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Ma Y, Zhen Y, Wang M, Gao L, Dang Y, Shang J, Chen X, Ma S, Zhou K, Feng K, Xin Y, Hou Y, Guo C. Associations between the serum triglyceride-glucose index and pericoronary adipose tissue attenuation and plaque features using dual-layer spectral detector computed tomography: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1166117. [PMID: 37234808 PMCID: PMC10206237 DOI: 10.3389/fendo.2023.1166117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Background and aims The triglyceride-glucose (TyG) index is a reliable alternative marker for insulin resistance (IR). Pericoronary adipose tissue (PCAT) can indirectly reflect coronary inflammation. IR and coronary inflammation play a key role in the development and progression of coronary atherosclerosis. Therefore, this study investigated the relationships between the TyG index, PCAT and atherosclerotic plaque characteristics to explore whether IR might lead to coronary artery atherosclerosis progression by inducing coronary inflammation. Methods We retrospectively collected data on patients with chest pain who underwent coronary computed tomography angiography using spectral detector computed tomography at our institution from June to December 2021. The patients were grouped based on their TyG index levels: T1 (low), T2 (medium), and T3 (high). Each patient was assessed for total plaque volume, plaque load, maximum stenosis, the plaque component volume proportion, high-risk plaques(HRPs), and plaque characteristics (including low attenuation plaques, positive remodeling, a napkin ring sign, and spot calcification). PCAT quantification was performed on the proximal right coronary artery using the fat attenuation index (FAI) measured from a conventional multicolor computed tomography image (FAI120kVp), a spectral virtual single-energy image (FAI40keV), and the slope of the spectral HU curve (λHU). Results We enrolled 201 patients. The proportion of patients with maximum plaque stenosis, positive remodeling, low-density plaques, and HRPs increased as the TyG index level increased. Moreover, the FAI40keV and λHU significantly differed among the three groups, and we identified good positive correlations between FAI40keV and λHU and the TyG index (r = 0.319, P <0.01 and r = 0.325, P <0.01, respectively). FAI120kVp did not significantly differ among the groups. FAI40keV had the highest area under the curve, with an optimal cutoff value of -130.5 HU for predicting a TyG index value of ≥9.13. The multivariate linear regression analysis demonstrated that FAI40keV and λHU were independently positively related to a high TyG index level (standardized regression coefficients: 0.117 [P <0.001] and 0.134 [P <0.001], respectively). Conclusions Patients with chest pain and a higher TyG index level were more likely to have severe stenosis and HRPs. Moreover, FAI40keV and λHU had good correlations with the serum TyG index, which may noninvasively reflect PCAT inflammation under insulin resistance. These results could help explain the mechanism of plaque progression and instability in patients with insulin resistance might be related to IR-induced coronary inflammation.
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Affiliation(s)
- Yue Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanhua Zhen
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Min Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lingfeng Gao
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuxue Dang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jin Shang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xujiao Chen
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shaowei Ma
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ke Zhou
- Department of Cardiac Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kai Feng
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xin
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chuanji Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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Dang Y, Chen X, Ma S, Ma Y, Ma Q, Zhou K, Liu T, Wang K, Hou Y. Association of Pericoronary Adipose Tissue Quality Determined by Dual-Layer Spectral Detector CT With Severity of Coronary Artery Disease: A Preliminary Study. Front Cardiovasc Med 2021; 8:720127. [PMID: 34660721 PMCID: PMC8514719 DOI: 10.3389/fcvm.2021.720127] [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: 06/03/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pericoronary adipose tissue (PCAT) is considered as a source of inflammatory mediators, leading to the development of coronary atherosclerosis. The study aimed to investigate the correlation between PCAT quality derived from dual-layer spectral detector CT (SDCT) and the severity of coronary artery disease (CAD), and whether PCAT parameters were independently associated with the presence of CAD. Materials and Methods: A total of 403 patients with symptoms of chest pain who underwent SDCT were included. PCAT quality including fat attenuation index (FAI) measured from conventional polychromatic CT images (FAI120kvp) and spectral virtual mono-energetic images at 40 keV (FAI40keV), slope of spectral HU curve (λHU), and effective atomic number (Eff-Z) were measured around the lesions representing the maximal degree of vascular stenosis in each patient. Meanwhile, overall epicardial adipose tissue (EAT) attenuation was acquired in the conventional polychromatic energy imaging. Results: FAI40keV, λHU, Eff-Z, and FAI120kvp increased along with the degree of CAD in general and were superior to the overall EAT attenuation for detecting the presence of CAD. Multivariate logistic regression analysis indicated that FAI40keV was the most powerful independent indicator (odds ratio 1.058, 95% CI 1.044–1.073; p < 0.001) of CAD among these parameters. Using an optimal cut-off (−131.8 HU), FAI40keV showed higher diagnostic accuracy of 80.6% compared with the other parameters. Conclusions: These preliminary findings suggest that FAI40keV on SDCT may be an appealing surrogate maker to allow monitoring of PCAT changes in the development of CAD.
