic 120-kVp images. Abdom Radiol (NY) 2017; 42:2579-2586. [PMID: 28421243 DOI: 10.1007/s00261-017-1151-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the image quality of 70-keV virtual monoenergetic (monoE) abdominal CT images compared to 120-kVp polychromatic images generated from a spectral detector CT (SDCT) scanner. METHODS This prospective study included generation of a 120-kVp polychromatic dataset and a 70-keV virtual monoE dataset after a single contrast-enhanced CT acquisition on a SDCT scanner (Philips Healthcare) during portal venous phase. The attenuation values (HU), noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured in the liver, spleen, pancreas, kidney, aorta, portal vein, and muscle. The subjective image quality including noise, soft tissue contrast, sharpness, and overall image quality were graded on a 5-point Likert scale by two radiologists independently (1-worst image quality, 5-best image quality). Statistical analysis was performed using paired sample t test and Fleiss's Kappa. RESULTS Fifty-five patients (54.3 ± 16.8 y/o; 28 M, 27 F) were recruited. The noise of target organs was significantly lower in virtual monoE images in comparison to polychromatic images (p < 0.001). The SNR and CNR were significantly higher in virtual monoE images (p < 0.001 for both). Subjective image quality of 70-keV virtual monoE images was significantly better (p < 0.001) for all evaluated parameters. Median scores for all subjective parameters were 3.0 versus 4.0 for polychromatic vs virtual monoE images, respectively. The inter-reader agreement for overall image quality was good (Kappa were 0.767 and 0.762 for polychromatic and virtual monoE images, respectively). CONCLUSION In abdominal imaging, 70-keV virtual monoE CT images demonstrated significantly better noise, SNR, CNR, and subjective score compared to conventional 120-kVp polychromatic images.
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Otrakji A, Digumarthy SR, Lo Gullo R, Flores EJ, Shepard JAO, Kalra MK. Dual-Energy CT: Spectrum of Thoracic Abnormalities. Radiographics 2016; 36:38-52. [PMID: 26761530 DOI: 10.1148/rg.2016150081] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Recent studies have demonstrated that dual-energy computed tomography (CT) can provide useful information in several chest-related clinical indications. Compared with single-energy CT, dual-energy CT of the chest is feasible with the use of a radiation-dose-neutral scanning protocol. This article highlights the different types of images that can be generated by using dual-energy CT protocols such as virtual monochromatic, virtual unenhanced (ie, water), and pulmonary blood volume (ie, iodine) images. The physical basis of dual-energy CT and material decomposition are explained. The advantages of the use of virtual low-monochromatic images include reduced volume of intravenous contrast material and improved contrast resolution of images. The use of virtual high-monochromatic images can reduce beam hardening and contrast streak artifacts. The pulmonary blood volume images can help differentiate various parenchymal abnormalities, such as infarcts, atelectasis, and pneumonias, as well as airway abnormalities. The pulmonary blood volume images allow quantitative and qualitative assessment of iodine distribution. The estimation of iodine concentration (quantitative assessment) provides objective analysis of enhancement. The advantages of virtual unenhanced images include differentiation of calcifications, talc, and enhanced thoracic structures. Dual-energy CT has applications in oncologic imaging, including diagnosis of thoracic masses, treatment planning, and assessment of response to treatment. Understanding the concept of dual-energy CT and its clinical application in the chest are the goals of this article.
