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Held J, Haschka D, Lacaita PG, Feuchtner GM, Klotz W, Stofferin H, Duftner C, Weiss G, Klauser AS. Review: The Role of Dual-Energy Computed Tomography in Detecting Monosodium Urate Deposits in Vascular Tissues. Curr Rheumatol Rep 2024; 26:302-310. [PMID: 38739298 PMCID: PMC11224090 DOI: 10.1007/s11926-024-01151-y] [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] [Accepted: 05/01/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE OF REVIEW To highlight novel findings in the detection of monosodium urate deposits in vessels using dual energy computed tomography, and to discuss the potential clinical implications for gout and hyperuricemia patients. RECENT FINDINGS Gout is an independent risk factor for cardiovascular disease. However, classical risk calculators do not take into account these hazards, and parameters to identify patients at risk are lacking. Monosodium urate measured by dual energy computed tomography is a well-established technology for the detection and quantification of monosodium urate deposits in peripheral joints and tendons. Recent findings also suggest its applicability to identify vascular urate deposits. Dual energy computed tomography is a promising tool for detection of cardiovascular monosodium urate deposits in gout patients, to better delineate individuals at increased risk for cardiovascular disease.
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Affiliation(s)
- Julia Held
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
| | - David Haschka
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria.
| | - Pietro G Lacaita
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Gudrun M Feuchtner
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Werner Klotz
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
| | - Hannes Stofferin
- Division of Clinical and Functional Anatomy, Department of Anatomy, Histology and Embryology, Medical University Innsbruck, Innsbruck, Austria
| | - Christina Duftner
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
| | - Andrea S Klauser
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
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Boccalini S, Mayard C, Lacombe H, Villien M, Si-Mohamed S, Delahaye F, Boussel L, Budde RPJ, Pozzi M, Douek P. Ultra-High-Resolution and K-Edge Imaging of Prosthetic Heart Valves With Spectral Photon-Counting CT: A Phantom Study. Invest Radiol 2024; 59:589-598. [PMID: 38421666 DOI: 10.1097/rli.0000000000001068] [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: 03/02/2024]
Abstract
BACKGROUND AND PURPOSE The contribution of cardiac computed tomography (CT) for the detection and characterization of prosthetic heart valve (PHV) complications is still limited due mainly to artifacts. Computed tomography systems equipped with photon-counting detectors (PCDs) have the potential to overcome these limitations. Therefore, the aim of the study was to compare image quality of PHV with PCD-CT and dual-energy dual-layer CT (DEDL-CT). MATERIALS AND METHODS Two metallic and 3 biological PHVs were placed in a tube containing diluted iodinated contrast inside a thoracic phantom and scanned repeatedly at different angles on a DEDL-CT and PCD-CT. Two small lesions (~2 mm thickness; containing muscle and fat, respectively) were attached to the structure of 4 valves, placed inside the thoracic phantom, with and without an extension ring, and scanned again. Acquisition parameters were matched for the 2 CT systems and used for all scans. Metallic valves were scanned again with parameters adapted for tungsten K-edge imaging. For all valves, different metallic parts were measured on conventional images to assess their thickness and blooming artifacts. In addition, 6 parallelepipeds per metallic valve were drawn, and all voxels with density <3 times the standard deviation of the contrast media were recorded as an estimate of streak artifacts. For subjective analysis, 3 expert readers assessed conventional images of the valves, with and without lesions, and tungsten K-edge images. Conspicuity and sharpness of the different parts of the valve, the lesions, metallic, and blooming artifacts were scored on a 4-point scale. Measurements and scores were compared with the paired t test or Wilcoxon test. RESULTS The objective analysis showed that, with PCD-CT, valvular metallic structures were thinner and presented less blooming artifacts. Metallic artifacts were also reduced with PCD-CT (11 [interquartile (IQ) = 6] vs 40 [IQ = 13] % of voxels). Subjective analysis allowed noticing that some structures were visible or clearly visible only with PCD-CT. In addition, PCD-CT yielded better scores for the conspicuity and for the sharpness of all structures (all P s < 0.006), except for the conspicuity of the leaflets of the mechanical valves, which were well visible with either technique (4 [IQ = 3] for both). Both blooming and streak artifacts were reduced with PCD-CT ( P ≤ 0.01). Overall, the use of PCD-CT resulted in better conspicuity and sharpness of the lesions compared with DEDL-CT (both P s < 0.02). In addition, only with PCD-CT some differences between the 2 lesions were detectable. Adding the extension ring resulted in reduced conspicuity and sharpness with DEDL-CT ( P = 0.04 and P = 0.02, respectively) and only in reduced sharpness with PCD-CT ( P = 0.04). Tungsten K-edge imaging allowed for the visualization of the only dense structure containing it, the leaflets, and it resulted in images judged having less blooming and metallic artifacts as compared with conventional PCD-CT images ( P < 0.01). CONCLUSIONS With PCD-CT, objective and subjective image quality of metallic and biological PHVs is improved compared with DEDL-CT. Notwithstanding the improvements in image quality, millimetric lesions attached to the structure of the valves remain a challenge for PCD-CT. Tungsten K-edge imaging allows for even further reduction of artifacts.