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Affiliation(s)
- Yuxue Dang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xujiao Chen
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shaowei Ma
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Quanmei Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ke Zhou
- Department of Cardiac Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting Liu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Kunhua Wang
- Department of Radiology, The People's Hospital of Liaoning Province, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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D'Angelo T, Lenga L, Arendt CT, Bucher AM, Peterke JL, Caruso D, Mazziotti S, Ascenti G, Blandino A, Othman AE, Martin SS, Albrecht MH, Bodelle B, Vogl TJ, Wichmann JL. Carotid and cerebrovascular dual-energy computed tomography angiography: Optimization of window settings for virtual monoenergetic imaging reconstruction. Eur J Radiol 2020; 130:109166. [PMID: 32693314 DOI: 10.1016/j.ejrad.2020.109166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 04/25/2020] [Accepted: 07/05/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE Dedicated post-processing of dual-energy computed tomography angiography (DE-CTA) datasets has been shown to allow for increased vascular contrast. The goal of our study was to define optimal window settings for displaying virtual monoenergetic images (VMI) reconstructed from dual-energy carotid and cerebrovascular DE-CTA. METHODS Fifty-seven patients who underwent clinically-indicated carotid and cerebrovascular third-generation dual-source DE-CTA were retrospectively evaluated. Standard linearly-blended (M_0.6), 70-keV traditional VMI (M70), and 40-keV noise-optimized VMI (M40+) reconstructions were analyzed. For M70 and M40+ datasets, the subjectively best window setting (width and level, B-W/L) was independently determined by two observers and subsequently related with aortic arch attenuation to calculate optimized values (O-W/L) using linear regression. Subjective evaluation of image quality (IQ) between W/L settings were assessed by two additional readers. Repeated measures analysis of variance were performed to compare W/L settings and IQ indices between M_0.6, M70, and M40 + . RESULTS B-W/L and O-W/L for M70 were 580/210 and 560/200, and for M40+ were 1630/570 and 1560/550, respectively, higher than standard DE-CTA W/L settings (450/100). Highest subjective scores were observed for M40+ regarding overall IQ (all p < 0.001). CONCLUSION Application of O-W/L settings is mandatory to optimize subjective IQ of VMI reconstructions of DE-CTA.