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Affiliation(s)
- Alexi Otrakji
- From the Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 213, Boston, MA 02114
| | - Subba R Digumarthy
- From the Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 213, Boston, MA 02114
| | - Roberto Lo Gullo
- From the Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 213, Boston, MA 02114
| | - Efren J Flores
- From the Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 213, Boston, MA 02114
| | - Jo-Anne O Shepard
- From the Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 213, Boston, MA 02114
| | - Mannudeep K Kalra
- From the Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Founders 213, Boston, MA 02114
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González-Pérez V, Arana E, Barrios M, Bartrés A, Cruz J, Montero R, González M, Deltoro C, Martínez-Pérez E, De Aguiar-Quevedo K, Arrarás M. Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings. Eur J Radiol 2016; 85:1765-1772. [DOI: 10.1016/j.ejrad.2016.07.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/29/2022]
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Chang S, Hur J, Im DJ, Suh YJ, Hong YJ, Lee HJ, Kim YJ, Han K, Kim DJ, Lee CY, Shin HY, Choi BW. Volume-based quantification using dual-energy computed tomography in the differentiation of thymic epithelial tumours: an initial experience. Eur Radiol 2016; 27:1992-2001. [DOI: 10.1007/s00330-016-4542-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 06/06/2016] [Accepted: 08/04/2016] [Indexed: 12/28/2022]
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Laroia ST, Bhadoria AS, Venigalla Y, Chibber GK, Bihari C, Rastogi A, Sarin SK. Role of dual energy spectral computed tomography in characterization of hepatocellular carcinoma: Initial experience from a tertiary liver care institute. Eur J Radiol Open 2016; 3:162-71. [PMID: 27504474 DOI: 10.1016/j.ejro.2016.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/26/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate dual-energy spectral CT in characterization of hepatocellular Carcinoma (HCC) in patients with chronic liver disease. METHODS Dynamic computed tomography (CT) was performed in 3600 patients (2879 males; 721 females, mean age 50.9 ± 11.9 years) with working clinical diagnosis of liver cirrhosis for hepatocellular carcinoma screening and other clinical indications. The study was conducted over a period of 3 years. During dynamic CT scanning, spectral (monochromatic) and routine (polychromatic) CT acquisitions were obtained on a single tube, dual energy, 64 slice multi-detector CT scanner. Imaging findings were studied on routine CT. On the basis of routine CT findings, indeterminate lesions (lesions not showing characteristic hypervascularity followed by washout on dynamic routine CT scan) that were referred for biopsy or surgery were segregated. A retrospective blinded review of the lesions, acquired by the spectral CT acquisitions was done with the help of gem stone imaging (GSI) software to characterize these lesions. All the above lesions were analyzed qualitatively in the arterial phase for lesion conspicuity as well as quantitatively using the monochromatic data sets and nodule Iodine concentration on material density maps, respectively. This data was studied with respect to predictability of HCC using the spectral CT technique. Iodine density of the lesion, surrounding liver parenchyma, and lesion to liver parenchyma ratio (LLR) were derived and statistically analyzed. Histopathology of the lesion in question was treated as gold standard for analysis. RESULTS It was observed via statistical analysis that the value of iodine density of the lesion on material density sets of ≥29.5 mg/dl, enabled a discriminatory power of 86.5%, sensitivity of 90.5% with 95% confidence Interval (CI) (69.2-98.8%) and specificity of 81.2% with 95% Confidence Interval (54.4-95.9%) in predicting HCC. Qualitative assessment also showed higher lesion conspicuity with spectral CT image sets as compared to routine CT data. CONCLUSION This study reveals that spectral imaging is an excellent qualitative as well as a quantitative tool for assessing and predicting hepatocellular carcinoma in cirrhotic patients.
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Affiliation(s)
- S T Laroia
- Department of Radiology, Institute of Liver and Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110070, India
| | - Ajeet Singh Bhadoria
- Department of Community Medicine, Institute of Liver & Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110 070, India
| | - Yamini Venigalla
- Department of Radiology, Institute of Liver and Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110070, India
| | - G K Chibber
- Department of Research, Institute of Liver & Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110 070, India
| | - Chagan Bihari
- Department of Hepatopathology, Institute of Liver & Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110 070, India
| | - Archana Rastogi
- Department of Hepatopathology, Institute of Liver & Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110 070, India
| | - S K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, Sector D-1, Vasant Kunj, New Delhi 110070, India
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Christensen HD, Sheta HM, Morillon MB, Hansen IMJ. Tophaceous Gout in an Anorectic Patient Visualized by Dual Energy Computed Tomography (DECT). AMERICAN JOURNAL OF CASE REPORTS 2016; 17:494-8. [PMID: 27418121 PMCID: PMC4948657 DOI: 10.12659/ajcr.898542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patient: Female, 40 Final Diagnosis: Gout Symptoms: Joint pain Medication: — Clinical Procedure: Dual energy Computed tomography Specialty: Rheumatology
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Affiliation(s)
- Heidi Dahl Christensen
- Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark
| | - Hussam Mahmoud Sheta
- Department of Medical Research, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark
| | - Melanie Birger Morillon
- Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark
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Feng Q, Li Q, Hu Y, Wang QX, Hu DY, Li Z. Small colorectal cancer liver metastases: Clinical value of quantitative iodine-based material decomposition images of spectral CT. Shijie Huaren Xiaohua Zazhi 2016; 24:2421-2428. [DOI: 10.11569/wcjd.v24.i15.2421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To retrospectively assess the diagnostic value of quantitative iodine-based material decomposition images of spectral CT in evaluating small liver metastases (<3 cm) from colorectal cancer.
