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Greffier J, Faby S, Pastor M, Frandon J, Erath J, Beregi JP, Dabli D. Comparison of the spectral performance between two dual-source CT systems on low-energy virtual monoenergetic images: A phantom study. Phys Med 2024; 124:103429. [PMID: 39024963 DOI: 10.1016/j.ejmp.2024.103429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/01/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024] Open
Abstract
PURPOSE To compare the spectral performance of two different DSCT (DSCT-Pulse and DSCT-Force) on virtual monoenergetic images (VMIs) at low energy levels. METHODS An image quality phantom was scanned on the two DSCTs at three dose levels: 11/6/1.8 mGy. Level 3 of an advanced modeled iterative reconstruction algorithm was used. Noise power spectrum and task-based transfer function were computed on VMIs from 40 to 70 keV to assess noise magnitude and noise texture (fav) and spatial resolution (f50). A detectability index (d') was computed to assess the detection of one contrast-enhanced abdominal lesion as a function of the keV level used. RESULTS For all dose levels and all energy levels, noise magnitude was significantly higher (p < 0.05) with DSCT-Pulse than with DSCT-Force (12.6 ± 2.7 % at 1.8 mGy, 9.1 ± 2.9 % at 6 mGy and 4.0 ± 2.7 % at 11 mGy). For all energy levels, fav values were significantly higher (p < 0.05) with DSCT-Pulse than with DSCT-Force at 1.8 mGy (4.8 ± 3.9 %) and at 6 mGy (5.5 ± 2.5 %) but similar at 11 mGy (0.2 ± 3.6 %; p = 0.518). For all energy levels, f50 values were significantly higher with DSCT-Pulse than with DSCT-Force (12.7 ± 5.6 % at 1.8 mGy, 17.9 ± 4.5 % at 6 mGy and 13.1 ± 2.6 % at 11 mGy). For all keV, similar d' values were found with both DSCT-Force and DSCT-Pulse at 11 mGy (-1.0 ± 3.1 %; p = 0.084). For other dose levels, d' values were significantly lower with DSCT-Pulse than with DSCT-Force (9.1 ± 3.2 % at 1.8 mGy and -6.3 ± 3.9 % at 6 mGy). CONCLUSION Compared with the DSCT-Force, the DSCT-Pulse improved noise texture and spatial resolution, but noise magnitude was slightly higher and detectability slightly lower, particularly when the dose level was reduced.
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Affiliation(s)
- Joël Greffier
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France.
| | - Sebastian Faby
- Department of Computed Tomography, Siemens Healthineers AG, Siemensstr. 3, 91301 Forchheim, Germany
| | - Maxime Pastor
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France
| | - Julien Frandon
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France
| | - Julien Erath
- Department of Computed Tomography, Siemens Healthineers AG, Siemensstr. 3, 91301 Forchheim, Germany
| | - Jean-Paul Beregi
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France
| | - Djamel Dabli
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France
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Abu-Omar A, Murray N, Ali IT, Khosa F, Barrett S, Sheikh A, Nicolaou S, Tamburrini S, Iacobellis F, Sica G, Granata V, Saba L, Masala S, Scaglione M. Utility of Dual-Energy Computed Tomography in Clinical Conundra. Diagnostics (Basel) 2024; 14:775. [PMID: 38611688 PMCID: PMC11012177 DOI: 10.3390/diagnostics14070775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Advancing medical technology revolutionizes our ability to diagnose various disease processes. Conventional Single-Energy Computed Tomography (SECT) has multiple inherent limitations for providing definite diagnoses in certain clinical contexts. Dual-Energy Computed Tomography (DECT) has been in use since 2006 and has constantly evolved providing various applications to assist radiologists in reaching certain diagnoses SECT is rather unable to identify. DECT may also complement the role of SECT by supporting radiologists to confidently make diagnoses in certain clinically challenging scenarios. In this review article, we briefly describe the principles of X-ray attenuation. We detail principles for DECT and describe multiple systems associated with this technology. We describe various DECT techniques and algorithms including virtual monoenergetic imaging (VMI), virtual non-contrast (VNC) imaging, Iodine quantification techniques including Iodine overlay map (IOM), and two- and three-material decomposition algorithms that can be utilized to demonstrate a multitude of pathologies. Lastly, we provide our readers commentary on examples pertaining to the practical implementation of DECT's diverse techniques in the Gastrointestinal, Genitourinary, Biliary, Musculoskeletal, and Neuroradiology systems.
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Affiliation(s)
- Ahmad Abu-Omar
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Nicolas Murray
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Ismail T. Ali
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Faisal Khosa
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Sarah Barrett
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Adnan Sheikh
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Savvas Nicolaou
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Stefania Tamburrini
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, A. Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy;
| | - Giacomo Sica
- Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy;
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS Di Napoli, 80131 Naples, Italy
| | - Luca Saba
- Medical Oncology Department, AOU Cagliari, Policlinico Di Monserrato (CA), 09042 Monserrato, Italy
| | - Salvatore Masala
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy; (S.M.)
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy; (S.M.)
- Department of Radiology, Pineta Grande Hospital, 81030 Castel Volturno, Italy
- Department of Radiology, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK
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Greffier J, Faby S, Pastor M, Frandon J, Erath J, Beregi JP, Dabli D. Comparison of low-energy virtual monoenergetic images between photon-counting CT and energy-integrating detectors CT: A phantom study. Diagn Interv Imaging 2024:S2211-5684(24)00044-5. [PMID: 38429207 DOI: 10.1016/j.diii.2024.02.009] [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: 02/07/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE The purpose of this study was to assess image quality and dose level using a photon-counting CT (PCCT) scanner by comparison with a dual-source CT (DSCT) scanner on virtual monoenergetic images (VMIs) at low energy levels. MATERIALS AND METHODS A phantom was scanned using a DSCT and a PCCT with a volume CT dose index of 11 mGy, and additionally at 6 mGy and 1.8 mGy for PCCT. Noise power spectrum and task-based transfer function were evaluated from 40 to 70 keV on VMIs to assess noise magnitude and noise texture (fav) and spatial resolution on two iodine inserts (f50), respectively. A detectability index (d') was computed to assess the detection of two contrast-enhanced lesions according to the energy level used. RESULTS For all energy levels, noise magnitude values were lower with PCCT than with DSCT at 11 and 6 mGy, but greater at 1.8 mGy. fav values were higher with PCCT than with DSCT at 11 mGy (8.6 ± 1.5 [standard deviation [SD]%), similar at 6 mGy (1.6 ± 1.5 [SD]%) and lower at 1.8 mGy (-17.8 ± 2.2 [SD]%). For both inserts, f50 values were higher with PCCT than DSCT at 11- and 6 mGy for all keV levels, except at 6 mGy and 40 keV. d' values were higher with PCCT than with DSCT at 11- and 6 mGy for all keV and both simulated lesions. Similar d' values to those of the DSCT at 11 mGy, were obtained at 2.25 mGy for iodine insert at 2 mg/mL and at 0.96 mGy for iodine insert at 4 mg/mL at 40 keV. CONCLUSION Compared to DSCT, PCCT reduces noise magnitude and improves noise texture, spatial resolution and detectability on VMIs for all low-keV levels.
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Affiliation(s)
- Joël Greffier
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30029 Nîmes, France.
| | - Sebastian Faby
- Department of Computed Tomography, Siemens Healthineers AG, 91301 Forchheim, Germany
| | - Maxime Pastor
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30029 Nîmes, France
| | - Julien Frandon
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30029 Nîmes, France
| | - Julien Erath
- Department of Computed Tomography, Siemens Healthineers AG, 91301 Forchheim, Germany
| | - Jean Paul Beregi
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30029 Nîmes, France
| | - Djamel Dabli
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30029 Nîmes, France
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Abu-Omar A, Murray N, Ali IT, Khosa F, Barrett S, Sheikh A, Nicolaou S, O'Neill SB. The Role of Dual-Energy CT in Solid Organ Injury. Can Assoc Radiol J 2023:8465371231215669. [PMID: 38146203 DOI: 10.1177/08465371231215669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
The liver, spleen, and kidneys are the commonest injured solid organs in blunt and penetrating trauma. The American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) is the most widely accepted system for categorizing traumatic injuries. Grading systems allow clear communication of findings between clinical teams and assign a measurable severity of injury, which directly correlates with morbidity and mortality. The 2018 revised AAST OIS emphasizes reliance on CT for accurate grading; in particular regarding vascular injuries. Dual-Energy CT (DECT) has emerged as a promising tool with multiple clinical applications already demonstrated. In this review article, we summarize the basic principles of CT attenuation to refresh the minds of our readers and we scrutinize DECT's technology as opposed to conventional Single-Energy CT (SECT). This is followed by outlining the benefits of various DECT postprocessing techniques, which authors of this article refer to as the 3Ms (Mapping of Iodine, Material decomposition, and Monoenergetic virtual imaging), in aiding radiologists to confidently assign an OIS as well as problem solve complex injury patterns. In addition, a thorough discussion of changes to the revised AAST OIS focusing on definitions of key terms used in reporting injuries is described.
