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Røhme LAG, Homme THF, Johansen ECK, Schulz A, Aaløkken TM, Johansson E, Johansen S, Mussmann B, Brunborg C, Eikvar LK, Martinsen ACT. Image quality and radiation doses in abdominal CT: A multicenter study. Eur J Radiol 2024; 178:111642. [PMID: 39079322 DOI: 10.1016/j.ejrad.2024.111642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 06/18/2024] [Accepted: 07/22/2024] [Indexed: 08/18/2024]
Abstract
PURPOSE To benchmark image quality and corresponding radiation doses for acute abdominal CT examination across different laboratories and CT manufacturers. METHOD An anthropomorphic phantom was scanned once with local abdominal CT protocols at 40 CT scanners, from four vendors, in thirty-three sites. Quantitative image quality was evaluated by CNR and SNR in the liver and kidney parenchyma. Qualitative image quality was assessed by visual grading analysis performed by three experienced radiologists using a five-point Likert scale to score thirteen image quality criteria. The CTDIvol was recorded for each scan. Pearson's correlation coefficient was calculated for the continuous variables, and the intraclass correlation coefficient was used to investigate interrater reliability between the radiologists. RESULTS CTDIvol ranged from 3.5 to 12 mGy (median 5.3 mGy, third quartile 6.7 mGy). SNR in liver parenchyma ranged from 4.4 to 14.4 (median 8.5), and CNR ranged from 2.7 to 11.2 (median 6.1). A weak correlation was found between CTDIvol and CNR (r = 0.270, p = 0.092). Variations in CNR across scanners at the same dose level CTDIvol were observed. No significant difference in CTDIvol or CNR was found based on scanner installation year. The oldest scanners had a 15 % higher median CTDIvol and a 12 % lower median CNR. The ICC showed acceptable agreement for all dose groups: low (ICC=0.889), medium (ICC=0.767), high (ICC=0.847), and in low (ICC=0.803) and medium (ICC=0.811) CNR groups. CONCLUSION There was large variation in radiation dose and image quality across the different CT scanners. Interestingly, the weak correlation between CTDIvol and CNR indicates that higher doses do not consistently improve CNR, indicating a need for systematic assessment and optimization of image quality and radiation doses for the abdominal CT examination.
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Affiliation(s)
- Linn Andrea Gjerberg Røhme
- Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University Oslo, Norway.
| | - Tora Hilde Fjeld Homme
- Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University Oslo, Norway.
| | | | - Anselm Schulz
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Trond Mogens Aaløkken
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Radiology and Nuclear Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
| | - Ellen Johansson
- Department of Radiology, Drammen Hospital, Vestre Viken Hospital Trust, Norway.
| | - Safora Johansen
- Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University Oslo, Norway; Department of Cancer Treatment, Oslo University Hospital, Oslo, Norway; Health and Social Science Cluster, Singapore Institute of Technology, Singapore.
| | - Bo Mussmann
- Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University Oslo, Norway; Department of Radiology, Odense University Hospital, Odense, Denmark; Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark.
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
| | - Lars Kristian Eikvar
- Department of Medicine and Health Services, The South-Eastern Norway Health Authority, Hamar, Norway.
| | - Anne Catrine T Martinsen
- Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University Oslo, Norway; Centre for Research and Innovation, Sunnaas Rehabilitation Hospital, Bjornemyr, Norway.
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El-Bakary MA, Sokkar TZN, Al-Kalali NA, Raslan MI. Microscopic investigation of the optical and morphological properties of iPP/TiO 2 nanocomposite fibres using computed tomography technique. J Microsc 2024; 295:199-213. [PMID: 38487931 DOI: 10.1111/jmi.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 07/13/2024]
Abstract
In this article, the optical and structural properties of iPP/TiO2 nanocomposite fibres, considering three distinct extrusion speeds (25, 50 and 78 m/min) in addition to blank isotactic polypropylene samples were determined. Employing computed tomographic scans, localised optical defects in the nanocomposite fibres are unveiled, while refractive indices are examined by analysing transmitted intensity with incident light vibrating parallel and perpendicular to the fibre axis. The internal structure is further characterised through birefringence and density calculations. Mechanical properties, specifically stiffness, are probed by measuring elastic modulus values along the fibre. The investigation extends to the presence of TiO2 nanoparticles in the isotactic polypropylene matrix, inspecting their influence on the uniform morphology along and across the fibre. While the addition of TiO2 nanoparticles has many advantages, including enhanced properties, the study shows adverse effects on the morphological integrity of the fibres, particularly at higher extrusion rates. Micrographs are included to visually illustrate these findings, providing a comprehensive understanding of the complex interaction between extrusion rates, TiO2 nanoparticle incorporation, and the resulting optical and structural properties in iPP fibres.
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Affiliation(s)
| | - Taha Z N Sokkar
- Faculty of Science, Physics Department, Mansoura University, Mansoura, Egypt
| | | | - Mohammed I Raslan
- Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Gamasa, Egypt
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Stammen L, Mihl C, Vandewall J, Pennetta F, Hersbach A, Wildberger JE, Martens B. Influence of Contrast Media Temperature and Concentration on Patient Comfort and Safety in Computed Tomography: CATCHY II Trial. Invest Radiol 2024; 59:577-582. [PMID: 38240647 DOI: 10.1097/rli.0000000000001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
BACKGROUND Previous research on the necessity to reduce the viscosity of contrast media (CM) by either prewarming CM before injection during computed tomography (CT) or by using less concentrated CM has yielded conflicting results. In addition, there is limited evidence on patient comfort. OBJECTIVES The aim of the study was to examine if prewarming CM, with varying CM concentrations, is superior to CM at room temperature, with respect to patient comfort and safety in CT. MATERIALS AND METHODS All elective patients scheduled for contrast-enhanced CT scans at Maastricht University Medical Center+ between October 27, 2021 and October 31, 2022 were eligible for inclusion when a questionnaire evaluating patient comfort was completed. This 1-year period was divided into 4 intervals (4 groups): group 1 (370 mg I/mL, 37°C), group 2 (370 mg I/mL, room temperature), group 3 (300 mg I/mL, 37°C), and group 4 (300 mg I/mL, room temperature). All CT scans were performed using state of the art equipment (Siemens Healthineers; SOMATOM Force and SOMATOM Definition AS, Forchheim, Germany). Contrast media injections were performed using a dual-head power injector (Stellant; Bayer Healthcare, Berlin, Germany) and individualized to body weight and/or tube voltage, depending on the CM protocols. After the CT scan, patients completed a questionnaire covering the primary outcomes comfort, pain, and adverse events such as feelings of heat, nausea, vomiting, itchiness, urticaria, difficulty breathing, dizziness, goosebumps, or an odd taste. Technicians were asked to report any adverse events, including extravasation and allergic-like reactions. The secondary outcome involved attenuation (in Hounsfield unit, HU), which was evaluated by assessing the HU of the coronary arteries for vascular CT, and liver enhancement in portal venous CT. The Kruskal-Wallis test was used for continuous scale outcomes and χ 2 tests for examining adverse events. RESULTS Results showed no significant differences examining comfort score ( P = 0.054), pain sensation ( P = 0.469), extravasation ( P = 0.542), or allergic-like reaction ( P = 0.253). Significant differences among the 4 groups were found with respect to heat sensation and dizziness ( P = 0.005 and P = 0.047, respectively), showing small effect sizes. All other adverse effects showed no significant results. No significant differences were observed in coronary attenuation among the 4 groups in coronary CT angiography ( P = 0.113). When analyzing attenuation in portal venous CT scans, significant differences were found among the 4 groups ( P = 0.008). CONCLUSIONS Administrating prewarmed CM is nonsuperior compared with CM at room temperature in relation to patient comfort and safety, regardless of CM concentration. These findings suggest that prewarming CM before usage is unnecessary, which will improve the efficiency of daily clinical workflow and brings environmentally friendly benefits.