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Affiliation(s)
- Tommaso D'Angelo
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, Via Consolare Valeria 1, 98100, Messina, Italy
| | - Lukas Lenga
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Christophe T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Andreas M Bucher
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Julia L Peterke
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Damiano Caruso
- Department of Radiological Sciences, Oncological and Pathological Sciences, "La Sapienza'' University Hospital, Latina, Italy
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, Via Consolare Valeria 1, 98100, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, Via Consolare Valeria 1, 98100, Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, Via Consolare Valeria 1, 98100, Messina, Italy
| | - Ahmed E Othman
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tübingen, Tübingen, Germany
| | - Simon S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Boris Bodelle
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Julian L Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
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Albrecht MH, Vogl TJ, Martin SS, Nance JW, Duguay TM, Wichmann JL, De Cecco CN, Varga-Szemes A, van Assen M, Tesche C, Schoepf UJ. Review of Clinical Applications for Virtual Monoenergetic Dual-Energy CT. Radiology 2019; 293:260-271. [DOI: 10.1148/radiol.2019182297] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Arendt CT, Czwikla R, Lenga L, Wichmann JL, Albrecht MH, Booz C, Martin SS, Leithner D, Tischendorf P, Blandino A, Vogl TJ, D'Angelo T. Improved coronary artery contrast enhancement using noise-optimised virtual monoenergetic imaging from dual-source dual-energy computed tomography. Eur J Radiol 2019; 122:108666. [PMID: 31786506 DOI: 10.1016/j.ejrad.2019.108666] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/04/2019] [Accepted: 09/12/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE To define optimal kiloelectron volt (keV) settings for virtual monoenergetic imaging (VMI) reconstruction at dual-energy coronary computed tomography angiography (DE-CCTA). METHOD Fifty-one DE-CCTA data sets (33 men; mean age, 63.9 ± 13.2 years) were reconstructed as standard linearly-blended images (F_0.6; 60% of 90 kVp, 40% of 150 kVpSn), and with traditional (VMI) and noise-optimised (VMI+) algorithms from 40 to 100 keV in 10-keV intervals. Objective image quality was assessed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements. Three observers subjectively evaluated vascular contrast, image sharpness, noise and delineation of coronary plaques. RESULTS Median values for objective image analysis were highest in VMI + series at 40 keV (SNR, 44.5; CNR: 33.5), significantly superior (allp < 0.001) to the best VMI series at 70 keV (SNR, 28.1; CNR, 18.4) and standard F_0.6 images (SNR, 23.2; CNR, 15.6). Overall subjective metrics achieved higher scores at 40-keV VMI+ series in comparison to 70-keV VMI series and F_0.6 images (all p < 0.001), with optimal vascular contrast (5; ICC, 0.90), good image sharpness (4; 0.88), low noise (4; 0.82), and optimal plaque delineation (5; 0.89). CONCLUSIONS DE-CCTA image reconstruction with 40-keV VMI + allows for significant improvement of both objective and subjective image quality.
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Affiliation(s)
- Christophe T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Rouben Czwikla
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Lukas Lenga
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Julian L Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Simon S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Doris Leithner
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Patricia Tischendorf
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Alfredo Blandino
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, Policlinico G. Martino - University Hospital Messina, Messina, Italy
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Tommaso D'Angelo
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany; Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, Policlinico G. Martino - University Hospital Messina, Messina, Italy
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Murray N, Darras KE, Walstra FE, Mohammed MF, McLaughlin PD, Nicolaou S. Dual-Energy CT in Evaluation of the Acute Abdomen. Radiographics 2019; 39:264-286. [DOI: 10.1148/rg.2019180087] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Nicolas Murray
- From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (N.M., K.E.D., F.E.W., P.D.M., S.N.); and the Medical Imaging Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Riyadh, Saudi Arabia (M.F.M.)
| | - Kathryn E. Darras
- From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (N.M., K.E.D., F.E.W., P.D.M., S.N.); and the Medical Imaging Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Riyadh, Saudi Arabia (M.F.M.)
| | - Frances E. Walstra
- From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (N.M., K.E.D., F.E.W., P.D.M., S.N.); and the Medical Imaging Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Riyadh, Saudi Arabia (M.F.M.)
| | - Mohammed F. Mohammed
- From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (N.M., K.E.D., F.E.W., P.D.M., S.N.); and the Medical Imaging Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Riyadh, Saudi Arabia (M.F.M.)
| | - Patrick D. McLaughlin
- From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (N.M., K.E.D., F.E.W., P.D.M., S.N.); and the Medical Imaging Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Riyadh, Saudi Arabia (M.F.M.)
| | - Savvas Nicolaou
- From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (N.M., K.E.D., F.E.W., P.D.M., S.N.); and the Medical Imaging Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Riyadh, Saudi Arabia (M.F.M.)