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Affiliation(s)
- Ahmad Abu-Omar
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Nicolas Murray
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Ismail T Ali
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Faisal Khosa
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Sarah Barrett
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Adnan Sheikh
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Savvas Nicolaou
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada
| | - Siobhán B O'Neill
- Department of Radiology, University of Alberta, University of Alberta Hospital, Edmonton, AB, Canada
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Lietz P, Brüntgens M, Wang-Leandro A, Volk HA, Meller S, Merhof K. Virtual non-contrast images of detector-based spectral computed tomography in dogs: a promising alternative to true non-contrast images in veterinary medicine. Front Vet Sci 2023; 10:1251535. [PMID: 38105773 PMCID: PMC10722308 DOI: 10.3389/fvets.2023.1251535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/19/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction In veterinary medicine, abdominal computer tomographic (CT) examinations regularly require a minimum of two scans, with a native scan (true unenhanced, TUE) as a reference for the subsequent contrast-enhanced CT scan (CECT). Spectral detector CT (SDCT) offers the possibility to calculate virtual non-contrast (VNC) images from the post-contrast scan, but this has not yet been investigated in veterinary medicine. The purpose of this study was to assess the reliability of VNC images for abdominal organs in 44 dogs without abdominal pathologies by evaluating their quantitative and qualitative parameters compared to TUE images. We hypothesized that the subtraction of iodine is sufficient in the VNC series compared to the TUE series and that the image quality of the SDCT series is superior to conventional CT images. Methods Corresponding attenuation values in the VNC and TUE series regarding the regions of interest (ROI) in different parenchymal organs and major vessels of the abdominal cavity were assessed by means of a two one-sided t-test (TOST) and Bland-Altman plots. Additionally, the signal-to-noise ratio (SNR) was calculated for each ROI in the different series. In the second step, two board-certified veterinary radiologists made a qualitative assessment of VNC images vs. TUE images in consensus by rating the iodine subtraction, image noise, and image quality of VNC images based on a specific 5-point Likert scale. Results The difference in corresponding Hounsfield units (HUs) between TUE and VNC images was less than 10 HU in 78.67% of all ROIs. Regarding the limit of less than 10 HU, in the performed TOST, significant p-values of < 0.05 were reached for the liver, spleen, pancreas, and musculature, implying equivalence of both modalities. The quality of spectral base image (SBI) data was rated equivalent to calculated conventional images in the subjective assessment by reaching an average Likert scale score of 3.2 points. Discussion VNC images calculated from SDCT data prove a valid alternative to conventional TUE images in the abdominal organs of canine patients without abdominal pathology. VNC offers the possibility to reduce time under general anesthesia and minimize radiation exposure. Future studies are needed to prove the application of this method in clinically diseased patients.
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Kazimierczak W, Kazimierczak N, Lemanowicz A, Nowak E, Migdalski A, Jawien A, Jankowski T, Serafin Z. Improved Detection of Endoleaks in Virtual Monoenergetic Images in Dual-Energy CT Angiography Following EVAR. Acad Radiol 2023; 30:2813-2824. [PMID: 37062628 DOI: 10.1016/j.acra.2023.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES The objective of this prospective study was to evaluate the virtual monoenergetic images (VMI) and virtual noncontrast (VNC) phase in the detection of endoleaks after endovascular abdominal aortic repair (EVAR). The potential dose reduction of abbreviated examination protocols was calculated. MATERIALS AND METHODS Ninety-seven patients after the EVAR procedure were enrolled in this study. An initial single-source noncontrast acquisition was followed by two dual-energy acquisitions (arterial and 60 s delayed). Fast-kVp switching scanner was used. VNC images were reconstructed from the delayed phase. First examination session (reference) included a full triphasic study protocol consisting of true noncontrast (TNC) images and two postcontrast phases, the latter ones presented as classical polyenergetic reconstructions. Reading sessions II and III were performed by two independent and blinded readers evaluating VMIs in abbreviated protocols-biphasic (VNC + arterial, delayed phase), monophasic (VNC + delayed phase). The diagnostic accuracy of sessions II and III was calculated. RESULTS The calculated sensitivity of the biphasic protocol with the use of VMIs in endoleak detection was 100%, with a statistically significant increase in the number of endoleaks detected in comparison with the reference study. The monophasic protocol showed 83.33% sensitivity. The use of abbreviated examination protocols led to a decrease in the mean effective dose (ED) of 23.28% (biphasic protocol) and 61.37% (monophasic protocol). CONCLUSION The use of VMIs increases the number of endoleaks diagnosed with a possible radiation reduction by up to ¼ (biphasic protocol). Further reduction to a monophasic protocol leads to over 60% dose reduction but with a decrease in diagnostic accuracy.
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Affiliation(s)
- Wojciech Kazimierczak
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, Bydgoszcz, Poland 85-067.
| | | | - Adam Lemanowicz
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, Bydgoszcz, Poland 85-067
| | - Ewa Nowak
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, Bydgoszcz, Poland 85-067
| | - Arkadiusz Migdalski
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, Bydgoszcz, Poland 85-067
| | - Arkadiusz Jawien
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, Bydgoszcz, Poland 85-067
| | | | - Zbigniew Serafin
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, Bydgoszcz, Poland 85-067
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Chu B, Gan L, Shen Y, Song J, Liu L, Li J, Liu B. A Deep Learning Image Reconstruction Algorithm for Improving Image Quality and Hepatic Lesion Detectability in Abdominal Dual-Energy Computed Tomography: Preliminary Results. J Digit Imaging 2023; 36:2347-2355. [PMID: 37580484 PMCID: PMC10584787 DOI: 10.1007/s10278-023-00893-y] [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: 06/29/2023] [Revised: 06/29/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
This study aimed to compare the performance of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASIR-V) in improving image quality and diagnostic performance using virtual monochromatic spectral images in abdominal dual-energy computed tomography (DECT). Sixty-two patients [mean age ± standard deviation (SD): 56 years ± 13; 30 men] who underwent abdominal DECT were prospectively included in this study. The 70-keV DECT images in the portal phase were reconstructed at 5-mm and 1.25-mm slice thicknesses with 40% ASIR-V (ASIR-V40%) and at 1.25-mm slice with deep learning image reconstruction at medium (DLIR-M) and high (DLIR-H) levels and then compared. Computed tomography (CT) attenuation, SD values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured in the liver, spleen, erector spinae, and intramuscular fat. The lesions in each reconstruction group at 1.25-mm slice thickness were counted. The image quality and diagnostic confidence were subjectively evaluated by two radiologists using a 5-point scale. For the 1.25-mm images, DLIR-M and DLIR-H had lower SD, higher SNR and CNR, and better subjective image quality compared with ASIR-V40%; DLIR-H performed the best (all P values < 0.001). Furthermore, the 1.25-mm DLIR-H images had similar SD, SNR, and CNR values as the 5-mm ASIR-V40% images (all P > 0.05). Three image groups had similar lesion detection rates, but DLIR groups exhibited higher confidence in diagnosing lesions. Compared with ASIR-V40% at 70 keV, 70-keV DECT with DLIR-H further reduced image noise and improved image quality. Additionally, it improved diagnostic confidence while ensuring a consistent lesion detection rate of liver lesions.