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Affiliation(s)
- Lion Stammen
- From the Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (L.S., C.M., J.V., F.P., A.H., J.E.W., B.M.); and CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands (L.S., C.M., J.E.W., B.M.)
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Maruyama S, Watanabe H, Shimosegawa M. An image quality assessment index based on image features and keypoints for X-ray CT images. PLoS One 2024; 19:e0304860. [PMID: 38990930 PMCID: PMC11238976 DOI: 10.1371/journal.pone.0304860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/21/2024] [Indexed: 07/13/2024] Open
Abstract
Optimization tasks in diagnostic radiological imaging require objective quantitative metrics that correlate with the subjective perception of observers. However, although one such metric, the structural similarity index (SSIM), is popular, it has limitations across various aspects in its application to medical images. In this study, we introduce a novel image quality evaluation approach based on keypoints and their associated unique image feature values, focusing on developing a framework to address the need for robustness and interpretability that are lacking in conventional methodologies. The proposed index quantifies and visualizes the distance between feature vectors associated with keypoints, which varies depending on changes in the image quality. This metric was validated on images with varying noise levels and resolution characteristics, and its applicability and effectiveness were examined by evaluating images subjected to various affine transformations. In the verification of X-ray computed tomography imaging using a head phantom, the distances between feature descriptors for each keypoint increased as the image quality degraded, exhibiting a strong correlation with the changes in the SSIM. Notably, the proposed index outperformed conventional full-reference metrics in terms of robustness to various transformations which are without changes in the image quality. Overall, the results suggested that image analysis performed using the proposed framework could effectively visualize the corresponding feature points, potentially harnessing lost feature information owing to changes in the image quality. These findings demonstrate the feasibility of applying the novel index to analyze changes in the image quality. This method may overcome limitations inherent in conventional evaluation methodologies and contribute to medical image analysis in the broader domain.
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Affiliation(s)
- Sho Maruyama
- Department of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Gunma, Japan
| | - Haruyuki Watanabe
- Department of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Gunma, Japan
| | - Masayuki Shimosegawa
- Department of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Gunma, Japan
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Nezami N, Malayeri AA. Sharper, Smarter, Safer: Unpacking the Potential of Photon-Counting CT in Urolithiasis Imaging. Radiology 2024; 312:e240497. [PMID: 39078304 PMCID: PMC11294758 DOI: 10.1148/radiol.240497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 07/31/2024]
Affiliation(s)
- Nariman Nezami
- From the Department of Radiology, MedStar Georgetown University
Hospital, 3800 Reservoir Rd NW, CCC Bldg, Rm CG225, Washington, DC 20007 (N.N.);
Georgetown University School of Medicine, Washington, DC (N.N.); Lombardi
Comprehensive Cancer Center, Washington, DC (N.N.); Fischell Department of
Bioengineering, University of Maryland College Park, College Park, Md (N.N.);
and Department of Radiology and Imaging Sciences, National Institutes of Health,
Bethesda, Md (A.A.M.)
| | - Ashkan A. Malayeri
- From the Department of Radiology, MedStar Georgetown University
Hospital, 3800 Reservoir Rd NW, CCC Bldg, Rm CG225, Washington, DC 20007 (N.N.);
Georgetown University School of Medicine, Washington, DC (N.N.); Lombardi
Comprehensive Cancer Center, Washington, DC (N.N.); Fischell Department of
Bioengineering, University of Maryland College Park, College Park, Md (N.N.);
and Department of Radiology and Imaging Sciences, National Institutes of Health,
Bethesda, Md (A.A.M.)
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Jannatdoust P, Valizadeh P, Pahlevan-Fallahy MT, Hassankhani A, Amoukhteh M, Behrouzieh S, Ghadimi DJ, Bilgin C, Gholamrezanezhad A. Diagnostic accuracy of CT-based radiomics and deep learning for predicting lymph node metastasis in esophageal cancer. Clin Imaging 2024; 113:110225. [PMID: 38905878 DOI: 10.1016/j.clinimag.2024.110225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Esophageal cancer remains a global challenge due to late diagnoses and limited treatments. Lymph node metastasis (LNM) is crucial for prognosis, yet traditional diagnostics fall short. Integrating radiomics and deep learning (DL) with CT imaging for LNM diagnosis could revolutionize prognostic assessment and treatment planning. METHODS A systematic review and meta-analysis were conducted by searching PubMed, Scopus, Web of Science, and Embase up to October 1, 2023. The focus was on studies developing CT-based radiomics and/or DL models for preoperative LNM detection in esophageal cancer. Methodological quality was assessed using the METhodological RadiomICs Score (METRICS). RESULTS Twelve studies were reviewed, and seven were included in the meta-analysis, most showing excellent methodological quality. Training sets revealed a pooled AUC of 87 % (95 % CI: 78 %-90 %), and internal validation sets showed an AUC of 85 % (95 % CI: 76 %-89 %), with no significant difference (p = 0.39). Sensitivity and specificity for training sets were 78.7 % and 81.8 %, respectively, with validation sets at 81.2 % and 76.2 %. DL models in training sets showed better diagnostic accuracy than radiomics (p = 0.054), significant after removing outliers (p < 0.01). Incorporating clinical data improved sensitivity in validation sets (p = 0.029). No significant difference was found between models based on CE or non-CE imaging (p = 0.281) or arterial or venous phase imaging (p = 0.927). CONCLUSION Integrating CT-based radiomics and DL improves LNM detection in esophageal cancer. Including clinical data could enhance model performance. Future research should focus on multicenter studies with independent validations to confirm these findings and promote broader clinical adoption.
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Affiliation(s)
- Payam Jannatdoust
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parya Valizadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Hassankhani
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Melika Amoukhteh
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Sadra Behrouzieh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Delaram J Ghadimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cem Bilgin
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
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Badawy MK, Kashish K, Payne S, Masterson M. Comparing fetal phantoms with surrogate organs in female phantoms during CT exposure of pregnant patients. Phys Eng Sci Med 2024; 47:531-538. [PMID: 38206532 PMCID: PMC11166780 DOI: 10.1007/s13246-024-01383-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
With the rising use of Computed Tomography (CT) in diagnostic radiology, there are concerns regarding radiation exposure to sensitive groups, including pregnant patients. Accurately determining the radiation dose to the fetus during CT scans is essential to balance diagnostic efficacy with patient safety. This study assessed the accuracy of using the female uterus as a surrogate for fetal radiation dose during CT imaging. The study used common CT protocols to encompass various scenarios, including primary beam, scatter, and partial exposure. The computational program NCICT was used to calculate radiation doses for an adult female and a fetus phantom. The study highlighted that using the uterus for dose estimation can result in consistent underestimations of the effective dose, particularly when the fetus lies within the primary radiation beam. These discrepancies may influence clinical decisions, affecting care strategies and perceptions of associated risks. In conclusion, while the female uterus can indicate fetal radiation dose if the fetus is outside the primary beam, it is unreliable when the fetus is within the primary beam. More reliable abdomen/pelvic organs were recommended.