METHODS: Nine hundred and fifteen consecutive patients with liver lesions were recruited, and 140 of them were confirmed to have metastatic liver cancer. All the patients underwent double-phase [arterial phase (AP) and portal venous phase (PVP)] spectral CT scans and the best single energy images were obtained at the workstation. Fifteen different sources of small metastatic liver lesions (<3 cm) were analyzed, and the diagnosis rate was compared between the best single energy images and traditional images. The final study group included 41 patients with hepatic metastases from colorectal cancer. Iodine concentrations and CT values of normal liver parenchyma and metastatic lesions were derived from iodine-based material-decomposition CT or conventional CT images. The differences in iodine concentration and CT values between the AP and PVP were recorded and the lesion-to-normal liver parenchyma differences were calculated. The paired t-test was employed to compare CT value and iodine concentrations between AP and PVP. Two readers qualitatively assessed lesion types on the basis of conventional CT characteristics. The two-sample t-test was performed to compare the iodine concentrations and CT values changes between AP and PVP in normal liver parenchyma and metastatic lesions (central and marginal).
RESULTS: Compared with traditional CT hybrid energy images, the detection rate of small metastases was much higher by spectral CT images (Wilcoxon sighed-rank test Z = 3.306, P = 0.001). In the AP, comparing the marginal with the central parts of the lesions, the CT values increased by 37.65% while the iodine value increased by 65.95%, and there was a significant difference between them (P < 0.001). Comparing normal liver tissues with the marginal parts of the lesions, the CT values increased by 22.99% while the iodine value increased by 17.96%, and there was no significant difference between them (P = 0.225). In the PVP, comparing the marginal with the central parts of the lesions, the CT values increased by 32.13% while the iodine value increased by 40.01%, and the difference was significant (P < 0.001). Comparing normal liver tissues with the marginal parts of the lesions, the CT values increased by 34.47% while the iodine value increased by 40.92%, and the difference was significant (P = 0.033).
CONCLUSION: Quantitative CT iodine value analysis may be able to improve the detection rate of small lesions, and it can display the enhancement features of colorectal cancer liver metastases. This technique may help to improve the diagnostic accuracy of small metastatic lesions.
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van Elmpt W, Landry G, Das M, Verhaegen F. Dual energy CT in radiotherapy: Current applications and future outlook. Radiother Oncol 2016; 119:137-44. [DOI: 10.1016/j.radonc.2016.02.026] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/13/2016] [Accepted: 02/28/2016] [Indexed: 11/17/2022]
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Xiao H, Liu Y, Tan H, Liang P, Wang B, Su L, Wang S, Gao J. A pilot study using low-dose Spectral CT and ASIR (Adaptive Statistical Iterative Reconstruction) algorithm to diagnose solitary pulmonary nodules. BMC Med Imaging 2015; 15:54. [PMID: 26576676 PMCID: PMC4647278 DOI: 10.1186/s12880-015-0096-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 10/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is the most common cancer which has the highest mortality rate. With the development of computed tomography (CT) techniques, the case detection rates of solitary pulmonary nodules (SPN) has constantly increased and the diagnosis accuracy of SPN has remained a hot topic in clinical and imaging diagnosis. The aim of this study was to evaluate the combination of low-dose spectral CT and ASIR (Adaptive Statistical Iterative Reconstruction) algorithm in the diagnosis of solitary pulmonary nodules (SPN). METHODS 62 patients with SPN (42 cases of benign SPN and 20 cases of malignant SPN, pathology confirmed) were scanned by spectral CT with a dual-phase contrast-enhanced method. The iodine and water concentration (IC and WC) of the lesion and the artery in the image that had the same density were measured by the GSI (Gemstone Spectral Imaging) software. The normalized iodine and water concentration (NIC and NWC) of the lesion and the normalized iodine and water concentration difference (ICD and WCD) between the arterial and venous phases (AP and VP) were also calculated. The spectral HU (Hounsfield Unit ) curve was divided into 3 sections based on the energy (40-70, 70-100 and 100-140 keV) and the slopes (λHU) in both phases were calculated. The ICAP, ICVP, WCAP and WCVP, NIC and NWC, and the λHU in benign and malignant SPN were compared by independent sample t-test. RESULTS The iodine related parameters (ICAP, ICVP, NICAP, NICVP, and the ICD) of malignant SPN were significantly higher than that of benign SPN (t = 3.310, 1.330, 2.388, 1.669 and 3.251, respectively, P <0.05). The 3 λHU values of venous phase in malignant SPN were higher than that of benign SPN (t = 3.803, 2.846 and 3.205, P <0.05). The difference of water related parameters (WCAP, WCVP, NWCAP, NWCVP and WCD) between malignant and benign SPN were not significant (t = 0.666, 0.257, 0.104, 0.550 and 0.585, P > 0.05). CONCLUSIONS The iodine related parameters and the slope of spectral curve are useful markers to distinguish the benign from the malignant lung diseases, and its application is extremely feasible in clinical applications.