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Affiliation(s)
- Bingqian Chu
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Heifei 230022, People's Republic of China
| | - Lu Gan
- Department of Radiology, Huainan Oriental Guangji Hospital, Huainan 232101, People's Republic of China
| | - Yi Shen
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Heifei 230022, People's Republic of China
| | - Jian Song
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Heifei 230022, People's Republic of China
| | - Ling Liu
- CT Research Center, GE Healthcare China, Shanghai 210000, People's Republic of China
| | - Jianying Li
- CT Research Center, GE Healthcare China, Shanghai 210000, People's Republic of China
| | - Bin Liu
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Heifei 230022, People's Republic of China.
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Nehra AK, Dane B, Yeh BM, Fletcher JG, Leng S, Mileto A. Dual-Energy, Spectral and Photon Counting Computed Tomography for Evaluation of the Gastrointestinal Tract. Radiol Clin North Am 2023; 61:1031-1049. [PMID: 37758355 DOI: 10.1016/j.rcl.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The use of dual-energy computed tomography (CT) allows for reconstruction of energy- and material-specific image series. The combination of low-energy monochromatic images, iodine maps, and virtual unenhanced images can improve lesion detection and disease characterization in the gastrointestinal tract in comparison with single-energy CT.
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Affiliation(s)
- Avinash K Nehra
- Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Bari Dane
- Department of Radiology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - Benjamin M Yeh
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Joel G Fletcher
- Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Achille Mileto
- Department of Radiology, Virginia Mason Medical Center, 1100 9th Avenue, Seattle, WA 98101, USA
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Kazimierczak W, Nowak E, Kazimierczak N, Jankowski T, Jankowska A, Serafin Z. The value of metal artifact reduction and iterative algorithms in dual energy CT angiography in patients after complex endovascular aortic aneurysm repair. Heliyon 2023; 9:e20700. [PMID: 37876478 PMCID: PMC10590777 DOI: 10.1016/j.heliyon.2023.e20700] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open
Abstract
Rationale and objectives Evaluation of the diagnostic value of linearly blended (LB) and virtual monoenergetic images (VMI) reconstruction techniques with and without metal artifacts reduction (MAR) and of adaptive statistical iterative reconstructions (ASIR) in the assessment of target vessels after branched/fenestrated endovascular aortic repair (f/brEVAR) procedures. Materials and methods CT scans of 28 patients were used in this study. Arterial phase of examination was obtained using a dual-energy fast-kVp switching scanner. CT numbers in the aorta, celiac trunk, superior mesenteric artery, and renal arteries were measured in the following reconstructions: LB, VMI 60 keV, VMI MAR 60 keV, VMI ASIR 60 % 60 keV. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were calculated for each reconstruction. Luminal diameters (measurements at 2 levels of stent) and subjective image quality (5-point Likert scale) were assessed (2 readers, blinded to the type of reconstruction). Results The highest mean values of CNR and SNR in vascular structures were obtained in VMI MAR 60 keV (CNR 12.526 ± 2.46, SNR 17.398 ± 2.52), lower in VMI 60 keV (CNR 11.508 ± 2.01, SNR 16.524 ± 2.07) and VMI ASIR (CNR 11.086 ± 1.78, SNR 15.928 ± 1.82), and the lowest in LB (CNR 6.808 ± 0.79, SNR 11.492 ± 0.79) reconstructions. There were no statistically significant differences in the measurements of the stent width between reconstructions (p > 0.05). The highest subjective image quality was obtained in the ASIR VMI (4.25 ± 0.44) and the lowest in the MAR VMI (1.57 ± 0.5) reconstruction. Conclusion Despite obtaining the highest values of SNR and CNR in the MAR VMI reconstruction, the subjective diagnostic value was the lowest for this technique due to significant artifacts. The type of reconstruction did not significantly affect vessel diameter measurements (p > 0.05). Iterative reconstructions raised both objective and subjective image quality.
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Affiliation(s)
- Wojciech Kazimierczak
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067, Bydgoszcz, Poland
- University Hospital No 1 in Bydgoszcz, Marii Skłodowskiej – Curie 9, 85-094, Bydgoszcz, Poland
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009, Bydgoszcz, Poland
| | - Ewa Nowak
- University Hospital No 1 in Bydgoszcz, Marii Skłodowskiej – Curie 9, 85-094, Bydgoszcz, Poland
| | - Natalia Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009, Bydgoszcz, Poland
| | - Tomasz Jankowski
- Jankowscy Private Dental Practice, Czerwonego Krzyża 24, 68-200, Żary, Poland
| | - Agnieszka Jankowska
- Jankowscy Private Dental Practice, Czerwonego Krzyża 24, 68-200, Żary, Poland
| | - Zbigniew Serafin
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067, Bydgoszcz, Poland
- University Hospital No 1 in Bydgoszcz, Marii Skłodowskiej – Curie 9, 85-094, Bydgoszcz, Poland
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Shaish H, Ream J, Huang C, Troost J, Gaur S, Chung R, Kim S, Patel H, Newhouse JH, Khalatbari S, Davenport MS. Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. JAMA Surg 2023; 158:e231112. [PMID: 37133836 PMCID: PMC10157504 DOI: 10.1001/jamasurg.2023.1112] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/04/2023] [Indexed: 05/04/2023]
Abstract
Importance Intravenous (IV) contrast medium is sometimes withheld due to risk of complication or lack of availability in patients undergoing computed tomography (CT) for abdominal pain. The risk from withholding contrast medium is understudied. Objective To determine the diagnostic accuracy of unenhanced abdominopelvic CT using contemporaneous contrast-enhanced CT as the reference standard in emergency department (ED) patients with acute abdominal pain. Design, Setting, and Participants This was an institutional review board-approved, multicenter retrospective diagnostic accuracy study of 201 consecutive adult ED patients who underwent dual-energy contrast-enhanced CT for the evaluation of acute abdominal pain from April 1, 2017, through April 22, 2017. Three blinded radiologists interpreted these scans to establish the reference standard by majority rule. IV and oral contrast media were then digitally subtracted using dual-energy techniques. Six different blinded radiologists from 3 institutions (3 specialist faculty and 3 residents) interpreted the resulting unenhanced CT examinations. Participants included a consecutive sample of ED patients with abdominal pain who underwent dual-energy CT. Exposure Contrast-enhanced and virtual unenhanced CT derived from dual-energy CT. Main outcome Diagnostic accuracy of unenhanced CT for primary (ie, principal cause[s] of pain) and actionable secondary (ie, incidental findings requiring management) diagnoses. The Gwet interrater agreement coefficient was calculated. Results There were 201 included patients (female, 108; male, 93) with a mean age of 50.1 (SD, 20.9) years and mean BMI of 25.5 (SD, 5.4). Overall accuracy of unenhanced CT was 70% (faculty, 68% to 74%; residents, 69% to 70%). Faculty had higher accuracy than residents for primary diagnoses (82% vs 76%; adjusted odds ratio [OR], 1.83; 95% CI, 1.26-2.67; P = .002) but lower accuracy for actionable secondary diagnoses (87% vs 90%; OR, 0.57; 95% CI, 0.35-0.93; P < .001). This was because faculty made fewer false-negative primary diagnoses (38% vs 62%; OR, 0.23; 95% CI, 0.13-0.41; P < .001) but more false-positive actionable secondary diagnoses (63% vs 37%; OR, 2.11, 95% CI, 1.26-3.54; P = .01). False-negative (19%) and false-positive (14%) results were common. Interrater agreement for overall accuracy was moderate (Gwet agreement coefficient, 0.58). Conclusion Unenhanced CT was approximately 30% less accurate than contrast-enhanced CT for evaluating abdominal pain in the ED. This should be balanced with the risk of administering contrast material to patients with risk factors for kidney injury or hypersensitivity reaction.