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Affiliation(s)
- Sara Boccalini
- From the University of Lyon, INSA-Lyon, University Claude Bernard Lyon 1, Villeurbanne, France (S.B., F.D.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France (S.B., C.M., S.S.-M., L.B., P.D.); University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, Villeurbanne, France (H.L., S.S.-M., L.B., P.D.); Philips Healthcare, Suresnes, France (M.V.); Department of Cardiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France (F.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (R.B.); and Department of Cardiac Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France (M.P.)
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Onishi H, Tsuboyama T, Nakamoto A, Ota T, Fukui H, Tatsumi M, Honda T, Kiso K, Matsumoto S, Kaketaka K, Enchi Y, Kawabata S, Nakasone S, Tomiyama N. Photon-counting CT: technical features and clinical impact on abdominal imaging. Abdom Radiol (NY) 2024:10.1007/s00261-024-04414-5. [PMID: 38888738 DOI: 10.1007/s00261-024-04414-5] [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: 03/28/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024]
Abstract
Photon-counting CT has a completely different detector mechanism than conventional energy-integrating CT. In the photon-counting detector, X-rays are directly converted into electrons and received as electrical signals. Photon-counting CT provides virtual monochromatic images with a high contrast-to-noise ratio for abdominal CT imaging and may improve the ability to visualize small or low-contrast lesions. In addition, photon-counting CT may offer the possibility of reducing radiation dose. This review provides an overview of the actual clinical operation of photon-counting CT and its diagnostic utility in abdominal imaging. We also describe the clinical implications of photon-counting CT including imaging of hepatocellular carcinoma, liver metastases, hepatic steatosis, pancreatic cancer, intraductal mucinous neoplasm of the pancreas, and thrombus.
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Affiliation(s)
- Hiromitsu Onishi
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan.
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Atsushi Nakamoto
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takashi Ota
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hideyuki Fukui
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mitsuaki Tatsumi
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Toru Honda
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kengo Kiso
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shohei Matsumoto
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Koki Kaketaka
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukihiro Enchi
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Suita, Japan
| | - Shuichi Kawabata
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Suita, Japan
| | - Shinya Nakasone
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Suita, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
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Chung J, Zhang J, Saimon AI, Liu Y, Johnson BN, Kong Z. Imbalanced spectral data analysis using data augmentation based on the generative adversarial network. Sci Rep 2024; 14:13230. [PMID: 38853181 PMCID: PMC11163007 DOI: 10.1038/s41598-024-63285-4] [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: 01/18/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024] Open
Abstract
Spectroscopic techniques generate one-dimensional spectra with distinct peaks and specific widths in the frequency domain. These features act as unique identities for material characteristics. Deep neural networks (DNNs) has recently been considered a powerful tool for automatically categorizing experimental spectra data by supervised classification to evaluate material characteristics. However, most existing work assumes balanced spectral data among various classes in the training data, contrary to actual experiments, where the spectral data is usually imbalanced. The imbalanced training data deteriorates the supervised classification performance, hindering understanding of the phase behavior, specifically, sol-gel transition (gelation) of soft materials and glycomaterials. To address this issue, this paper applies a novel data augmentation method based on a generative adversarial network (GAN) proposed by the authors in their prior work. To demonstrate the effectiveness of the proposed method, the actual imbalanced spectral data from Pluronic F-127 hydrogel and Alpha-Cyclodextrin hydrogel are used to classify the phases of data. Specifically, our approach improves 8.8%, 6.4%, and 6.2% of the performance of the existing data augmentation methods regarding the classifier's F-score, Precision, and Recall on average, respectively. Specifically, our method consists of three DNNs: the generator, discriminator, and classifier. The method generates samples that are not only authentic but emphasize the differentiation between material characteristics to provide balanced training data, improving the classification results. Based on these validated results, we expect the method's broader applications in addressing imbalanced measurement data across diverse domains in materials science and chemical engineering.