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Affiliation(s)
- Mohamed Khaldoun Badawy
- Monash Health Imaging, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, 3800, Australia.
| | - Kashish Kashish
- School of Life and Environmental Sciences, Deakin University, Burwood, VIC, 3125, Australia
| | - Shay Payne
- Monash Health Imaging, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Maeve Masterson
- Monash Health Imaging, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
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André L, Björkelund A, Ekelund U, Vedin T, Björk J, Forberg JL. The prevalence of clinically relevant delayed intracranial hemorrhage in head trauma patients treated with oral anticoagulants is very low: a retrospective cohort register study. Scand J Trauma Resusc Emerg Med 2024; 32:42. [PMID: 38730480 PMCID: PMC11084042 DOI: 10.1186/s13049-024-01214-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Current guidelines from Scandinavian Neuro Committee mandate a 24-hour observation for head trauma patients on anticoagulants, even with normal initial head CT scans, as a means not to miss delayed intracranial hemorrhages. This study aimed to assess the prevalence, and time to diagnosis, of clinically relevant delayed intracranial hemorrhage in head trauma patients treated with oral anticoagulants. METHOD Utilizing comprehensive two-year data from Region Skåne's emergency departments, which serve a population of 1.3 million inhabitants, this study focused on adult head trauma patients prescribed oral anticoagulants. We identified those with intracranial hemorrhage within 30 days, defining delayed intracranial hemorrhage as a bleeding not apparent on their initial CT head scan. These cases were further defined as clinically relevant if associated with mortality, any intensive care unit admission, or neurosurgery. RESULTS Out of the included 2,362 head injury cases (median age 84, 56% on a direct acting oral anticoagulant), five developed delayed intracranial hemorrhages. None of these five cases underwent neurosurgery nor were admitted to an intensive care unit. Only two cases (0.08%, 95% confidence interval [0.01-0.3%]) were classified as clinically relevant, involving subdural hematomas in patients aged 82 and 87 years, who both subsequently died. The diagnosis of these delayed intracranial hemorrhages was made at 4 and 7 days following initial presentation to the emergency department. CONCLUSION In patients with head trauma, on oral anticoagulation, the incidence of clinically relevant delayed intracranial hemorrhage was found to be less than one in a thousand, with detection occurring four days or later after initial presentation. This challenges the effectiveness of the 24-hour observation period recommended by the Scandinavian Neurotrauma Committee guidelines, suggesting a need to reassess these guidelines to optimise care and resource allocation. TRIAL REGISTRATION This is a retrospective cohort study, does not include any intervention, and has therefore not been registered.
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Affiliation(s)
- Lars André
- Department of Clinical Sciences, Lund University, Lund, Sweden.
- Department of Emergency Medicine, Helsingborg Hospital, Helsingborg, Sweden.
| | - Anders Björkelund
- Centre for Environmental and Climate Science, Lund University, Lund, Sweden
| | - Ulf Ekelund
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Internal medicine and Emergency care, Skåne University Hospital, Lund, Sweden
| | - Tomas Vedin
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Skåne University Hospital, Forum South, Clinical Studies Sweden, Lund, Sweden
| | - Jakob Lundager Forberg
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Emergency Medicine, Helsingborg Hospital, Helsingborg, Sweden
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LaBella A, Zhang D. Protocol parameter extraction and centralization framework for comprehensive and in-depth CT protocol review and management. J Appl Clin Med Phys 2024; 25:e14316. [PMID: 38462952 PMCID: PMC11005989 DOI: 10.1002/acm2.14316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/23/2024] [Accepted: 02/14/2024] [Indexed: 03/12/2024] Open
Abstract
CT protocol management is an arduous task that requires expertise from a variety of radiology professionals, including technologists, radiologists, radiology IT professionals, and medical physicists. Each CT vendor has unique, proprietary protocol file structures, some of which may vary by scanner model, making it difficult to develop a universal framework for distilling technical parameters to a human-readable file format. An ideal solution for CT protocol management is to minimize the work required for parameter extraction by introducing a data format into the workflow that is universal to all CT scanners. In this paper, we report a framework for CT protocol management that converts raw protocol files to an intermediary format before outputting them in a human-readable format for a variety of practical clinical applications, including routine protocol review, protocol version tracking, and cross-protocol comparisons. The framework was developed in Python 3. Technical parameters of interest were determined via collaborative effort between medical physicists and lead technologists. Protocol files were extracted and analyzed from a variety of scanners across our hospital-wide CT fleet, including various systems from Siemens and GE. Protocols were subcategorized based on relevant technical parameters into regular, dual-energy, and cardiac CT protocols. Backend code for technical parameter extraction from raw protocol files to a JavaScript Object Notation (JSON) format was performed on a per-system basis. Conversion from JSON to a readable output format (MS Excel) was performed identically for all scanners using the universal framework developed and presented in this work. Example results for Siemens and GE scanners are shown, including side-by-side comparisons for protocols with similar clinical indications. In conclusion, our CT protocol management framework may be deployed on any CT system to improve clinical efficiency in protocol review and upkeep.
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Affiliation(s)
- Andy LaBella
- Department of RadiologyStony Brook UniversityStony BrookNew YorkUSA
| | - Da Zhang
- Department of RadiologyBoston Children's HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Zahariev OJ, Bunduc S, Kovács A, Demeter D, Havelda L, Budai BC, Veres DS, Hosszúfalusi N, Erőss BM, Teutsch B, Juhász MF, Hegyi P. Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 10:1257222. [PMID: 38264039 PMCID: PMC10803425 DOI: 10.3389/fmed.2023.1257222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Within 5 years of having acute pancreatitis (AP), approximately 20% of patients develop diabetes mellitus (DM), which later increases to approximately 40%. Some studies suggest that the prevalence of prediabetes (PD) and/or DM can grow as high as 59% over time. However, information on risk factors is limited. We aimed to identify risk factors for developing PD or DM following AP. Methods We systematically searched three databases up to 4 September 2023 extracting direct, within-study comparisons of risk factors on the rate of new-onset PD and DM in AP patients. When PD and DM event rates could not be separated, we reported results for this composite outcome as PD/DM. Meta-analysis was performed using the random-effects model to calculate pooled odds ratios (OR) with 95% confidence intervals (CI). Results Of the 61 studies identified, 50 were included in the meta-analysis, covering 76,797 participants. The studies reported on 79 risk factors, and meta-analysis was feasible for 34 risk factor and outcome pairs. The odds of developing PD/DM was significantly higher after severe and moderately severe AP (OR: 4.32; CI: 1.76-10.60) than mild AP. Hypertriglyceridemic AP etiology (OR: 3.27; CI: 0.17-63.91) and pancreatic necrosis (OR: 5.53; CI: 1.59-19.21) were associated with a higher risk of developing PD/DM. Alcoholic AP etiology (OR: 1.82; CI: 1.09-3.04), organ failure (OR: 3.19; CI: 0.55-18.64), recurrent AP (OR: 1.89; CI: 0.95-3.77), obesity (OR: 1.85; CI: 1.43-2.38), chronic kidney disease (OR: 2.10; CI: 1.85-2.38), liver cirrhosis (OR: 2.48; CI: 0.18-34.25), and dyslipidemia (OR: 1.82; CI: 0.68-4.84) were associated with a higher risk of developing DM. Discussion Severe and moderately severe AP, alcoholic and hypertriglyceridemic etiologies, pancreatic necrosis, organ failure, recurrent acute pancreatitis and comorbidities of obesity, chronic kidney disease liver disease, and dyslipidemia are associated with a higher risk of developing PD or DM. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42021281983.