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Affiliation(s)
- Hiram Shaish
- Department of Radiology, Columbia University, New York, New York
| | - Justin Ream
- Department of Radiology, Cleveland Clinic, Cleveland, Ohio
| | - Chenchan Huang
- Department of Radiology, New York University Langone, New York
| | - Jonathan Troost
- Michigan Institute for Clinical and Translational Research, Ann Arbor
| | - Sonia Gaur
- Department of Radiology, Michigan Medicine, Ann Arbor
| | - Ryan Chung
- Department of Radiology, Massachusetts General Hospital, Boston
| | - Sooah Kim
- Department of Radiology, New York University Langone, New York
| | - Hanisha Patel
- Department of Radiology, Columbia University, New York, New York
| | | | | | - Matthew S. Davenport
- Department of Radiology and Urology, Michigan Medicine, Ann Arbor
- Michigan Radiology Quality Collaborative, Michigan Medicine, Ann Arbor
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Alizzi Z, Gogbashian A, Karteris E, Hall M. Development of a dual energy CT based model to assess response to treatment in patients with high grade serous ovarian cancer: a pilot cohort study. Cancer Imaging 2023; 23:62. [PMID: 37322564 DOI: 10.1186/s40644-023-00579-2] [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: 03/16/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND In patients with cancer, the current gold standard for assessing response to treatment involves measuring cancer lesions on computed tomography (CT) imaging. The percentage change in size of specific lesions determines whether patients have had a complete/partial response or progressive disease, according to RECIST criteria. Dual Energy CT (DECT) permits additional measurements of iodine concentration, a surrogate marker of vascularity. Here we explore the role of changes in iodine concentration within cancer tissue on CT scans to assess its suitability for determining treatment response in patients with high grade serous ovarian cancer (HGSOC). METHODS Suitable RECIST measurable lesions were identified from the CT images of HGSOC patients, taken at 2 different time points (pre and post treatment). Changes in size and iodine concentration were measured for each lesion. PR/SD were classified as responders, PD was classified as non-responder. Radiological responses were correlated with clinical and CA125 outcomes. RESULTS 62 patients had appropriate imaging for assessment. 22 were excluded as they only had one DECT scan. 32/40 patients assessed (113 lesions) had received treatment for relapsed HGSOC. RECIST and GCIG (Gynaecologic Cancer Inter Group) CA125 criteria / clinical assessment of response for patients was correlated with changes in iodine concentration, before and after treatment. The prediction of median progression free survival was significantly better associated with changes in iodine concentration (p = 0.0001) and GCIG Ca125 / clinical assessment (p = 0.0028) in comparison to RECIST criteria (p = 0.43). CONCLUSION Changes in iodine concentration from dual energy CT imaging may be more suitable than RECIST in assessing response to treatment in patients with HGSOC. TRIAL REGISTRATION CICATRIx IRAS number 198179, 14 Dec 2015, https://www.myresearchproject.org.uk/ .
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Affiliation(s)
- Zena Alizzi
- Mount Vernon Cancer Centre, Rickmansworth Road, HA6 2RN, Northwood Middx, England
- Brunel University London, Kingston Lane, UB3 8PH, Uxbridge, England
| | - Andrew Gogbashian
- Paul Strickland Scanner Centre, Rickmansworth Road, HA6 2RN, Northwood, Middlesex, England
| | | | - Marcia Hall
- Mount Vernon Cancer Centre, Rickmansworth Road, HA6 2RN, Northwood Middx, England.
- Brunel University London, Kingston Lane, UB3 8PH, Uxbridge, England.
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Arico' FM, Trimarchi R, Portaluri A, Barilla' C, Migliaccio N, Bucolo GM, Cicero G, Sofia C, Booz C, Vogl TJ, Marino MA, Ascenti V, D'Angelo T, Mazziotti S, Ascenti G. Virtual monoenergetic dual-layer dual-energy CT images in colorectal cancer: CT diagnosis could be improved? LA RADIOLOGIA MEDICA 2023:10.1007/s11547-023-01663-0. [PMID: 37310558 DOI: 10.1007/s11547-023-01663-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE To compare conventional CT images and virtual monoenergetic images (VMI) at dual-layer dual-energy CT (dlDECT) in patients with colorectal cancer (CRC) through quantitative analysis and to investigate the added value of VMI. MATERIAL AND METHODS Sixty-six consecutive patients with histologically documented CRC and available VMI reconstructions were retrospectively investigated. Subsequently, forty-two patients, without any colonic disease at colonoscopy, were selected as control group. Conventional CT images and VMI reconstructions at energy levels ranging from 40 (VMI40) to 100 keV (VMI100) in 10 keV increments, were obtained from the late arterial phase. First, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were obtained to select the best VMI reconstruction. Finally, the diagnostic accuracy of conventional CT and VMI40 in late arterial phase was evaluated. RESULTS On quantitative analysis, SNR and CNR were higher for VMI40 (19.5 ± 7.7 and 11.8 ± 6.2, respectively) with statistically significant differences compared to conventional CT (P < 0.05) and all the other VMI reconstructions (P < 0.05), except for VMI50 (P > 0.05). The addition of VMI40 to conventional CT images significantly improved the area under the curve (AUC) for the diagnosis of CRC, increasing it from 0.875 to 0.943 for reader 1 (P < 0.05) and from 0.916 to 0.954 for reader 2 (P < 0.05). The improvement was greater in the less experienced radiologist (0.068) compared to the more experienced one (0.037). CONCLUSION VMI40 has showed the highest quantitative image parameters. Furthermore, the use of VMI40 can lead to a significant improvement in the diagnostic performance for detecting CRC.
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Affiliation(s)
- Francesco Marcello Arico'
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Renato Trimarchi
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy.
| | - Antonio Portaluri
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Claudia Barilla'
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Nicola Migliaccio
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Giuseppe Mauro Bucolo
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Giuseppe Cicero
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Thomas J Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Maria Adele Marino
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Velio Ascenti
- Postgraduate School of Radiodiagnostics, Policlinico Universitario, University of Milan, Milan, Italy
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
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Guerrini S, Bagnacci G, Perrella A, Meglio ND, Sica C, Mazzei MA. Dual Energy CT in Oncology: Benefits for Both Patients and Radiologists From an Emerging Quantitative and Functional Diagnostic Technique. Semin Ultrasound CT MR 2023; 44:205-213. [PMID: 37245885 DOI: 10.1053/j.sult.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Dual-energy CT (DECT) imaging makes it possible to identify the characteristics of materials that cannot be recognized with conventional single-energy CT (SECT). In the postprocessing study phase, virtual monochromatic images and virtual-non-contrast (VNC) images, also permits reduction of dose exposure by eliminating the precontrast acquisition scan. Moreover, in virtual monochromatic images, the iodine contrast increases when the energy level decreases resulting in better visualization of hypervascular lesions and in a better tissue contrast between hypovascular lesions and the surrounding parenchyma; thus, allowing for reduction of required iodinate contrast material, especially important in patients with renal impairment. All these advantages are particularly important in oncology, providing the possibility of overcoming many SECT imaging limits and making CT examinations safer and more feasible in critical patients. This review explores the basis of DECT imaging and its utility in routine oncologic clinical practice, with particular attention to the benefits of this technique for both the patients and the radiologists.