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Affiliation(s)
- Jihoon Chung
- Department of Industrial Engineering, Pusan National University, Busan, South Korea
| | - Junru Zhang
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Amirul Islam Saimon
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Yang Liu
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Blake N Johnson
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA.
| | - Zhenyu Kong
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA.
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Liu LP, Pasyar P, Liu F, Cao Q, Sandvold OF, Sahbaee P, Shinohara RT, Litt HI, Noël PB. Assessing the Stability of Photon-Counting CT: Insights from a Two-Year Longitudinal Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.05.24308046. [PMID: 38883741 PMCID: PMC11177916 DOI: 10.1101/2024.06.05.24308046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background Among the advancements in computed tomography (CT) technology, photon-counting computed tomography (PCCT) stands out as a significant innovation, providing superior spectral imaging capabilities while simultaneously reducing radiation exposure. Its long-term stability is important for clinical care, especially longitudinal studies, but is currently unknown. Purpose This study sets out to comprehensively analyze the long-term stability of a first-generation clinical PCCT scanner. Materials and Methods Over a two-year period, from November 2021 to November 2023, we conducted weekly identical experiments utilizing the same multi-energy CT protocol. These experiments included various tissue-mimicking inserts to rigorously assess the stability of Hounsfield Units (HU) and image noise in Virtual Monochromatic Images (VMIs) and iodine density maps. Throughout this period, notable software and hardware modifications were meticulously recorded. Each week, VMIs and iodine density maps were reconstructed and analyzed to evaluate quantitative stability over time. Results Spectral results consistently demonstrated the quantitative stability of PCCT. VMIs exhibited stable HU values, such as variation in relative error for VMI 70 keV measuring 0.11% and 0.30% for single-source and dual-source modes, respectively. Similarly, noise levels remained stable with slight fluctuations linked to software changes for VMI 40 and 70 keV that corresponded to changes of 8 and 1 HU, respectively. Furthermore, iodine density quantification maintained stability and showed significant improvement with software and hardware changes, especially in dual-source mode with nominal errors decreasing from 1.44 to 0.03 mg/mL. Conclusion This study provides the first long-term reproducibility assessment of quantitative PCCT imaging, highlighting its potential for the clinical arena. This study indicates its long-term utility in diagnostic radiology, especially for longitudinal studies.
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Holmes TW, Yin Z, Bujila R, Madhav P, Kim C, Maltz JS, Pourmorteza A. Ultrahigh-Resolution K-Edge Imaging of Coronary Arteries With Prototype Deep-Silicon Photon-Counting CT: Initial Results in Phantoms. Radiology 2024; 311:e231598. [PMID: 38916502 DOI: 10.1148/radiol.231598] [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: 06/26/2024]
Abstract
Background Photon-counting CT (PCCT) represents a recent advancement in CT, offering improved spatial resolution and spectral separability. By using multiple adjustable energy bins, PCCT enables K-edge imaging, allowing mixed contrast agent distinction. Deep-silicon is a new type of photon-counting detector with different characteristics compared with cadmium photon-counting detectors. Purpose To evaluate the performance of a prototype deep-Si PCCT scanner and compare it with that of a state-of-the-art dual-energy energy-integrating detector (EID) scanner in imaging coronary artery plaques enhanced with iodine and K-edge contrast agents. Materials and Methods A series of 10 three-dimensional-printed inserts (diameter, 3.5 mm) was prepared, and materials mimicking soft and calcified plaques were added to simulate stenosed coronary arteries. Inserts filled with an iodine- or gadolinium-based contrast agent (GBCA) were scanned. Virtual monoenergetic images (VMIs) and iodine maps were generated using two- and eight-energy bin data from EID CT and PCCT, respectively. Gadolinium maps were calculated for PCCT. The CT numbers of VMIs and iodine maps were compared. Spatial resolution and blooming artifacts were compared on the 70-keV VMIs in plaque-free and calcified coronary arteries. Results No evidence of a significant difference in the CT number of 70-keV images was found except in inserts containing GBCAs. In the absence of a GBCA, excellent (r > 0.99) agreement for iodine was found. PCCT could quantify the GBCA within 0.2 mg Gd/mL ± 0.8 accuracy of the ground truth, whereas EID CT failed to detect the GBCA. Lumen measurements were more accurate for PCCT than for EID CT, with mean errors of 167 versus 442 µm (P < .001) compared with the 3.5-mm ground truth. Conclusion Deep-Si PCCT demonstrated good accuracy in iodine quantification and could accurately decompose mixtures of two contrast agents. Its improved spatial resolution resulted in sharper images with blooming artifacts reduced by 50% compared with a state-of-the-art dual-energy EID CT scanner. © RSNA, 2024.