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Affiliation(s)
- Olga Julia Zahariev
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adrienn Kovács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Dóra Demeter
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Dietetic Services, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary
| | - Luca Havelda
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Bettina Csilla Budai
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Dániel Sándor Veres
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Nóra Hosszúfalusi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Bálint Mihály Erőss
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Márk Félix Juhász
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Translational Pancreatology Research Group, Interdisciplinary Center of Excellence for Research Development and Innovation University of Szeged, Szeged, Hungary
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Taasti VT, Wohlfahrt P. From computed tomography innovation to routine clinical application in radiation oncology - A joint initiative of close collaboration. Phys Imaging Radiat Oncol 2024; 29:100550. [PMID: 38390587 PMCID: PMC10881422 DOI: 10.1016/j.phro.2024.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Affiliation(s)
- Vicki Trier Taasti
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Patrick Wohlfahrt
- Siemens Healthineers, Varian, Cancer Therapy Imaging, Forchheim, Germany
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12
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Kim K, Kwon S, Kwon J, Hwang J. A review of robotic-assisted total hip arthroplasty. Biomed Eng Lett 2023; 13:523-535. [PMID: 37872985 PMCID: PMC10590363 DOI: 10.1007/s13534-023-00312-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 10/25/2023] Open
Abstract
Total hip arthroplasty (THA) is a successful surgical method for hip replacement but still poses challenges and risks. Robotic-assisted THA (rTHA) using new generation robotic systems has emerged to improve surgical precision and outcomes. The purpose of this paper is to review the literature on rTHA, with a focus on its advantages, such as individualized preoperative planning, intraoperative assistance, and improved accuracy in implantation, especially in complex cases. Additionally, it aims to explore the disadvantages associated with the use of rTHA, including high costs, the learning curve, and prolonged operation time compared to manual THA (mTHA), which are critical drawbacks that require careful consideration and efforts for minimization. Some financial analyses suggest that rTHA may offer cost-effectiveness and reduced postoperative costs compared to mTHA. While technological advancements are expected to reduce technical complications, there are still debates surrounding long-term outcomes. Practical limitations, such as limited availability and accessibility, also warrant attention. Although the development of rTHA shows promise, it is still in its early stages, necessitating critical evaluation and further research to ensure optimal patient benefits.
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Affiliation(s)
- Kwangkyoun Kim
- Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, South Korea
- Department of Orthopaedic Surgery, Konyang University School of Medicine, Daejeon, South Korea
| | - Seungcheol Kwon
- Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, South Korea
- Department of Orthopaedic Surgery, Konyang University School of Medicine, Daejeon, South Korea
| | - Junhyuk Kwon
- Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, South Korea
- Department of Orthopaedic Surgery, Konyang University School of Medicine, Daejeon, South Korea
| | - Jihyo Hwang
- Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, South Korea
- Department of Orthopaedic Surgery, Konyang University School of Medicine, Daejeon, South Korea
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13
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Gerrits W, Danad I, Velthuis B, Mushtaq S, Cramer MJ, van der Harst P, van Slochteren FJ, Meine M, Suchá D, Guglielmo M. Cardiac CT in CRT as a Singular Imaging Modality for Diagnosis and Patient-Tailored Management. J Clin Med 2023; 12:6212. [PMID: 37834855 PMCID: PMC10573271 DOI: 10.3390/jcm12196212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Between 30-40% of patients with cardiac resynchronization therapy (CRT) do not show an improvement in left ventricular (LV) function. It is generally known that patient selection, LV lead implantation location, and device timing optimization are the three main factors that determine CRT response. Research has shown that image-guided CRT placement, which takes into account both anatomical and functional cardiac properties, positively affects the CRT response rate. In current clinical practice, a multimodality imaging approach comprised of echocardiography, cardiac magnetic resonance imaging, or nuclear medicine imaging is used to capture these features. However, with cardiac computed tomography (CT), one has an all-in-one acquisition method for both patient selection and the division of a patient-tailored, image-guided CRT placement strategy. This review discusses the applicability of CT in CRT patient identification, selection, and guided placement, offering insights into potential advancements in optimizing CRT outcomes.
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Affiliation(s)
- Willem Gerrits
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Ibrahim Danad
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Birgitta Velthuis
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Saima Mushtaq
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138 Milan, Italy
| | - Maarten J. Cramer
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Frebus J. van Slochteren
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- CART-Tech BV, Padualaan 8, 3584 CH Utrecht, The Netherlands
| | - Mathias Meine
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Dominika Suchá
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Marco Guglielmo
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, 2545 AA The Hague, The Netherlands
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14
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Bergenfeldt H, Forberg JL, Lehtinen R, Anefjäll E, Vedin T. Delayed intracranial hemorrhage after head trauma seems rare and rarely needs intervention-even in antiplatelet or anticoagulation therapy. Int J Emerg Med 2023; 16:54. [PMID: 37667208 PMCID: PMC10476369 DOI: 10.1186/s12245-023-00530-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/20/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Traumatic brain injury causes morbidity, mortality, and at least 2,500,000 yearly emergency department visits in the USA. Computerized tomography of the head is the gold standard to detect traumatic intracranial hemorrhage. Some are not diagnosed at the first scan, and they are denoted "delayed intracranial hemorrhages. " To detect these delayed hemorrhages, current guidelines for head trauma recommend observation and/or rescanning for patients on anticoagulation therapy but not for patients on antiplatelet therapy. The aim of this study was to investigate the prevalence and need for interventions of delayed intracranial hemorrhage after head trauma. METHODS The study was a retrospective review of medical records of adult patients with isolated head trauma presenting at Helsingborg General Hospital between January 1, 2020, and December 31, 2020. Univariate statistical analyses were performed. RESULTS In total, 1627 patients were included and four (0.25%, 95% confidence interval 0.06-0.60%) patients had delayed intracranial hemorrhage. One of these patients was diagnosed within 24 h and three within 2-30 days. The patient was diagnosed within 24 h, and one of the patients diagnosed within 2-30 days was on antiplatelet therapy. None of these four patients was prescribed anticoagulation therapy, and no intensive care, no neurosurgical operations, or deaths were recorded. CONCLUSION Traumatic delayed intracranial hemorrhage is rare and consequences mild and antiplatelet and anticoagulation therapy might confer similar risk. Because serious complications appear rare, observing, and/or rescanning all patients with either of these medications can be debated. Risk stratification of these patients might have the potential to identify the patients at risk while safely reducing observation times and rescanning.