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Lenga L, Czwikla R, Wichmann JL, Leithner D, Albrecht MH, D'Angelo T, Arendt CT, Booz C, Hammerstingl R, Vogl TJ, Martin SS. Dual-energy CT in patients with abdominal malignant lymphoma: impact of noise-optimised virtual monoenergetic imaging on objective and subjective image quality. Clin Radiol 2018; 73:833.e19-833.e27. [PMID: 29884524 DOI: 10.1016/j.crad.2018.04.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 04/25/2018] [Indexed: 12/12/2022]
Abstract
AIM To investigate the impact of noise-optimised virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with malignant lymphoma at dual-energy computed tomography (DECT) examinations of the abdomen. MATERIALS AND METHODS Thirty-five consecutive patients (mean age, 53.8±18.6 years; range, 21-82 years) with histologically proven malignant lymphoma of the abdomen were included retrospectively. Images were post-processed with standard linear blending (M_0.6), traditional VMI, and VMI+ technique at energy levels ranging from 40 to 100 keV in 10 keV increments. Signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were objectively measured in lymphoma lesions. Image quality, lesion delineation, and image noise were rated subjectively by three blinded observers using five-point Likert scales. RESULTS Quantitative image quality parameters peaked at 40-keV VMI+ (SNR, 15.77±7.74; CNR, 18.27±8.04) with significant differences compared to standard linearly blended M_0.6 (SNR, 7.96±3.26; CNR, 13.55±3.47) and all traditional VMI series (p<0.001). Qualitative image quality assessment revealed significantly superior ratings for image quality at 60-keV VMI+ (median, 5) in comparison with all other image series (p<0.001). Assessment of lesion delineation showed the highest rating scores for 40-keV VMI+ series (median, 5), while lowest subjective image noise was found for 100-keV VMI+ reconstructions (median, 5). CONCLUSION Low-keV VMI+ reconstructions led to improved image quality and lesion delineation of malignant lymphoma lesions compared to standard image reconstruction and traditional VMI at abdominal DECT examinations.
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Affiliation(s)
- L Lenga
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - R Czwikla
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - J L Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
| | - D Leithner
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - M H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - T D'Angelo
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - C T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - C Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - R Hammerstingl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - T J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - S S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
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Characterization of Small (< 4 cm) Focal Renal Lesions: Diagnostic Accuracy of Spectral Analysis Using Single-Phase Contrast-Enhanced Dual-Energy CT. AJR Am J Roentgenol 2017; 209:815-825. [DOI: 10.2214/ajr.17.17824] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Scholtz JE, Ghoshhajra B. Advances in cardiac CT contrast injection and acquisition protocols. Cardiovasc Diagn Ther 2017; 7:439-451. [PMID: 29255688 PMCID: PMC5716940 DOI: 10.21037/cdt.2017.06.07] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/25/2017] [Indexed: 01/27/2023]
Abstract
Cardiac computed tomography (CT) imaging has become an important part of modern cardiovascular care. Coronary CT angiography (CTA) is the first choice imaging modality for non-invasive visualization of coronary artery stenosis. In addition, cardiac CT does not only provide anatomical evaluation, but also functional and valvular assessment, and myocardial perfusion evaluation. In this article we outline the factors which influence contrast enhancement, give an overview of current contrast injection and acquisition protocols, with focus on current emerging topics such as pre-transcatheter aortic valve replacement (TAVR) planning, cardiac CT for congenital heart disease (CHD) patients, and myocardial CT perfusion (CTP). Further, we point out areas where we see potential for future improvements in cardiac CT imaging based on a closer interaction between CT scanner settings and contrast injection protocols to tailor injections to patient- and exam-specific factors.
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Affiliation(s)
- Jan-Erik Scholtz
- Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Brian Ghoshhajra
- Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Abstract
Reignited by innovations in scanner engineering and software design, dual-energy computed tomography (CT) has come back into the clinical radiology arena in the last decade. Possibilities for noninvasive in vivo characterization of genitourinary disease, especially for renal stones and renal masses, have become the pinnacle offerings of dual-energy CT for body imaging in clinical practice. This article renders a state-of-the-art review on clinical applications of dual-energy CT in genitourinary imaging.