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Affiliation(s)
- Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
| | - Giulio Bagnacci
- Diagnostic Imaging Unit, Department of Diagnostic Imaging, Azienda USL-Toscana Sud-Est, Poggibonsi, Valdelsa, Italy
| | - Armando Perrella
- Diagnostic Imaging Unit, Department of Diagnostic Imaging, Azienda USL-Toscana Sud-Est, Grosseto, Italy
| | - Nunzia Di Meglio
- Unit of Diagnostic Imaging, Department of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Cristian Sica
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
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14
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Gruber M, Munjal V, Eaton R, Viljoen S, Grossbach A, Xu D. Letter: Arthrodesis With Titanium Implants: A Different Picture. Neurosurgery 2023; 92:e91-e92. [PMID: 36722953 DOI: 10.1227/neu.0000000000002385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 02/02/2023] Open
Affiliation(s)
- Maxwell Gruber
- Department of Pediatric Neurosurgery, Nationwide Children's Hospital, Columbus , Ohio , USA
| | - Vikas Munjal
- Department of Neurosurgery, The Ohio State University, Columbus , Ohio , USA
| | - Ryan Eaton
- Department of Neurosurgery, The Ohio State University, Columbus , Ohio , USA
| | - Stephanus Viljoen
- Department of Neurosurgery, The Ohio State University, Columbus , Ohio , USA
| | - Andrew Grossbach
- Department of Neurosurgery, The Ohio State University, Columbus , Ohio , USA
| | - David Xu
- Department of Neurosurgery, The Ohio State University, Columbus , Ohio , USA
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Agarwal A, Kumar KP, Madhusudhan KS. Utility of dual energy CT angiography in the evaluation of acute non-variceal gastrointestinal hemorrhage: comparison with digital subtraction angiography. Abdom Radiol (NY) 2023; 48:1880-1890. [PMID: 36939912 DOI: 10.1007/s00261-023-03864-7] [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: 12/11/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE To evaluate the utility of dual energy CT angiography (DECTA) in acute non-variceal gastrointestinal hemorrhage (ANVGIH) compared to digital subtraction angiography (DSA) as gold standard. MATERIALS AND METHODS 111 Patients (mean age: 39.2 years; 94 males) of ANVGIH who underwent both DECTA and DSA between January 2016 and September 2021 were included. Virtual monochromatic (VM) images at 10 keV increments from 40 to 70 keV and blended (120kVp equivalent) images of arterial phase of DECTA were evaluated independently by two readers blinded to DSA information. Quantitative analysis included measurement of attenuation in the major arteries (abdominal aorta, celiac artery, superior mesenteric artery), suspected vascular lesion, and lesion feeding artery to calculate contrast-to-noise ratios (CNRs) and signal-to-noise ratios (SNRs). Qualitative analysis assessed the image quality of each data set using a 3-point Likert scale. Findings on DSA were evaluated by a third reader and both DECTA and DSA were compared. RESULTS On linear blended images, vascular lesion was identified by reader 1 in 88 (79.3%) and by reader 2 in 87 (78.4%) patients and DSA showed lesion in 92 (82.9%) patients. The sensitivity and specificity of blended images and VM images of DECTA for lesion detection were not significantly different from each other. The CNR and SNR of arteries, vascular lesion and feeding artery were significantly higher at 70 keV (p < 0.005) compared to blended and other VM images. Although subjective scores for image quality were higher for 60 keV images by both readers, the difference was not statistically significant (p = 0.3). The interobserver agreement was mostly good. CONCLUSION In the assessment of ANVGIH, the 60 keV and 70 keV VM images improved the image quality and contrast, respectively, but there was no increase in diagnostic accuracy of VM image datasets compared to linearly blended images. Hence, the diagnostic utility of DECTA in ANVGIH is still uncertain.
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Affiliation(s)
- Ayushi Agarwal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Korukanti Pradeep Kumar
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Kumble Seetharama Madhusudhan
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
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Xu JJ, Ulriksen PS, Bjerrum CW, Achiam MP, Resch TA, Lönn L, Lindskov Hansen K. Characterizing incidental mass lesions in abdominal dual-energy CT compared to conventional contrast-enhanced CT. Acta Radiol 2023; 64:945-950. [PMID: 35918808 DOI: 10.1177/02841851221116306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Incidental findings are common in abdominal computed tomography (CT) and often warrant further investigations with economic implications as well as implications for patients. PURPOSE To evaluate the potential of dual-energy CT (DECT) in the identification and/or characterization of abdominal incidental mass lesions compared to conventional contrast-enhanced CT. MATERIAL AND METHODS This retrospective study from a major tertiary hospital included 96 patients, who underwent contrast-enhanced abdominal DECT. Incidental lesions in adrenals, kidneys, liver, and pancreas were evaluated by two board-certified abdominal radiologists. Observer 1 only had access to standard CT reconstructions, while observer 2 had access to standard CT as well as DECT reconstructions. Disagreements were resolved by consensus review and used as a reference for observers using McNemar's test. RESULTS Observers 1 and 2 identified a total of 40 and 34 findings, respectively. Furthermore, observer 1 registered 13 lesions requiring follow-up, of which seven (two renal and five adrenal lesions) were resolved following consensus review using DECT (P = 0.008). The inter-observer agreement was near perfect (κ = 0.82). CONCLUSION DECT has the potential to improve the immediate characterization of incidental findings when compared to conventional CT for abdominal imaging.
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Affiliation(s)
- Jack Junchi Xu
- Department of Diagnostic Radiology, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Sommer Ulriksen
- Department of Diagnostic Radiology, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
| | - Camilla Wium Bjerrum
- Department of Diagnostic Radiology, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
| | - Michael Patrick Achiam
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Surgical Gastroenterology, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
| | - Timothy Andrew Resch
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Vascular Surgery, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
| | - Lars Lönn
- Department of Diagnostic Radiology, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer Lindskov Hansen
- Department of Diagnostic Radiology, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Photon-Counting Computed Tomography (PCCT): Technical Background and Cardio-Vascular Applications. Diagnostics (Basel) 2023; 13:diagnostics13040645. [PMID: 36832139 PMCID: PMC9955798 DOI: 10.3390/diagnostics13040645] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/28/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Photon-counting computed tomography (PCCT) is a new advanced imaging technique that is going to transform the standard clinical use of computed tomography (CT) imaging. Photon-counting detectors resolve the number of photons and the incident X-ray energy spectrum into multiple energy bins. Compared with conventional CT technology, PCCT offers the advantages of improved spatial and contrast resolution, reduction of image noise and artifacts, reduced radiation exposure, and multi-energy/multi-parametric imaging based on the atomic properties of tissues, with the consequent possibility to use different contrast agents and improve quantitative imaging. This narrative review first briefly describes the technical principles and the benefits of photon-counting CT and then provides a synthetic outline of the current literature on its use for vascular imaging.
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18
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Yoon H, Kang Y, Kim HJ, Lee E, Ahn JM, Lee JW. Dual-layer spectral detector CT arthrography of the shoulder: assessment of image quality and value in differentiating calcium from iodine. Acta Radiol 2023; 64:638-647. [PMID: 35300534 DOI: 10.1177/02841851221087991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dual-layer spectral detector computed tomography (DLCT) may potentially improve CT arthrography through enhanced image quality and analysis of the chemical composition of tissue. PURPOSE To evaluate the image quality of monoenergetic reconstructions from DLCT arthrography of the shoulder and assess the additional diagnostic value in differentiating calcium from iodine. MATERIAL AND METHODS Images from consecutive shoulder DLCT arthrography examinations performed between December 2016 and February 2018 were retrospectively reviewed for hyperattenuating lesions within the labrum and tendons. The mean attenuation of the target lesion, noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of the virtual monoenergetic images obtained at 40-200 keV were compared with conventional 140-kVp images. Two evaluators independently classified each target lesion as contrast media or calcification, without and with DLCT spectral data. Receiver operating curve (ROC) analysis was performed to assess the diagnostic performance of shoulder DLCT arthrography, without and with the aid of spectral data. RESULTS The study included 20 target lesions (18 DLCT arthrography examinations of 17 patients). The SNRs of the monoenergetic images at 40-60 keV were significantly higher than those of conventional images (P < 0.05). The CNRs of the monoenergetic images at 40-70 keV were significantly higher than those of conventional images (P < 0.001). The ability to differentiate calcium from iodine, without and with DLCT spectral data, did not significantly differ (P = 0.441 and P = 0.257 for reviewers 1 and 2, respectively). CONCLUSION DLCT had no additive value in differentiating calcium from iodine in small, hyperattenuating lesions in the labrum and tendons.