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Affiliation(s)
- Henrik Bergenfeldt
- Clinical Research Centre, Department of Clinical Sciences, Skåne University Hospital, Lund University, Box 50332, 20213 Malmö, Sweden
| | - Jakob Lundager Forberg
- Clinical Sciences, Helsingborg General Hospital, Lund University, Svartbrödragränden 3-5, 25187 Helsingborg, Sweden
| | - Riikka Lehtinen
- Clinical Sciences, Helsingborg General Hospital, Lund University, Svartbrödragränden 3-5, 25187 Helsingborg, Sweden
| | - Ebba Anefjäll
- Clinical Sciences, Helsingborg General Hospital, Lund University, Svartbrödragränden 3-5, 25187 Helsingborg, Sweden
| | - Tomas Vedin
- Clinical Research Centre, Department of Clinical Sciences, Skåne University Hospital, Lund University, Box 50332, 20213 Malmö, Sweden
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15
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Lee DH, Ha HI, Jang JY, Lee JW, Choi JY, Bang S, Lee CH, Kim WB, Lee SS, Kim SC, Kang BK, Lee JM. High-resolution pancreatic computed tomography for assessing pancreatic ductal adenocarcinoma resectability: a multicenter prospective study. Eur Radiol 2023; 33:5965-5975. [PMID: 36988715 DOI: 10.1007/s00330-023-09584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/07/2023] [Accepted: 02/17/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE This prospective multicenter study aimed to evaluate the diagnostic performance of 80-kVp thin-section pancreatic CT in determining pancreatic ductal adenocarcinoma (PDAC) resectability according to the recent National Comprehensive Cancer Network (NCCN) guidelines. METHODS We prospectively enrolled surgical resection candidates for PDAC from six tertiary referral hospitals (study identifier: NCT03895177). All participants underwent pancreatic CT using 80 kVp tube voltage with 1-mm reconstruction interval. The local resectability was prospectively evaluated using NCCN guidelines at each center and classified into three categories: resectable, borderline resectable, and unresectable. RESULTS A total of 138 patients were enrolled; among them, 60 patients underwent neoadjuvant therapy. R0 resection was achieved in 103 patients (74.6%). The R0 resection rates were 88.7% (47/53), 52.4% (11/21), and 0.0% (0/4) for resectable, borderline resectable, and unresectable disease, respectively, in 78 patients who underwent upfront surgery. Meanwhile, the rates were 90.9% (20/22), 76.7% (23/30), and 25.0% (2/8) for resectable, borderline resectable, and unresectable PDAC, respectively, in patients who received neoadjuvant therapy. The area under curve of high-resolution CT in predicting R0 resection was 0.784, with sensitivity, specificity, and accuracy of 87.4% (90/103), 48.6% (17/35), and 77.5% (107/138), respectively. Tumor response was significantly associated with the R0 resection after neoadjuvant therapy (odds ratio [OR] = 38.99, p = 0.016). CONCLUSION An 80-kVp thin-section pancreatic CT has excellent diagnostic performance in assessing PDAC resectability, enabling R0 resection rates of 88.7% and 90.9% for patients with resectable PDAC who underwent upfront surgery and patients with resectable PDAC after neoadjuvant therapy, respectively. KEY POINTS • The margin-negative (R0) resection rates were 88.7% (47/53), 52.4% (11/21), and 0.0% (0/4) for resectable, borderline resectable, and unresectable pancreatic ductal adenocarcinoma (PDAC), respectively, on 80-kVp thin-section pancreatic CT in the 78 patients who underwent upfront surgery. • Among the 60 patients who underwent neoadjuvant therapy, the R0 rates were 90.9% (20/22), 76.7% (23/30), and 25.0% (2/8) for resectable, borderline resectable, and unresectable PDAC, respectively. • Tumor response, along with the resectability status on pancreatic CT, was significantly associated with the R0 resection rate after neoadjuvant therapy.
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Affiliation(s)
- Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea
| | - Hong Il Ha
- Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jin-Young Jang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Woo Lee
- Department of Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jin-Young Choi
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seungmin Bang
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Hee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Wan Bae Kim
- Division of Hepato-Biliary-Pancreatic Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Song Cheol Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bo-Kyeong Kang
- Department of Radiology, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.
- Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea.
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16
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Bott KN, Matheson BE, Smith ACJ, Tse JJ, Boyd SK, Manske SL. Addressing Challenges of Opportunistic Computed Tomography Bone Mineral Density Analysis. Diagnostics (Basel) 2023; 13:2572. [PMID: 37568935 PMCID: PMC10416827 DOI: 10.3390/diagnostics13152572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/20/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Computed tomography (CT) offers advanced biomedical imaging of the body and is broadly utilized for clinical diagnosis. Traditionally, clinical CT scans have not been used for volumetric bone mineral density (vBMD) assessment; however, computational advances can now leverage clinically obtained CT data for the secondary analysis of bone, known as opportunistic CT analysis. Initial applications focused on using clinically acquired CT scans for secondary osteoporosis screening, but opportunistic CT analysis can also be applied to answer research questions related to vBMD changes in response to various disease states. There are several considerations for opportunistic CT analysis, including scan acquisition, contrast enhancement, the internal calibration technique, and bone segmentation, but there remains no consensus on applying these methods. These factors may influence vBMD measures and therefore the robustness of the opportunistic CT analysis. Further research and standardization efforts are needed to establish a consensus and optimize the application of opportunistic CT analysis for accurate and reliable assessment of vBMD in clinical and research settings. This review summarizes the current state of opportunistic CT analysis, highlighting its potential and addressing the associated challenges.
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Affiliation(s)
- Kirsten N. Bott
- Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.N.B.); (S.K.B.)
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Bryn E. Matheson
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Ainsley C. J. Smith
- Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.N.B.); (S.K.B.)
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Justin J. Tse
- Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.N.B.); (S.K.B.)
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Steven K. Boyd
- Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.N.B.); (S.K.B.)
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Sarah L. Manske
- Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.N.B.); (S.K.B.)
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
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17
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Hackenbroch C, Strobel JRB, Lorenz KJ, Beer M, Schüle S. Dose development in sinonasal imaging over the last decade - a retrospective patient study. Head Face Med 2023; 19:28. [PMID: 37430304 PMCID: PMC10332007 DOI: 10.1186/s13005-023-00378-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Computed tomography (CT) has become the primary imaging modality for visualization of the paranasal sinuses. In this retrospective, single center patient study the radiation dose development in the past 12 years in CT imaging of the paranasal sinuses was assessed. METHODS The computed tomography dose index (CTDIVol) and dose length product (DLP) of a total of 1246 patients (average age: 41 ± 18 years, 361 females, 885 males) were evaluated, who received imaging of the paranasal sinuses either for chronic sinusitis diagnostic, preoperatively or posttraumatically. Scans were performed on three different CT scanners (Somatom Definition AS, Somatom Definition AS+, Somatom Force, all from Siemens Healthineers) and on one CBCT (Morita) ranging from 2010 to 2022. Reconstruction techniques were filtered back projection and three generations of iterative reconstruction (IRIS, SAFIRE, ADMIRE, all from Siemens Healthineers). Group comparisons were performed using either parametrical (ANOVA) or non-parametrical tests (Kruskal-Wallis Test), where applicable. RESULTS Over the past 12 years, there was a 73%, 54%, and 66% CTDIVol reduction and a significant (p < 0.001) 72%, 33%, and 67% DLP reduction in assessing the paranasal sinuses for chronic sinusitis, preoperatively and posttraumatically, respectively. CONCLUSION Technological developments in CT imaging, both hardware and software based, have led to a significant reduction in dose exposure in recent years. Particularly in imaging of the paranasal sinuses, the reduction of radiation exposure is of great interest due to the often young patient age and radiation-sensitive organs in the area of radiation exposure.