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Affiliation(s)
- Thomas Wesley Holmes
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
| | - Zhye Yin
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
| | - Robert Bujila
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
| | - Priti Madhav
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
| | - Changlyong Kim
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
| | - Jonathan S Maltz
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
| | - Amir Pourmorteza
- From the Department of Radiology and Imaging Sciences (T.W.H., A.P.) and Winship Cancer Institute (A.P.), Emory University, 1701 Uppergate Dr, Ste 5018A, Atlanta, GA 30322; GE HealthCare, Waukesha, Wis (Z.Y., R.B., P.M., C.K., J.S.M.); and Department of Biomedical Engineering, Emory University-Georgia Institute of Technology, Atlanta, Ga (A.P.)
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Leng S, Toia GV, Hoodeshenas S, Ramirez-Giraldo JC, Yagil Y, Maltz JS, Boedeker K, Li K, Baffour F, Fletcher JG. Standardizing technical parameters and terms for abdominopelvic photon-counting CT: laying the groundwork for innovation and evidence sharing. Abdom Radiol (NY) 2024:10.1007/s00261-024-04342-4. [PMID: 38769199 DOI: 10.1007/s00261-024-04342-4] [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: 03/01/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/22/2024]
Abstract
Photon-counting detector CT (PCD-CT) is a new technology that has multiple diagnostic benefits including increased spatial resolution, iodine signal, and radiation dose efficiency, as well as multi-energy imaging capability, but which also has unique challenges in abdominal imaging. The purpose of this work is to summarize key features, technical parameters, and terms, which are common amongst current abdominopelvic PCD-CT systems and to propose standardized terminology (where none exists). In addition, user-selectable protocol parameters are highlighted to facilitate both scientific evaluation and early clinical adoption. Unique features of PCD-CT systems include photon-counting detectors themselves, energy thresholds and bins, and tube potential considerations for preserved spectral separation. Key parameters for describing different PCD-CT systems are reviewed and explained. While PCD-CT can generate multi-energy images like dual-energy CT, there are new types of images such as threshold images, energy bin images, and special spectral images. The standardized terms and concepts herein build upon prior interdisciplinary consensus and have been endorsed by the newly created Society of Abdominal Radiology Photon-counting CT Emerging Technology Commission.