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Affiliation(s)
- Hyeyoung Yoon
- Department of Radiology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yusuhn Kang
- Department of Radiology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyo Jin Kim
- Department of Radiology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, 65633Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eugene Lee
- Department of Radiology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joong Mo Ahn
- Department of Radiology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joon Woo Lee
- Department of Radiology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Identification of Bone Mineral Density Deficit Using L1 Trabecular Attenuation by Opportunistic Multidetector CT Scan in Adult Patients. Tomography 2023; 9:150-161. [PMID: 36649000 PMCID: PMC9844499 DOI: 10.3390/tomography9010013] [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: 10/19/2022] [Revised: 11/30/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Multidetector computer tomography (CT) has been used to diagnose pathologies such as osteoporosis via opportunistic screening, where the assessment of the bone structure and the measurement of bone mineral density (BMD) are of great relevance. PURPOSE To construct reference BMD values based on the measurement of the attenuation of the L1 vertebral body by multidetector CT scan (in the soft tissue and bone windows) in adult patients and to establish normative ranges by sex and age of BMD values. MATERIALS AND METHODS A retrospective cross-sectional study of 5080 patients who underwent multidetector CT scan between January and December 2021. Adult patients (≥18 years) with non-contrast multidetector CT scan of the abdomen or thorax-abdomen at a voltage 120 kV. The attenuation of the L1 vertebral body in Hounsfield units (HU) in both windows were compared using the Mann-Whitney U-test with α = 0.05. Additionally, the quartiles of the BMD were constructed (in both windows) grouped by sex and age. RESULTS Only 454 (51.30 ± 15.89 years, 243 women) patients met the inclusion criteria. There is no difference in BMD values between windows (soft tissue: 163.90 ± 57.13, bone: 161.86 ± 55.80, p = 0.625), mean L1 attenuation decreased linearly with age at a rate of 2 HU per year, and the presence of BMD deficit among patients was high; 152 of 454 (33.48%) patients presented BMD values suggestive of osteoporosis, and of these, approximately half 70 of 454 (15.42%) corresponded to patients with BMD values suggestive of a high risk of osteoporotic fracture. CONCLUSIONS From clinical practice, the bone mineral density (BMD) of a patient in either window below the first quartile for age- and sex-matched peers suggests a deficit in BMD that cannot be ignored and requires clinical management that enables identification of the etiology, its evolution, and the consequences of this alteration.
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CT-Net: Cascaded T-shape network using spectral redundancy for dual-energy CT limited-angle reconstruction. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Wu W, Fang X, Li J, Zhang A, Zou Y, Zheng X. Application of dual-source computed tomography in the diagnosis of thyroid cancer and evaluation of biological behaviors. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:195-202. [PMID: 36539919 DOI: 10.1002/jcu.23413] [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: 09/23/2022] [Revised: 11/23/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Thyroid cancer (TC) is an extremely prevailing malignant endocrine tumor. Therefore, effective diagnostic tools are necessary. This study explored the application value of dual-source computed tomography (DSCT) in TC diagnosis and biological behavior assessment. METHODS This study retrospectively selected 68 TC patients and another 74 benign patients with thyroid adenoma, nodular goiter, or adenomatous hyperplasia. All patients were confirmed by pathological examination and underwent DSCT examination. The iodine concentration (IC) obtained from plain computed tomography (CT) scanning and normalized iodine concentration (NIC) in the arterial phase and venous phase were recorded. The positive expression rates of estrogen receptor alpha (ERα), estrogen receptors beta (ERβ), and Ki67 in pathological tissues were determined by immunohistochemistry, and their correlation with IC in plain CT was assessed by Pearson correlation analysis, respectively. The diagnostic values of IC in plain CT and venous phase NIC in TC patients were evaluated using the receiver operating characteristic curve. RESULTS Malignant patients had lower IC in plain DSCT scanning, venous phase NIC, and ERβ, and higher ERα and Ki67 than benign patients. IC level in plain DSCT scanning was inversely-correlated with ERα and Ki-67 positive expression rates, but positively-related to ERβ to different degrees. For the diagnosis of TC patients, the AUC of IC level in plain DSCT was 0.771, with a cut-off value of 1.250 (97.06% sensitivity and 41.89% specificity), and the AUC of venous phase NIC was 0.738, with a cut-off value of 0.825 (100% sensitivity and 43.24% specificity). CONCLUSION The IC level obtained from DSCT scanning could assist in the differential diagnosis of malignant and benign thyroid nodules and evaluation of biological behaviors.
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Affiliation(s)
- Wenhui Wu
- Department of Radiology, Dongguan People's Hospital, Dongguan, China
| | - Xuewen Fang
- Department of Radiology, Dongguan People's Hospital, Dongguan, China
| | - Jianming Li
- Department of Radiology, Dongguan People's Hospital, Dongguan, China
| | - An Zhang
- Department of Radiology, Dongguan People's Hospital, Dongguan, China
| | - Yujian Zou
- Department of Radiology, Dongguan People's Hospital, Dongguan, China
| | - Xiaolin Zheng
- Department of Radiology, Kanghua Hospital, Dongguan, China
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22
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Lim CY, Min JH, Hwang JA, Choi SY, Ko SE. Assessment of main pancreatic duct cutoff with dilatation, but without visible pancreatic focal lesion on MDCT: a novel diagnostic approach for malignant stricture using a CT-based nomogram. Eur Radiol 2022; 32:8285-8295. [PMID: 35726102 DOI: 10.1007/s00330-022-08928-8] [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: 01/26/2022] [Revised: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To identify useful features to predict hidden pancreatic malignancies in patients with main pancreatic duct (MPD) abrupt cutoff and dilatation, but without visible focal pancreatic lesions on CT. METHODS This retrospective study included 92 patients (mean age, 63.4 ± 10.6 years, 63 men and 29 women) with MPD abrupt cutoff and dilatation, but without visible focal pancreatic lesion on contrast-enhanced CT between 2009 and 2021. Two radiologists independently evaluated the CT imaging features. Multivariable logistic regression analysis was performed to identify clinical and CT imaging features for hidden pancreatic malignancies. A nomogram was developed based on these results and assessed its performance. RESULTS Thirty-eight (41.3%) and 54 (58.7%) were classified into the malignant and benign groups, respectively. In the multivariable analysis, CA19-9 elevation (odds ratio [OR] 7.5, p = 0.003), duct cutoff site at the head/neck (OR 7.6, p = 0.006), parenchymal contour abnormality at the duct cutoff site (OR 13.7, p < 0.001), and presence of acute pancreatitis (OR 11.5, p = 0.005) were independent predictors of pancreatic malignancy. A combination of any two significant features showed an accuracy of 77.2%, and a combination of any three features exhibited a specificity of 100%. The CT-based nomogram showed an area under the curve (AUC) of 0.84 (95% confidence interval, 0.77-0.90). CONCLUSIONS The three CT imaging features and CA19-9 elevation translated into a nomogram permit a reliable estimation of hidden pancreatic malignancies in patients with MPD abrupt cutoff without visible focal pancreatic lesion. It may facilitate determining whether to proceed to further diagnostic tests. KEY POINTS • Isoattenuating pancreatic ductal adenocarcinoma can manifest only as an isolated main pancreatic duct (MPD) dilatation with abrupt cutoff, making it difficult to distinguish from benign strictures. • Along with the serum CA 19-9 elevation, MPD cutoff site at the pancreas head or neck, parenchymal contour abnormality at the duct cutoff site, and associated acute pancreatitis indicated a higher probability of the malignant MPD strictures. • The CT-based nomogram provided excellent diagnostic performance (AUC of 0.84) for hidden pancreatic malignancies in patients with MPD abrupt cutoff and dilatation.
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Affiliation(s)
- Chae Young Lim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Ji Hye Min
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Jeong Ah Hwang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Seo-Youn Choi
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Seong Eun Ko
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea
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23
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“All-in-one” window/level whole-body computed tomography scan – A faster way to evaluate trauma cases. Am J Emerg Med 2022; 62:62-68. [DOI: 10.1016/j.ajem.2022.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 11/27/2022] Open
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Son K, Kim D, Lee S. Improving the Accuracy of the Effective Atomic Number (EAN) and Relative Electron Density (RED) with Stoichiometric Calibration on PCD-CT Images. SENSORS (BASEL, SWITZERLAND) 2022; 22:9220. [PMID: 36501922 PMCID: PMC9738673 DOI: 10.3390/s22239220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
The photon counting detector (PCD) in computed tomography (CT) can count the number of incoming photons in order to obtain energy information for photons corresponding to user-defined thresholds. Research on the extraction of effective atomic number (EAN) and relative electron density (RED) using dual-energy CT (DECT) is currently underway. This study proposes a method for improving EAN and RED accuracy of tissue-equivalent materials by using PCD-CT-based stoichiometric calibration. After obtaining DECT images in energy bin (EB) and full spectrum (FS) modes for eight tissue-equivalent materials, the EAN was calculated with stoichiometric calibration. Using the EAN image, the RED image was acquired to evaluate the accuracy. The errors of both EAN and RED obtained with EB were within 4%. In particular, the accuracy of RED was higher than that of the FS method. Study results indicate that PCD-CT contributes to improving EAN and RED accuracy. Further studies will be aimed at reducing ring artifacts by pixel-correcting PCD images and improving stopping power ratio (SPR) measurements for dose calculation in particle therapy.