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Affiliation(s)
- Carsten Hackenbroch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany.
- Department of Radiology, University Hospital of Ulm, Ulm, Baden-Wurttemberg, Germany.
| | - Joachim Rudolf Balthasar Strobel
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Kai Johannes Lorenz
- Department of Otorhinolaryngology and Head and Neck Surgery, German Armed Forces Central Hospital Koblenz, Koblenz, Rhineland-Palatinate, Germany
| | - Meinrad Beer
- Department of Radiology, University Hospital of Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Simone Schüle
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
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18
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van der Bie J, van Straten M, Booij R, Bos D, Dijkshoorn ML, Hirsch A, Sharma SP, Oei EHG, Budde RPJ. Photon-counting CT: Review of initial clinical results. Eur J Radiol 2023; 163:110829. [PMID: 37080060 DOI: 10.1016/j.ejrad.2023.110829] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
Photon-counting computed tomography (PCCT) is a new technology that enables higher spatial resolution compared to conventional CT techniques, energy resolved imaging and spectral post-processing. This leads to improved contrast-to-noise ratio, artifact and potential dose reduction as well as elimination of electronic noise. Since the introduction of clinical PCCT in 2021, a shift has been observed from solely pre-clinical studies to clinical research (i.e. use of PCCT imaging in humans). This review article is focused on the initial clinical results of PCCT by explaining the current PCCT systems, the applications themselves and, the challenges of PCCT.
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Affiliation(s)
- Judith van der Bie
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Marcel van Straten
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Ronald Booij
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Daniel Bos
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Marcel L Dijkshoorn
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Alexander Hirsch
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Simran P Sharma
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Ricardo P J Budde
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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19
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Deleu M, Maurice JB, Devos L, Remy M, Dubus F. Image Quality Analysis of Photon-Counting CT Compared with Dual-Source CT: A Phantom Study for Chest CT Examinations. Diagnostics (Basel) 2023; 13:diagnostics13071325. [PMID: 37046543 PMCID: PMC10092985 DOI: 10.3390/diagnostics13071325] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
A comparison was made between the image quality of a photon-counting CT (PCCT) and a dual-source CT (DSCT). The evaluation of image quality was performed using a Catphan CT phantom, and the physical metrics, such as the noise power spectrum and task transfer function, were measured for both PCCT and DSCT at three CT dose indices (1, 5 and 10 mGy). Polyenergetic and virtual monoenergetic reconstructions were used to evaluate the performance differences by simulating a Gaussian spot with a radius of 5 mm and calculating the detectability index. The highest iterative reconstruction level was able to decrease the noise by about 70% compared with the filtered back projection using a parenchyma reconstruction kernel. The PCCT task transfer functions remained constant, while those of the DSCT increased with the reconstruction strength level. At monoenergetic 70 keV, a 50% decrease in noise was observed for DSCT with image smoothing, while PCCT had the same 50% decrease in noise without any smoothing. The PCCT detectability index at a reconstruction strength level of two was equivalent to the highest level of ADMIRE 5 for DSCT. The PCCT showed its superiority over the DSCT, especially for lung nodule detection.
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Affiliation(s)
- Marine Deleu
- Medical Physics Department, University Hospital, 59037 Lille, France
| | | | - Laura Devos
- Medical Physics Department, University Hospital, 59037 Lille, France
| | - Martine Remy
- Radiology Department, Heart-Lung Institute, University Hospital, 59037 Lille, France
| | - François Dubus
- Medical Physics Department, University Hospital, 59037 Lille, France
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20
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Gohla G, Kraus MS, Peyker I, Springer F, Keller G. Diagnostic Accuracy of 128-Slice Single-Source CT for the Detection of Dislocated Bucket Handle Meniscal Tears in the Setting of an Acute Knee Trauma—Correlation with MRI and Arthroscopy. Diagnostics (Basel) 2023; 13:diagnostics13071295. [PMID: 37046513 PMCID: PMC10093062 DOI: 10.3390/diagnostics13071295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/16/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
(1) Background: Meniscal tears are amongst the most common knee injuries. Dislocated bucket handle meniscal tears in particular should receive early intervention. The purpose of this study was to evaluate the diagnostic performance of CT in detecting dislocated bucket handle meniscal tears compared with the gold-standard MRI and arthroscopy. (2) Methods: Retrospectively, 96 consecutive patients underwent clinically indicated CT of the knee for suspected acute traumatic knee injuries (standard study protocol, 120 kV, 90 mAs). Inclusion criteria were the absence of an acute fracture on CT and a timely MRI (<6 months). Corresponding arthroscopy was assessed. Two experienced musculoskeletal radiologists analyzed the images for dislocated bucket handle meniscal tears, associated signs thereof (double posterior cruciate ligament sign, double delta sign, disproportional posterior horn sign), and subjective diagnostic confidence on a 5-point-Likert scale (1 = ‘non-diagnostic image quality’, 5 = ‘very confident’). (3) Results: Dislocated bucket handle meniscal tears were detected on CT by standard three-plane bone kernel reconstructions with a sensitivity of 90.7% and a specificity of 99.3% by transferring the knowledge of established MRI signs. The additional use of soft-tissue kernel reconstructions in three planes increased the sensitivity by 4.0% to 94.7%, specificity to 100%, inter-rater agreement to 1.0, and the diagnostic confidence of both readers improved to a median 4/5 (‘confident’) in both readers. (4) Conclusions: Trauma CT scan of the knee with three-plane soft-tissue reconstructions delivers the potential for the detection of dislocated bucket handle meniscal tears with very high diagnostic accuracy.