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Affiliation(s)
- Achille Mileto
- Department of Radiology, University of Washington School of Medicine, Box 357115, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
| | - Daniele Marin
- Department of Radiology, Duke University Medical Center, Box 3808 Erwin Road, Durham, NC 27710, USA.
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Prospective Comparison of Reduced-Iodine-Dose Virtual Monochromatic Imaging Dataset From Dual-Energy CT Angiography With Standard-Iodine-Dose Single-Energy CT Angiography for Abdominal Aortic Aneurysm. AJR Am J Roentgenol 2016; 207:W125-W132. [PMID: 27610820 DOI: 10.2214/ajr.15.15814] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the image quality of reduced-iodine-dose single-source dual-energy CT angiography (CTA) with that of standard-iodine-dose single-energy CTA in examinations of patients with abdominal aortic aneurysm and to assess the effect of the concentration of iodinated contrast medium on intravascular enhancement and image quality of reduced-iodine-dose CTA. SUBJECTS AND METHODS In a prospective randomized clinical trial, 66 consecutively registered patients with abdominal aortic aneurysm who had previously undergone single-energy CTA (30-37 g I) underwent follow-up CTA at a reduced dose (21-27 g I) of iodinated contrast medium of either 270 mg I/mL (n = 33) or 320 mg I/mL (n = 33). Two readers independently evaluated virtual monochromatic imaging datasets (40-140 keV) and single-energy CTA images for image quality and noise and their preference for optimal energy virtual monochromatic imaging dataset. A value of p < 0.05 was considered statistically significant. RESULTS All 66 dual-energy CTA examinations were rated diagnostic with mean image quality and image noise scores of 4.8 and 4.5 for reader 1 and 3.8 and 3.4 for reader 2 compared with single-energy CTA results of 4.5 and 4.2 for reader 1 and 4.5 and 4.1 for reader 2. Low-energy virtual monochromatic images (40-60 keV) from reduced-iodine-dose (28%) dual-energy CTA had significantly higher intravascular aortic attenuation (26-185%) and contrast-to-noise ratio (CNR) (20-25%) than standard-iodine-dose single-energy CTA images (p < 0.0001). No significant difference was found between patients who received 270 and those who received 320 mg I/mL with respect to intravascular aortic attenuation (p = 0.6331) or CNR (p = 0.9775). CONCLUSION Low-energy virtual monochromatic imaging datasets from reduced-iodine (24 g I) single-source dual-energy CTA of the abdomen provide up to 185% higher attenuation and 25% higher CNR than standard-iodine-dose (33.3 g I) single-energy CTA while offering a wide range of energy settings irrespective of the concentration of IV contrast medium used.
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Du X, Yang X, Cheng W, Huang N, Zhou L, Zhang J. Spectral CT imaging in cervical computed tomography angiography: comparison of spectral CT monochromatic imaging and conventional CT polychromatic imaging. Int J Clin Pract 2016; 70 Suppl 9B:B44-9. [PMID: 27577513 DOI: 10.1111/ijcp.12854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/15/2016] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To compare the image quality of spectral CT monochromatic imaging and conventional CT polychromatic imaging for analysing CTAs in patients with cervical cancer. METHODS In this IRB approved prospective study, 60 patients who had been diagnosed with cervical cancer underwent pelvic arterial CTA between May 2013 and July 2013. They were randomly divided into two groups; one group (30 patients) received 120 kVp polychromatic imaging (conventional CT group) and the other group (30 patients) received spectral CT imaging (spectral CT group), while all patients in both the groups received injections of 1 ml/kg of contrast agent. A total of 101 sets of monochromatic images (40-140 keV) were obtained via data reconstruction in the spectral CT group, and the monochromatic images with the best contrast-to-noise ratio (CNR) between the common iliac artery and pelvic fat (i.e. the best monochromatic energy) were selected. The best monochromatic images for the spectral CT group and the polychromatic images for the conventional CT group were postprocessed and visualised in MIP, VR and CPR mode. The CT attenuation value, noise and CNR of bilateral common iliac arteries were measured with the best monochromatic energy, as well as with 70 keV, in the spectral CT group and in the conventional CT group. The quality of the CT images was evaluated