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Affiliation(s)
- Shuai Leng
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Giuseppe V Toia
- Departments of Radiology and Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Safa Hoodeshenas
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Yoad Yagil
- PD CT/AMI R&D Advanced Development, Philips Medical Systems, Haifa, Israel
| | - Jonathan S Maltz
- Molecular Imaging and Computed Tomography, GE Healthcare, Waukesha, WI, USA
| | | | - Ke Li
- Departments of Radiology and Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Francis Baffour
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Joel G Fletcher
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Bellin MF, Valente C, Bekdache O, Maxwell F, Balasa C, Savignac A, Meyrignac O. Update on Renal Cell Carcinoma Diagnosis with Novel Imaging Approaches. Cancers (Basel) 2024; 16:1926. [PMID: 38792005 PMCID: PMC11120239 DOI: 10.3390/cancers16101926] [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: 03/21/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
This review highlights recent advances in renal cell carcinoma (RCC) imaging. It begins with dual-energy computed tomography (DECT), which has demonstrated a high diagnostic accuracy in the evaluation of renal masses. Several studies have suggested the potential benefits of iodine quantification, particularly for distinguishing low-attenuation, true enhancing solid masses from hyperdense cysts. By determining whether or not a renal mass is present, DECT could avoid the need for additional imaging studies, thereby reducing healthcare costs. DECT can also provide virtual unenhanced images, helping to reduce radiation exposure. The review then provides an update focusing on the advantages of multiparametric magnetic resonance (MR) imaging performance in the histological subtyping of RCC and in the differentiation of benign from malignant renal masses. A proposed standardized stepwise reading of images helps to identify clear cell RCC and papillary RCC with a high accuracy. Contrast-enhanced ultrasound may represent a promising diagnostic tool for the characterization of solid and cystic renal masses. Several combined pharmaceutical imaging strategies using both sestamibi and PSMA offer new opportunities in the diagnosis and staging of RCC, but their role in risk stratification needs to be evaluated. Although radiomics and tumor texture analysis are hampered by poor reproducibility and need standardization, they show promise in identifying new biomarkers for predicting tumor histology, clinical outcomes, overall survival, and the response to therapy. They have a wide range of potential applications but are still in the research phase. Artificial intelligence (AI) has shown encouraging results in tumor classification, grade, and prognosis. It is expected to play an important role in assessing the treatment response and advancing personalized medicine. The review then focuses on recently updated algorithms and guidelines. The Bosniak classification version 2019 incorporates MRI, precisely defines previously vague imaging terms, and allows a greater proportion of masses to be placed in lower-risk classes. Recent studies have reported an improved specificity of the higher-risk categories and better inter-reader agreement. The clear cell likelihood score, which adds standardization to the characterization of solid renal masses on MRI, has been validated in recent studies with high interobserver agreement. Finally, the review discusses the key imaging implications of the 2017 AUA guidelines for renal masses and localized renal cancer.
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Affiliation(s)
- Marie-France Bellin
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
- Faculté de Médecine, University of Paris-Saclay, 63 Rue Gabriel Péri, 94276 Le Kremlin-Bicêtre, France
- BioMaps, UMR1281 INSERM, CEA, CNRS, University of Paris-Saclay, 94805 Villejuif, France
| | - Catarina Valente
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
| | - Omar Bekdache
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
| | - Florian Maxwell
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
| | - Cristina Balasa
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
| | - Alexia Savignac
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
| | - Olivier Meyrignac
- Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; (C.V.); (O.B.); (F.M.); (A.S.); (O.M.)
- Faculté de Médecine, University of Paris-Saclay, 63 Rue Gabriel Péri, 94276 Le Kremlin-Bicêtre, France
- BioMaps, UMR1281 INSERM, CEA, CNRS, University of Paris-Saclay, 94805 Villejuif, France
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Gennari AG, Rossi A, De Cecco CN, van Assen M, Sartoretti T, Giannopoulos AA, Schwyzer M, Huellner MW, Messerli M. Artificial intelligence in coronary artery calcium score: rationale, different approaches, and outcomes. Int J Cardiovasc Imaging 2024; 40:951-966. [PMID: 38700819 PMCID: PMC11147943 DOI: 10.1007/s10554-024-03080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/09/2024] [Indexed: 06/05/2024]
Abstract
Almost 35 years after its introduction, coronary artery calcium score (CACS) not only survived technological advances but became one of the cornerstones of contemporary cardiovascular imaging. Its simplicity and quantitative nature established it as one of the most robust approaches for atherosclerotic cardiovascular disease risk stratification in primary prevention and a powerful tool to guide therapeutic choices. Groundbreaking advances in computational models and computer power translated into a surge of artificial intelligence (AI)-based approaches directly or indirectly linked to CACS analysis. This review aims to provide essential knowledge on the AI-based techniques currently applied to CACS, setting the stage for a holistic analysis of the use of these techniques in coronary artery calcium imaging. While the focus of the review will be detailing the evidence, strengths, and limitations of end-to-end CACS algorithms in electrocardiography-gated and non-gated scans, the current role of deep-learning image reconstructions, segmentation techniques, and combined applications such as simultaneous coronary artery calcium and pulmonary nodule segmentation, will also be discussed.