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Affiliation(s)
- Georg Gohla
- Department of Diagnostic and Interventional Neuroradiology, University-Hospital of Tuebingen, 72076 Tuebingen, Germany
- Department of Diagnostic and Interventional Radiology, University-Hospital of Tuebingen, 72076 Tuebingen, Germany
- Correspondence:
| | - Mareen Sarah Kraus
- Department of Diagnostic Radiology, IWK Health Care Centre, 5850 University Avenue, Halifax, NS B3K 6R8, Canada
| | - Isabell Peyker
- Department of Diagnostic and Interventional Radiology, University-Hospital of Tuebingen, 72076 Tuebingen, Germany
| | - Fabian Springer
- Department of Diagnostic and Interventional Radiology, University-Hospital of Tuebingen, 72076 Tuebingen, Germany
| | - Gabriel Keller
- Department of Diagnostic and Interventional Radiology, University-Hospital of Tuebingen, 72076 Tuebingen, Germany
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21
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Pulumati A, Pulumati A, Dwarakanath BS, Verma A, Papineni RVL. Technological advancements in cancer diagnostics: Improvements and limitations. Cancer Rep (Hoboken) 2023; 6:e1764. [PMID: 36607830 PMCID: PMC9940009 DOI: 10.1002/cnr2.1764] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/20/2022] [Accepted: 11/27/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Cancer is characterized by the rampant proliferation, growth, and infiltration of malignantly transformed cancer cells past their normal boundaries into adjacent tissues. It is the leading cause of death worldwide, responsible for approximately 19.3 million new diagnoses and 10 million deaths globally in 2020. In the United States alone, the estimated number of new diagnoses and deaths is 1.9 million and 609 360, respectively. Implementation of currently existing cancer diagnostic techniques such as positron emission tomography (PET), X-ray computed tomography (CT), and magnetic resonance spectroscopy (MRS), and molecular diagnostic techniques, have enabled early detection rates and are instrumental not only for the therapeutic management of cancer patients, but also for early detection of the cancer itself. The effectiveness of these cancer screening programs are heavily dependent on the rate of accurate precursor lesion identification; an increased rate of identification allows for earlier onset treatment, thus decreasing the incidence of invasive cancer in the long-term, and improving the overall prognosis. Although these diagnostic techniques are advantageous due to lack of invasiveness and easier accessibility within the clinical setting, several limitations such as optimal target definition, high signal to background ratio and associated artifacts hinder the accurate diagnosis of specific types of deep-seated tumors, besides associated high cost. In this review we discuss various imaging, molecular, and low-cost diagnostic tools and related technological advancements, to provide a better understanding of cancer diagnostics, unraveling new opportunities for effective management of cancer, particularly in low- and middle-income countries (LMICs). RECENT FINDINGS Herein we discuss various technological advancements that are being utilized to construct an assortment of new diagnostic techniques that incorporate hardware, image reconstruction software, imaging devices, biomarkers, and even artificial intelligence algorithms, thereby providing a reliable diagnosis and analysis of the tumor. Also, we provide a brief account of alternative low cost-effective cancer therapy devices (CryoPop®, LumaGEM®, MarginProbe®) and picture archiving and communication systems (PACS), emphasizing the need for multi-disciplinary collaboration among radiologists, pathologists, and other involved specialties for improving cancer diagnostics. CONCLUSION Revolutionary technological advancements in cancer imaging and molecular biology techniques are indispensable for the accurate diagnosis and prognosis of cancer.
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Affiliation(s)
- Akhil Pulumati
- University of Missouri‐Kansas CityKansas CityMissouriUSA
| | - Anika Pulumati
- University of Missouri‐Kansas CityKansas CityMissouriUSA
| | - Bilikere S. Dwarakanath
- Central Research FacilitySri Ramachandra Institute of Higher Education and Research PorurChennaiIndia
- Department of BiotechnologyIndian Academy Degree CollegeBangaloreIndia
| | | | - Rao V. L. Papineni
- PACT & Health LLCBranfordConnecticutUSA
- Department of SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
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22
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Amalaraj T, Jeyasugiththan J, Satharasinghe D, Pallewatte AS. Dose reference level based on size-specific dose estimate (SSDE) and feasibility of deriving effective body diameter using tube current and time product (mAs) for adult chest and abdomen computed tomography (CT) procedures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:011505. [PMID: 36626827 DOI: 10.1088/1361-6498/acb1bf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to establish dose reference level (NDRLSSDE) based on size-specific dose estimate (SSDE) derived using effective diameter (Deff) for adult chest and abdomen computed tomography (CT) procedures and to explore the feasibility of drivingDeffusing the product of tube current and time (mAs). In this retrospective study, dose data, scan parameters and patient body dimensions at the mid-slice level from 14 CT units (out of 63 total) were extracted. Additionally, the mAs values of the axial slice at the samez-location where the diameter measurements were made (mAsz) were recorded. Pearson's correlation (r) analysis was used to determine the relationship ofDeffwith patient BMI, weight, and mAsz. The NDRLSSDEfor the chest and abdomen were 9.72 mGy and 13.4 mGy, respectively. The BMI and body weight were less correlated (r= 0.24 andr= 0.33, respectively) withDeff. The correlation between mAszandDeffwas considerably strong (r= 0.78) and can be used to predictDeffaccurately. The absolute dose differences between SSDEs calculated using the AAPM-204 method and mAszwas less than 1.1 mGy (15%). Therefore, mAszis an efficient parameter to deriveDeff. Further, the direct conversion factors to estimate SSDEs at different locations along thez-direction in the scan region from corresponding mAs and CTDIvolwere calculated. The NDRLSSDEsuggested in the present study can be used as a reference for size-dependent dose optimisation in Sri Lanka, and existing NDRL based on CTDIvolunderestimate the average adult CT dose by 36.0% and 39.7% for chest and abdomen regions respectively. The results show that using mAszto determine SSDE is a simple and practical approach with an accuracy of 95% and 85% for abdomen and chest scans, respectively. However, the obtained linear relationship betweenDeffand mAs is highly dependent on the ATCM technique and the user-determined noise levels of the scanning protocol. Finally, the phantom study resulted in the strongest correlation (r= 0.99) between theDwzand mAsz, and the prediction of patient size would be more precise thanDeffmethod.
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Affiliation(s)
- T Amalaraj
- Department of Nuclear Science, University of Colombo, Colombo, Sri Lanka
| | | | | | - A S Pallewatte
- Department of Radiology, National Hospital of Sri Lanka, Colombo, Sri Lanka
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23
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Bullock EKC, Brown MJ, Clark G, Plant JGA, Blakeney WG. Robotics in Total Hip Arthroplasty: Current Concepts. J Clin Med 2022; 11:6674. [PMID: 36431151 PMCID: PMC9695933 DOI: 10.3390/jcm11226674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/25/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022] Open
Abstract
This current concepts article reviews the literature pertaining to the use of robot-assisted systems in total hip arthroplasty (THA). The bulk of the literature is regarding the MAKO (currently the most used system worldwide) and the historic ROBODOC robotic systems. There is a paucity of literature available on other systems, with several still in pilot-phase development. Whilst the evidence shows improved radiological outcomes with robotic THA, functional outcomes are equivocal between conventional and robotic techniques. Acceptance of robotic THA worldwide is limited by its accessibility including cost, and by already exceptional results with the conventional technique. It is, however, a rapidly developing area of orthopaedic surgery. This article discusses the history of robotics in THA, current surgical techniques, functional and radiological outcomes, and ongoing avenues for development.