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Affiliation(s)
- Kihong Son
- Medical Information Research Section, Electronics and Telecommunications Research Institute, Daejeon 34129, Republic of Korea
| | - Daehong Kim
- Department of Radiological Science, Eulji University, Seongnam 13135, Republic of Korea
| | - Sooyeul Lee
- Medical Information Research Section, Electronics and Telecommunications Research Institute, Daejeon 34129, Republic of Korea
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25
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Greffier J, Villani N, Defez D, Dabli D, Si-Mohamed S. Spectral CT imaging: Technical principles of dual-energy CT and multi-energy photon-counting CT. Diagn Interv Imaging 2022; 104:167-177. [PMID: 36414506 DOI: 10.1016/j.diii.2022.11.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022]
Abstract
Spectral computed tomography (CT) imaging encompasses a unique generation of CT systems based on a simple principle that makes use of the energy-dependent information present in CT images. Over the past two decades this principle has been expanded with the introduction of dual-energy CT systems. The first generation of spectral CT systems, represented either by dual-source or dual-layer technology, opened up a new imaging approach in the radiology community with their ability to overcome the limitations of tissue characterization encountered with conventional CT. Its expansion worldwide can also be considered as an important leverage for the recent groundbreaking technology based on a new chain of detection available on photon counting CT systems, which holds great promise for extending CT towards multi-energy CT imaging. The purpose of this article was to detail the basic principles and techniques of spectral CT with a particular emphasis on the newest technical developments of dual-energy and multi-energy CT systems.
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Li Y, Younis MH, Wang H, Zhang J, Cai W, Ni D. Spectral computed tomography with inorganic nanomaterials: State-of-the-art. Adv Drug Deliv Rev 2022; 189:114524. [PMID: 36058350 PMCID: PMC9664656 DOI: 10.1016/j.addr.2022.114524] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/09/2022] [Accepted: 08/27/2022] [Indexed: 01/24/2023]
Abstract
Recently, spectral computed tomography (CT) technology has received great interest in the field of radiology. Spectral CT imaging utilizes the distinct, energy-dependent X-ray absorption properties of substances in order to provide additional imaging information. Dual-energy CT and multi-energy CT (Spectral CT) are capable of constructing monochromatic energy images, material separation images, energy spectrum curves, constructing effective atomic number maps, and more. However, poor contrast, due to neighboring X-ray attenuation of organs and tissues, is still a challenge to spectral CT. Hence, contrast agents (CAs) are applied for better differentiation of a given region of interest (ROI). Currently, many different kinds of inorganic nanoparticulate CAs for spectral CT have been developed due to the limitations of clinical iodine (I)-based contrast media, leading to the conclusion that inorganic nanomedicine applied to spectral CT will be a powerful collaboration both in basic research and in clinics. In this review, the underlying principles and types of spectral CT techniques are discussed, and some evolving clinical diagnosis applications of spectral CT techniques are introduced. In particular, recent developments in inorganic CAs used for spectral CT are summarized. Finally, the challenges and future developments of inorganic nanomedicine in spectral CT are briefly discussed.
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Affiliation(s)
- Yuhan Li
- School of Medicine, Shanghai University, No. 99 Shangda Rd, Shanghai 200444, PR China
| | - Muhsin H Younis
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, WI 53705, United States
| | - Han Wang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Rd, Shanghai 200025, PR China
| | - Jian Zhang
- School of Medicine, Shanghai University, No. 99 Shangda Rd, Shanghai 200444, PR China; Shanghai Universal Medical Imaging Diagnostic Center, Bldg 8, No. 406 Guilin Rd, Shanghai 200233, PR China.
| | - Weibo Cai
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, WI 53705, United States.
| | - Dalong Ni
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Rd, Shanghai 200025, PR China.
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Comprehensive analysis of the results of surgical treatment of patients with degenerative diseases of the lumbar spine using rigid fixation systems. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.4.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction. According to the literature, the development of adjacent-level syndrome 10 years after posterior rigid stabilization is noted in 6.7–80 % of patients, of which 24 % require revision surgery.The aim: to conduct a comprehensive analysis of the results of surgical treatment of patients with degenerative diseases of the lumbar spine using rigid fixation systems.Materials and methods. A multicenter retrospective study of the results of surgical treatment of 268 patients with degenerative-dystrophic diseases of the lumbar spine, who underwent mono- or bisegmental decompression-stabilizing intervention with the implementation of the TLIF (Transforaminal Lumbar Interbody Fusion) technique and open transpedicular rigid fixation, was conducted. The study included radiography, MRI and CT (in 2-energy mode) of intervertebral discs and isolated facet degeneration of the upper adjacent level.Results and discussion. The combination of the initial degeneration of the adjacent spinal motion segment in the form of disc degeneration of grade III and higher according to Pfirrmann with threshold values of the density of the outer cartilaginous plate from 161.7 ± 18.8 to 164.8 ± 14.2 HU, the density of the outer facet – from 702.43 ± 12.3 to 713.65 ± 13.6 HU and the density of the inner facet – from 580.5 ± 11.6 to 582.1 ± 15.1 HU, as well as with signs of segmental instability of the adjacent segment can be considered as risk factors for the development of its degeneration. With the progression of degeneration of the upper intervertebral disc, revision interventions were performed within 12–60 months after surgery.Conclusion. Bisegmental stabilization with signs of initial degeneration in the intervertebral disc and facet joints in the upper segment has proven its clinical and instrumental effectiveness in the period of 36 months and reduces the risks of developing degenerative disease of the adjacent disc.
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Iodine Images in Dual-energy CT: Detection of Hepatic Steatosis by Quantitative Iodine Concentration Values. J Digit Imaging 2022; 35:1738-1747. [PMID: 35879495 DOI: 10.1007/s10278-022-00682-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 07/04/2022] [Accepted: 07/12/2022] [Indexed: 10/16/2022] Open
Abstract
Hepatic steatosis is a common condition and an early manifestation of a systemic metabolic syndrome. As of today, there is no broadly accepted method for the diagnosis of hepatic steatosis in contrast-enhanced CT images. This retrospective study evaluates the potential of quantitative iodine values in portal venous phase iodine images in dual-energy CT (DECT) by measuring iodine concentrations in regions of interest (ROI) and analyzing the absolute iodine concentration of the liver parenchyma as well as three different blood-normalized iodine concentrations in a study cohort of 251 patients. An independent two sample t-test (p < 0.05) was used to compare the iodine concentrations of healthy and fatty liver. Diagnostic performance was assessed by ROC (receiver operating characteristic) curve analysis. The results showed significant differences between the average iodine concentration of healthy and fatty liver parenchyma for the absolute and for the blood-normalized iodine concentrations. The study concludes that the iodine uptake of the liver parenchyma is impaired by hepatic steatosis, and that the measurement of iodine concentration can provide a suitable method for the detection of hepatic steatosis in quantitative iodine images. Suitable thresholds of quantitative iodine concentration values for the diagnosis of hepatic steatosis are provided.
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Chun M, Choi JH, Kim S, Ahn C, Kim JH. Fully automated image quality evaluation on patient CT: Multi-vendor and multi-reconstruction study. PLoS One 2022; 17:e0271724. [PMID: 35857804 PMCID: PMC9299323 DOI: 10.1371/journal.pone.0271724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/06/2022] [Indexed: 12/21/2022] Open
Abstract
While the recent advancements of computed tomography (CT) technology have contributed in reducing radiation dose and image noise, an objective evaluation of image quality in patient scans has not yet been established. In this study, we present a patient-specific CT image quality evaluation method that includes fully automated measurements of noise level, structure sharpness, and alteration of structure. This study used the CT images of 120 patients from four different CT scanners reconstructed with three types of algorithm: filtered back projection (FBP), vendor-specific iterative reconstruction (IR), and a vendor-agnostic deep learning model (DLM, ClariCT.AI, ClariPi Inc.). The structure coherence feature (SCF) was used to divide an image into the homogeneous (RH) and structure edge (RS) regions, which in turn were used to localize the regions of interests (ROIs) for subsequent analysis of image quality indices. The noise level was calculated by averaging the standard deviations from five randomly selected ROIs on RH, and the mean SCFs on RS was used to estimate the structure sharpness. The structure alteration was defined by the standard deviation ratio between RS and RH on the subtraction image between FBP and IR or DLM, in which lower structure alterations indicate successful noise reduction without degradation of structure details. The estimated structure sharpness showed a high correlation of 0.793 with manually measured edge slopes. Compared to FBP, IR and DLM showed 34.38% and 51.30% noise reduction, 2.87% and 0.59% lower structure sharpness, and 2.20% and -12.03% structure alteration, respectively, on an average. DLM showed statistically superior performance to IR in all three image quality metrics. This study is expected to contribute to enhance the CT protocol optimization process by allowing a high throughput and quantitative image quality evaluation during the introduction or adjustment of lower-dose CT protocol into routine practice.