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Affiliation(s)
- Antonio G Gennari
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Alexia Rossi
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
- Translational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Emory University, Atlanta, GA, USA
| | - Marly van Assen
- Translational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Emory University, Atlanta, GA, USA
| | - Thomas Sartoretti
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
| | - Moritz Schwyzer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland.
- University of Zurich, Zurich, Switzerland.
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10
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Lacaita PG, Luger A, Troger F, Widmann G, Feuchtner GM. Photon-Counting Detector Computed Tomography (PCD-CT): A New Era for Cardiovascular Imaging? Current Status and Future Outlooks. J Cardiovasc Dev Dis 2024; 11:127. [PMID: 38667745 PMCID: PMC11050624 DOI: 10.3390/jcdd11040127] [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: 03/31/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Photon-counting detector computed tomography (PCD-CT) represents a revolutionary new generation of computed tomography (CT) for the imaging of patients with cardiovascular diseases. Since its commercial market introduction in 2021, numerous studies have identified advantages of this new technology in the field of cardiovascular imaging, including improved image quality due to an enhanced contrast-to-noise ratio, superior spatial resolution, reduced artifacts, and a reduced radiation dose. The aim of this narrative review was to discuss the current scientific literature, and to find answers to the question of whether PCD-CT has yet led to a true step-change and significant progress in cardiovascular imaging.
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Affiliation(s)
| | | | | | | | - Gudrun M. Feuchtner
- Department Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria; (P.G.L.); (A.L.); (F.T.); (G.W.)
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11
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Tárnoki ÁD, Tárnoki DL, Dąbrowska M, Knetki-Wróblewska M, Frille A, Stubbs H, Blyth KG, Juul AD. New developments in the imaging of lung cancer. Breathe (Sheff) 2024; 20:230176. [PMID: 38595936 PMCID: PMC11003524 DOI: 10.1183/20734735.0176-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/25/2024] [Indexed: 04/11/2024] Open
Abstract
Radiological and nuclear medicine methods play a fundamental role in the diagnosis and staging of patients with lung cancer. Imaging is essential in the detection, characterisation, staging and follow-up of lung cancer. Due to the increasing evidence, low-dose chest computed tomography (CT) screening for the early detection of lung cancer is being introduced to the clinical routine in several countries. Radiomics and radiogenomics are emerging fields reliant on artificial intelligence to improve diagnosis and personalised risk stratification. Ultrasound- and CT-guided interventions are minimally invasive methods for the diagnosis and treatment of pulmonary malignancies. In this review, we put more emphasis on the new developments in the imaging of lung cancer.
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Affiliation(s)
- Ádám Domonkos Tárnoki
- Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- National Tumour Biology Laboratory, Oncologic Imaging and Invasive Diagnostic Centre, National Institute of Oncology, Budapest, Hungary
| | - Dávid László Tárnoki
- Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- National Tumour Biology Laboratory, Oncologic Imaging and Invasive Diagnostic Centre, National Institute of Oncology, Budapest, Hungary
| | - Marta Dąbrowska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | | | - Armin Frille
- Department of Respiratory Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Harrison Stubbs
- Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Kevin G. Blyth
- Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
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12
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Rajiah PS, Alkadhi H, Van Mieghem NM, Budde RPJ. Utility of Photon Counting CT in Transcatheter Structural Heart Disease Interventions. Semin Roentgenol 2024; 59:32-43. [PMID: 38388095 DOI: 10.1053/j.ro.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 02/24/2024]
Affiliation(s)
| | - Hatem Alkadhi
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicolas M Van Mieghem
- Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus University Medical Center, 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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13
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Goodman L, Baruah D. Lung Nodules Attached to the Pleura: Insights from Lung Cancer Screening. Radiology 2024; 310:e233290. [PMID: 38165248 DOI: 10.1148/radiol.233290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Lawrence Goodman
- From the Department of Radiology, Pulmonary Medicine and Intensive Care, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226 (L.G.); and Department of Radiology, Divisions of Thoracic and Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Dhiraj Baruah
- From the Department of Radiology, Pulmonary Medicine and Intensive Care, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226 (L.G.); and Department of Radiology, Divisions of Thoracic and Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC (D.B.)
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