with a 5-point scale. The CTDIvol and the dose-length product (DLP) of the two groups were measured, and the results were statistically analysed. RESULTS When images were at 50±1 keV, the common iliac artery and pelvic fat had the highest CNR, which was 72.00% higher than the images at 70 keV (P=.001) in the spectral group, and thus, the images at 50±1 keV were considered to have the best monochromatic energy. The average CT value of the internal iliac artery, which had the best monochromatic energy from the spectral CT group, was higher than that of the images from the conventional CT group (603.96±62.68 vs 251.24±28.77; P<.001), and the differences in the CNR (73.97±11.83 vs 45.21±16.63) and the subjective score (3.10±1.73 vs 2.80±1.63) were statistically significant (both P<.05). There were no significant differences in the CTDIvol (10.48±2.86 vs 12.38±1.88 mGy) or the DLP (317.76±95.50 vs 332.25±21.25 mGy cm) between the spectral and the conventional CT groups. CONCLUSION Monochromatic spectral CT imaging has excellent soft tissue contrast and good spatial resolution and can visualise the arteries and branches supplying the tumours more clearly in patients with cervical cancer. Compared with polychromatic images, monochromatic spectral CT images are higher quality, which helps the treatment of patients with cervical cancer.
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Affiliation(s)
- Xiaosong Du
- MR & CT Room, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | - Xiaotang Yang
- MR & CT Room, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | - Weiling Cheng
- MR & CT Room, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | | | - Lifang Zhou
- MR & CT Room, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | - Jianxin Zhang
- MR & CT Room, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
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Martin SS, Albrecht MH, Wichmann JL, Hüsers K, Scholtz JE, Booz C, Bodelle B, Bauer RW, Metzger SC, Vogl TJ, Lehnert T. Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement. Eur Radiol 2016; 27:705-714. [DOI: 10.1007/s00330-016-4422-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 02/10/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
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Cardiovascular Imaging: The Past and the Future, Perspectives in Computed Tomography and Magnetic Resonance Imaging. Invest Radiol 2016; 50:557-70. [PMID: 25985464 DOI: 10.1097/rli.0000000000000164] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Today's noninvasive imaging of the cardiovascular system has revolutionized the approach to various diseases and has substantially affected prognostic information. Cardiovascular magnetic resonance (MR) and computed tomographic (CT) imaging are at center stage of these approaches, although 5 decades ago, these technologies were unheard of. Both modalities had their inception in the 1970s with a primary focus on noncardiovascular applications. The technical development of the various decades, however, substantially pushed the envelope for cardiovascular MR and CT applications. Within the past 10-15 years, MR and CT technologies have pushed each other in cardiac applications; and without the "rival" modality, neither one would likely not have reached its potential today. This view on the history of MR and CT in the field of cardiovascular applications provides insight into the story of success of applications that once have been ideas only but are at prime time today.
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Mileto A, Barina A, Marin D, Stinnett SS, Roy Choudhury K, Wilson JM, Nelson RC. Virtual Monochromatic Images from Dual-Energy Multidetector CT: Variance in CT Numbers from the Same Lesion between Single-Source Projection-based and Dual-Source Image-based Implementations. Radiology 2016; 279:269-77. [DOI: 10.1148/radiol.2015150919] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mileto A, Sofue K, Marin D. Imaging the renal lesion with dual-energy multidetector CT and multi-energy applications in clinical practice: what can it truly do for you? Eur Radiol 2016; 26:3677-90. [DOI: 10.1007/s00330-015-4180-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 01/30/2023]
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Megibow AJ, Chandarana H, Hindman NM. Increasing the Precision of CT Measurements with Dual-Energy Scanning. Radiology 2014; 272:618-21. [DOI: 10.1148/radiol.14141118] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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