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Affiliation(s)
- Huijuan Xiao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Yihe Liu
- The No.7 People's Hospital of Zhengzhou, 17 Jingnan 5th Road, Zhengzhou Economic and Technological Development Zone, Zhengzhou, Henan Province, 450000, China.
| | - Hongna Tan
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Pan Liang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Bo Wang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Lei Su
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Suya Wang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Jianbo Gao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
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Li JH, Du YM, Huang HM. Accuracy of dual-energy computed tomography for the quantification of iodine in a soft tissue-mimicking phantom. J Appl Clin Med Phys 2015; 16:418–426. [PMID: 26699312 PMCID: PMC5690187 DOI: 10.1120/jacmp.v16i5.5519] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 04/21/2015] [Accepted: 04/19/2015] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to evaluate the accuracy of dual-energy CT (DECT) for quantifying iodine using a soft tissue-mimicking phantom across various DECT acquisition parameters and dual-source CT (DSCT) scanners. A phantom was constructed with plastic tubes containing soft tissue-mimicking materials with known iodine concentrations (0-20 mg/mL). Experiments were performed on two DSCT scanners, one equipped with an integrated detector and the other with a conventional detector. DECT data were acquired using two DE modes (80 kV/Sn140 kV and 100 kV/Sn140 kV) with four pitch values (0.6, 0.8, 1.0, and 1.2). Images were reconstructed using a soft tissue kernel with and without beam hardening correction (BHC) for iodine. Using the dedicated DE software, iodine concentrations were measured and compared to true concentrations. We also investigated the effect of reducing gantry rotation time on the DECT-based iodine measurement. At iodine concentrations higher than 10 mg/mL, the relative error in measured iodine concentration increased slightly. This error can be decreased by using the kernel with BHC, compared with the kernel without BHC. Both 80 kV/Sn140 kV and 100 kV/Sn140 kV modes could provide accurate quantification of iodine content. Increasing pitch value or reducing gantry rotation time had only a minor impact on the DECT-based iodine measurement. The DSCT scanner, equipped with the new integrated detector, showed more accurate iodine quantification for all iodine concentrations higher than 10 mg/mL. An accurate quantification of iodine can be obtained using the second-generation DSCT scanner in various DE modes with pitch values up to 1.2 and gantry rotation time down to 0.28 s. For iodine concentrations ≥ 10 mg/mL, using the new integrated detector and the kernel with BHC can improve the accuracy of DECT-based iodine measurements.
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Affiliation(s)
- Jung-Hui Li
- Chang Gung Memorial Hospital, Kaohsiung Medical Center.
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Jia Y, Zhang J, Fan J, Li C, Sun Y, Li D, Xiao X. Gemstone spectral imaging reduced artefacts from metal coils or clips after treatment of cerebral aneurysms: a retrospective study of 35 patients. Br J Radiol 2015; 88:20150222. [PMID: 26329465 PMCID: PMC4743447 DOI: 10.1259/bjr.20150222] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/19/2015] [Accepted: 09/01/2015] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of gemstone spectral imaging (GSI) for metal artefact reduction in cerebral artery CT angiography (CTA) after metal coils or clips treatment. METHODS 35 patients with cerebral aneurysms were treated with metal coils or clips and underwent CTA using gemstone spectral CT between February and December 2013. The data were reconstructed into three image groups including Group A (quality check images with 140 kVp), Group B (monochromatic image sets in the range of 40-140 keV) and Group C [monochromatic image sets with metal artefacts reduction software (MARS GE Medical Systems, Waukesha, WI)]. CT attenuation value of cerebral artery, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR) and the subjective score of all images were measured and compared statistically. RESULTS CT attenuation value of cerebral artery decreased in Groups B and C as the photon energy increased. The average energy levels of 60.05 ± 5.37 and 59.93 ± 5.57 keV presented the best CNR in Groups B and C, respectively. CNR values, SNR values and the subjective scores of the image quality of the two sets were higher than those of Group A. CONCLUSION GSI reduced metal artefact and improved the image quality of CTA after metal coils or clips treatment in patients with cerebral aneurysm. The monochromatic images at the average energy level of 60.05 ± 5.37 keV with MARS and 59.93 ± 5.57 keV without MARS were suggested to be the optimal parameters. ADVANCES IN KNOWLEDGE GSI could reduce metal artefact after metal coils or clips treatment in patients with cerebral aneurysm.