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Affiliation(s)
- Emily K. C. Bullock
- Department of Orthopaedic Surgery, Royal Perth Hospital, Wellington St., Perth, WA 6000, Australia
| | - Michael J. Brown
- Department of Orthopaedic Surgery, Royal Perth Hospital, Wellington St., Perth, WA 6000, Australia
| | - Gavin Clark
- Department of Orthopaedic Surgery, St John of God Subiaco Hospital, 12 Salvado Road, Subiaco, WA 6008, Australia
| | - James G. A. Plant
- Department of Orthopaedic Surgery, Royal Perth Hospital, Wellington St., Perth, WA 6000, Australia
- Department of Orthopaedic Surgery, St John of God Subiaco Hospital, 12 Salvado Road, Subiaco, WA 6008, Australia
| | - William G. Blakeney
- Department of Orthopaedic Surgery, Royal Perth Hospital, Wellington St., Perth, WA 6000, Australia
- Department of Orthopaedic Surgery, St John of God Subiaco Hospital, 12 Salvado Road, Subiaco, WA 6008, Australia
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24
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Booij R, Sandstedt M, Tesselaar E, Farnebo S. Photon-counting detector computed tomography (PCD-CT) - an emerging technology in hand and wrist imaging. J Hand Surg Eur Vol 2022; 48:489-494. [PMID: 36324209 DOI: 10.1177/17531934221132692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ronald Booij
- Department of Radiology & Nuclear Medicine, Erasmus MC, The Netherlands.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Mårten Sandstedt
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Radiology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Erik Tesselaar
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Medical Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Simon Farnebo
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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25
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Tonkopi E, Wikan EJ, Hovland TO, Høgset S, Kofod TA, Sefenu SK, Hughes-Ryan E, d´Entremont-O´Connell D, Gunn C, Holter T, Johansen S. A survey of local diagnostic reference levels for the head, thorax, abdomen and pelvis computed tomography in Norway and Canada. Acta Radiol Open 2022; 11:20584601221131477. [PMID: 36225897 PMCID: PMC9549116 DOI: 10.1177/20584601221131477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022] Open
Abstract
Background Computed tomography (CT) contributes to 60% of the collective dose in medical
imaging. Literature has demonstrated that patient dose varies across regions
and countries. Establishing diagnostic reference levels (DRLs) contributes
to the optimization of clinical practices and radiation protection. Purpose To survey the dose indices (CTDIvol and dose-length product) for frequently
performed CT examinations from the chosen hospitals in Norway and Canada and
to determine local DRLs (LDRLs) based on the collected data. Material and Methods The survey included eight scanners from two Norwegian hospitals and four
scanners from four Canadian hospitals. Dosimetry data were collected for the
following routine CT examinations: head, contrast-enhanced thorax, and
abdomen and pelvis. Overall 480 adult average-sized patients from Norway and
360 from Canada were included in the survey. The LDRLs were determined as
the 75th percentile of distributions of median values of dose indicators
from different CT scanners. The differences in dose between scanners were
determined using single-factor ANOVA. Results The LDRLs determined in Norway were higher overall than in Canada. The
obtained values were compared to the national DRLs. The dose from several
scanners in Norway exceeded national Norwegian DRLs, while Canadian LDRLs
were below the Canadian reference levels. The differences between the means
of the dose distributions from each scanner were statistically significant
(p < 0.05) for all examinations with exception of
identical scanners located in the same hospital and using the same
protocols. Conclusion Observed dose variations even in the same hospital, or from the same scanner
model confirmed the need for CT protocol optimization.
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Affiliation(s)
- Elena Tonkopi
- Department of Diagnostic Imaging,
Nova Scotia
Health Authority, Halifax, NS,
Canada,Department of Radiation Oncology,
Dalhousie
University, Halifax, NS, Canada,Department of Diagnostic Radiology,
Dalhousie
University, Halifax, NS, Canada
| | | | | | - Sivert Høgset
- Health faculty,
Oslo
Metropolitan University, Oslo,
Norway
| | | | | | - Emily Hughes-Ryan
- School of Health Sciences,
Dalhousie
University, Halifax, NS, Canada
| | | | - Catherine Gunn
- Department of Radiation Oncology,
Dalhousie
University, Halifax, NS, Canada,School of Health Sciences,
Dalhousie
University, Halifax, NS, Canada
| | - Tanja Holter
- Department of Physics and
Computational Radiology, Oslo University
Hospital, Oslo Norway
| | - Safora Johansen
- Health faculty,
Oslo
Metropolitan University, Oslo,
Norway,Department of Cancer Treatment,
Oslo
University Hospital, Oslo, Norway,Safora Johansen, Oslo Metropolitan
University and Oslo Hospital, Pilestredet 48, Oslo 0130, Norway.
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26
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Booij R, van der Werf NR, Dijkshoorn ML, van der Lugt A, van Straten M. Assessment of Iodine Contrast-To-Noise Ratio in Virtual Monoenergetic Images Reconstructed from Dual-Source Energy-Integrating CT and Photon-Counting CT Data. Diagnostics (Basel) 2022; 12:diagnostics12061467. [PMID: 35741277 PMCID: PMC9222007 DOI: 10.3390/diagnostics12061467] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
To evaluate whether the contrast-to-noise ratio (CNR) of an iodinated contrast agent in virtual monoenergetic images (VMI) from the first clinical photon-counting detector (PCD) CT scanner is superior to VMI CNR from a dual-source dual-energy CT scanner with energy-integrating detectors (EID), two anthropomorphic phantoms in three different sizes (thorax and abdomen, QRM GmbH), in combination with a custom-built insert containing cavities filled with water, and water with 15 mg iodine/mL, were scanned on an EID-based scanner (Siemens SOMATOM Force) and on a PCD-based scanner (Siemens, NAEOTOM Alpha). VMI (range 40−100 keV) were reconstructed without an iterative reconstruction (IR) technique and with an IR strength of 60% for the EID technique (ADMIRE) and closest matching IR strengths of 50% and 75% for the PCD technique (QIR). CNR was defined as the difference in mean CT numbers of water, and water with iodine, divided by the root mean square value of the measured noise in water, and water with iodine. A two-sample t-test was performed to evaluate differences in CNR between images. A p-value < 0.05 was considered statistically significant. For VMI without IR and below 60 keV, the CNR of the PCD-based images at 120 and 90 kVp was up to 55% and 75% higher than the CNR of the EID-based images, respectively (p < 0.05). For VMI above 60 keV, CNRs of PCD-based images at both 120 and 90 kVp were up to 20% lower than the CNRs of EID-based images. Similar or improved performance of PCD-based images in comparison with EID-based images were observed for VMIs reconstructed with IR techniques. In conclusion, with PCD-CT, iodine CNR on low energy VMI (<60 keV) is better than with EID-CT.
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27
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Sookpeng S, Martin CJ. A PHANTOM EVALUATION OF THE USE OF CT AUTOMATIC TUBE CURRENT MODULATION WITH LOW TUBE POTENTIALS FOR IODINATED CONTRAST STUDIES. RADIATION PROTECTION DOSIMETRY 2022; 198:188-195. [PMID: 35224645 DOI: 10.1093/rpd/ncac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/29/2021] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
This paper aimed to investigate effects of different tube voltage and image quality settings on radiation dose and image quality for patients undergoing computed tomography iodinated contrast studies using automatic tube current modulation system and to recommend settings to achieve improved radiation dose and image quality values. A Pagoda phantom with an additional rod of iodine contrast was scanned using different tube voltages and noise index (NI) settings. Size-specific dose estimate (SSDE) and image quality (noise, contrast, contrast-to-noise ratio (CNR) and figure of merit (FOM)) were analysed. Values of SSDE were maintained with similar NI settings. Contrast and CNR were higher for lower tube voltage settings. Better FOM values can be achieved with higher NI settings with the lower kVs. To achieve better CNR and SSDE compared with the standard setting of 120 kV, a 80 kV with an NI setting of 15 was recommended.
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Affiliation(s)
- Supawitoo Sookpeng
- Department of Radiological Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - Colin J Martin
- Department of Clinical Physics and Bioengineering, University of Glasgow, Gartnavel Royal Hospital, Glasgow G12 0XH, UK
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