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Affiliation(s)
- Yulin Jia
- Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jinling Zhang
- Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jinyu Fan
- Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chao Li
- Department of Medical Imaging, Heilongjiang Provincial Hospital, Harbin, China
| | - Yuanyuan Sun
- Department of CT, The First Hospital of Harbin, Harbin, China
| | - Di Li
- Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xigang Xiao
- Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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de Souza SL, Santiago F, Ribeiro-Carvalho MDM, Arnóbio A, Soares AR, Ornellas MH. Leptomeningeal involvement in B-cell chronic lymphocytic leukemia: a case report and review of the literature. BMC Res Notes 2014; 7:645. [PMID: 25218117 PMCID: PMC4246480 DOI: 10.1186/1756-0500-7-645] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 09/08/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Central nervous system involvement is considered a rare complication of chronic lymphocytic leukemia, and so there is the risk of being overlooked. CASE PRESENTATION We report a case of central nervous system involvement in a 75-year-old mulatto woman with chronic lymphocytic leukemia after 5 years of follow-up and a literature review on the subject. The clinical course, treatment and outcome are described. A systematic, meticulous and comprehensive analysis of existing publications regarding chronic lymphocytic leukemia with central nervous system involvement was performed. CONCLUSION We concluded that central nervous system involvement of chronic lymphocytic leukemia is probably not associated with any evident risk factors. Diagnostic approach differs by institutions but often includes imaging, morphology and flow cytometry. Resolution of central nervous system symptoms can usually be accomplished with intrathecal chemotherapy or irradiation followed by systemic treatment. The recognition of this entity by clinicians could lead to early detection and treatment, resulting in better outcomes in this rare complication.
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Affiliation(s)
- Simone Lima de Souza
- />Departamento de Patologia, Faculdade de Ciências Medicas, Programa de Pós Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, 444/4° andar, Vila Isabel, Rio de Janeiro Brazil
| | - Fábio Santiago
- />Departamento de Patologia, Faculdade de Ciências Medicas, Programa de Pós Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, 444/4° andar, Vila Isabel, Rio de Janeiro Brazil
| | - Marilza de Moura Ribeiro-Carvalho
- />Departamento de Patologia, Faculdade de Ciências Medicas, Programa de Pós Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, 444/4° andar, Vila Isabel, Rio de Janeiro Brazil
| | - Adriano Arnóbio
- />Departamento de Patologia, Faculdade de Ciências Medicas, Programa de Pós Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, 444/4° andar, Vila Isabel, Rio de Janeiro Brazil
| | - Andréa Ribeiro Soares
- />Serviço de Hematologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Helena Ornellas
- />Departamento de Patologia, Faculdade de Ciências Medicas, Programa de Pós Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, 444/4° andar, Vila Isabel, Rio de Janeiro Brazil
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Aoki M, Takai Y, Narita Y, Hirose K, Sato M, Akimoto H, Kawaguchi H, Hatayama Y, Miura H, Ono S. Correlation between tumor size and blood volume in lung tumors: a prospective study on dual-energy gemstone spectral CT imaging. JOURNAL OF RADIATION RESEARCH 2014; 55:917-23. [PMID: 24829253 PMCID: PMC4202284 DOI: 10.1093/jrr/rru026] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 03/04/2014] [Accepted: 03/19/2014] [Indexed: 05/24/2023]
Abstract
The purpose of this study was to investigate the relationship between tumor size and blood volume for patients with lung tumors, using dual-energy computed tomography (DECT) and a gemstone spectral imaging (GSI) viewer. During the period from March 2011 to March 2013, 50 patients with 57 medically inoperable lung tumors underwent DECT before stereotactic body radiotherapy (SBRT) of 50-60 Gy in 5-6 fractions. DECT was taken for pretreatment evaluation. The region-of-interest for a given spatial placement of the tumors was set, and averages for CT value, water density and iodine density were compared with tumor size. The average values for iodine density in tumors of ≤ 2 cm, 2-3 cm, and >3 cm maximum diameter were 24.7, 19.6 and 16.0 (100 µg/cm(3)), respectively. The average value of the iodine density was significantly lower in larger tumors. No significant correlation was detected between tumor size and average CT value or between tumor size and average water density. Both the average water density and the average CT value were affected by the amount of air in the tumor, but the average iodine density was not affected by air in the tumor. The average water density and the average CT value were significantly correlated, but the average iodine density and the average CT value showed no significant correlation. The blood volume of tumors can be indicated by the average iodine density more accurately than it can by the average CT value. The average iodine density as assessed by DECT might be a non-invasive and quantitative assessment of the radio-resistance ascribable to the hypoxic cell population in a tumor.
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Affiliation(s)
- Masahiko Aoki
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Yoshihiro Takai
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Yuichiro Narita
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Katsumi Hirose
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Mariko Sato
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Hiroyoshi Akimoto
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Hideo Kawaguchi
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Yoshiomi Hatayama
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Hiroyuki Miura
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Shuichi Ono
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
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Lin XZ, Wu ZY, Li WX, Zhang J, Xu XQ, Chen KM, Yan FH. Differential diagnosis of pancreatic serous oligocystic adenoma and mucinous cystic neoplasm with spectral CT imaging: initial results. Clin Radiol 2014; 69:1004-10. [PMID: 24919983 DOI: 10.1016/j.crad.2014.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 05/01/2014] [Accepted: 05/02/2014] [Indexed: 01/07/2023]
Abstract
AIM To investigate the imaging characteristics of pancreatic serous oligocystic adenoma (SOA) and mucinous cystic neoplasms (MCNs) using spectral computed tomography (CT) and to evaluate whether quantitative information derived from spectral imaging can improve the differential diagnosis of these diseases. MATERIALS AND METHODS From February 2010 to June 2013, 44 patients (24 SOAs and 20 MCNs) who underwent spectral CT imaging were included in the study. Conventional characteristics and quantitative parameters were compared between the two disease groups. Logistic regression was used for multiparametric analysis. The receiver-operating characteristic curve was used to evaluate the diagnostic performance of single parameter and multiparametric analysis. Two radiologists diagnosed the diseases blinded and independently, without and with the information of the statistical analysis. RESULTS Tumour location, contour, size, and monochromatic CT values at 40 keV to 70 keV, iodine concentration, and effective atomic number (effective-Z) in the late arterial phase were the independent factors correlated with category. Multiparametric analysis with logistic regression showed that tumour size, location, and contour were the most effective variations, and obtained an area under the ROC curve (AUC) of 0.934. With the knowledge of statistical analysis, the accuracy of the first reader increased from 70.5% to 86.4%, and the accuracy of the second reader increased from 81.8% to 90.9%. CONCLUSIONS Although CT spectral imaging provided additional information and multiparametric analysis obtained better performance than single-parameter analysis in differentiating MCNs from SOAs, multiparametric analysis with the combination of quantitative parameters derived from CT spectral imaging did not improve the diagnostic performance. Tumour size, location, and contour played an important role in differentiating MCNs from SOAs.
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Affiliation(s)
- X-Z Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China
| | - Z-Y Wu
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China
| | - W-X Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China
| | - J Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China
| | - X-Q Xu
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China
| | - K-M Chen
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China
| | - F-H Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China.
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Pushing CT and MR imaging to the molecular level for studying the "omics": current challenges and advancements. BIOMED RESEARCH INTERNATIONAL 2014; 2014:365812. [PMID: 24738056 PMCID: PMC3971568 DOI: 10.1155/2014/365812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/26/2013] [Accepted: 01/24/2014] [Indexed: 12/24/2022]
Abstract
During the past decade, medical imaging has made the transition from anatomical imaging to functional and even molecular imaging. Such transition provides a great opportunity to begin the integration of imaging data and various levels of biological data. In particular, the integration of imaging data and multiomics data such as genomics, metabolomics, proteomics, and pharmacogenomics may open new avenues for predictive, preventive, and personalized medicine. However, to promote imaging-omics integration, the practical challenge of imaging techniques should be addressed. In this paper, we describe key challenges in two imaging techniques: computed tomography (CT) and magnetic resonance imaging (MRI) and then review existing technological advancements. Despite the fact that CT and MRI have different principles of image formation, both imaging techniques can provide high-resolution anatomical images while playing a more and more important role in providing molecular information. Such imaging techniques that enable single modality to image both the detailed anatomy and function of tissues and organs of the body will be beneficial in the imaging-omics field.
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