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Affiliation(s)
- Minsoo Chun
- Department of Radiation Oncology, Chung-Ang University Gwang Myeong Hospital, Gyeonggi-do, Republic of Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jin Hwa Choi
- Department of Radiation Oncology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sihwan Kim
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Chulkyun Ahn
- Department of Transdisciplinary Studies, Program in Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- ClariPi Research, Seoul, Republic of Korea
| | - Jong Hyo Kim
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- Department of Transdisciplinary Studies, Program in Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- ClariPi Research, Seoul, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Center for Medical-IT Convergence Technology Research, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
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Beck S, Jahn L, Deniffel D, Riederer I, Sauter A, Makowski MR, Pfeiffer D. Iodine images in dual energy CT: A monocentric study benchmarking quantitative iodine concentration values of the healthy liver. PLoS One 2022; 17:e0270805. [PMID: 35834594 PMCID: PMC9282453 DOI: 10.1371/journal.pone.0270805] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 06/17/2022] [Indexed: 12/01/2022] Open
Abstract
Dual energy computed tomography (DECT) allows the quantification of specific materials such as iodine contrast agent in human body tissue, potentially providing additional diagnostic data. Yet full diagnostic value can only be achieved if physiological normal values for iodine concentrations are known. We retrospectively evaluated abdominal DECT scans of 105 patients with healthy liver between March and August 2018 (age 17 to 86 years, 43 female and 62 male). The iodine concentrations within ROIs of the liver parenchyma as well as of the abdominal aorta and main portal vein were obtained. We evaluated the absolute iodine concentration and blood-normalized iodine concentrations relating the measured iodine concentration of the liver parenchyma to those of the supplying vessels. The influence of age and gender on the iodine uptake was assessed. The absolute iodine concentration was significantly different for the male and female cohort, but the difference was eliminated by the blood-normalized values. The average blood-normalized iodine concentrations were 2.107 mg/ml (+/- 0.322 mg/ml), 2.125 mg/ml (+/- 0.426 mg/ml) and 2.103 mg/ml (+/- 0.317 mg/ml) for the portal vein normalized, aorta normalized and mixed blood normalized iodine concentrations, respectively. A significant negative correlation between the patients’ age and the iodine concentration was detected only for the blood-normalized values. A physiological range for iodine concentration in portal venous phase contrast enhanced DECT images can be defined for absolute and blood-normalized values. Deviations of blood-normalized iodine concentration values might be a robust biomarker for diagnostic evaluation. Patient age but not the gender influences the blood-normalized iodine concentrations in healthy liver parenchyma.
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Affiliation(s)
- Stefanie Beck
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
- * E-mail:
| | - Laurenz Jahn
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Dominik Deniffel
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Isabelle Riederer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Marcus R. Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
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Gomes MJ, Manakkal JM. Photon-Counting Detectors in Computed Tomography: A Review. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1749180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractPhoton-counting computed tomography (CT) is a new technique that has the potential to revolutionize clinical CT and is predicted to be the next significant advancement. In recent years, tremendous research has been conducted to demonstrate the developments in hardware assembly and its working principles. The articles in this review were obtained by conducting a search of the MEDLINE database. Photon-counting detectors (PCDs) provide excellent quality diagnostic images with high spatial resolution, reduced noise, artifacts, increased contrast-to-noise ratio, and multienergy data acquisition as compared with conventionally used energy-integrating detector (EID). The search covered articles published between 2011 and 2021. The title and abstract of each article were reviewed as determined by the search strategy. From these, eligible studies and articles that provided the working and clinical application of PCDs were selected. This article aims to provide a systematic review of the basic working principles of PCDs, emphasize the uses and clinical applications of PCDs, and compare it to EIDs. It provides a nonmathematical explanation and understanding of photon-counting CT systems for radiologists as well as clinicians.
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Affiliation(s)
- Muriel Jeremia Gomes
- Department of Radiodiagnosis and Imaging, Medical Imaging Technology, KS Hegde Medical Academy, Mangalore, Karnataka, India
| | - Jaseemudheen M Manakkal
- Department of Radiodiagnosis and Imaging, Medical Imaging Technology, KS Hegde Medical Academy, Mangalore, Karnataka, India
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Hepatobiliary Dual-Energy Computed Tomography. Radiol Clin North Am 2022; 60:731-743. [DOI: 10.1016/j.rcl.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Pichotka M. Photon-Counting Detektoren - ein Quantensprung für die Computertomographie? Z Med Phys 2022; 32:257-259. [PMID: 35688673 PMCID: PMC9948821 DOI: 10.1016/j.zemedi.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Farr KP, Moses D, Haghighi KS, Phillips PA, Hillenbrand CM, Chua BH. Imaging Modalities for Early Detection of Pancreatic Cancer: Current State and Future Research Opportunities. Cancers (Basel) 2022; 14:cancers14102539. [PMID: 35626142 PMCID: PMC9139708 DOI: 10.3390/cancers14102539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary While survival rates for many cancers have improved dramatically over the last 20 years, patients with pancreatic cancer have persistently poor outcomes. The majority of patients with pancreatic cancer are not suitable for potentially curative surgery due to locally advanced or metastatic disease stage at diagnosis. Therefore, early detection would potentially improve survival of pancreatic cancer patients through earlier intervention. Here, we present clinical challenges in the early detection of pancreatic cancer, characterise high risk groups for pancreatic cancer and current screening programs in high-risk individuals. The aim of this scoping review is to investigate the role of both established and novel imaging modalities for early detection of pancreatic cancer. Furthermore, we investigate innovative imaging techniques for early detection of pancreatic cancer, but its widespread application requires further investigation and potentially a combination with other non-invasive biomarkers. Abstract Pancreatic cancer, one of the most lethal malignancies, is increasing in incidence. While survival rates for many cancers have improved dramatically over the last 20 years, people with pancreatic cancer have persistently poor outcomes. Potential cure for pancreatic cancer involves surgical resection and adjuvant therapy. However, approximately 85% of patients diagnosed with pancreatic cancer are not suitable for potentially curative therapy due to locally advanced or metastatic disease stage. Because of this stark survival contrast, any improvement in early detection would likely significantly improve survival of patients with pancreatic cancer through earlier intervention. This comprehensive scoping review describes the current evidence on groups at high risk for developing pancreatic cancer, including individuals with inherited predisposition, pancreatic cystic lesions, diabetes, and pancreatitis. We review the current roles of imaging modalities focusing on early detection of pancreatic cancer. Additionally, we propose the use of advanced imaging modalities to identify early, potentially curable pancreatic cancer in high-risk cohorts. We discuss innovative imaging techniques for early detection of pancreatic cancer, but its widespread application requires further investigation and potentially a combination with other non-invasive biomarkers.
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Affiliation(s)
- Katherina P. Farr
- School of Clinical Medicine, Faculty of Medicine & Health, UNSW, Sydney, NSW 2052, Australia; (K.S.H.); (B.H.C.)
- Correspondence:
| | - Daniel Moses
- Graduate School of Biomedical Engineering, UNSW, Sydney, NSW 2052, Australia;
| | - Koroush S. Haghighi
- School of Clinical Medicine, Faculty of Medicine & Health, UNSW, Sydney, NSW 2052, Australia; (K.S.H.); (B.H.C.)
- Department of General Surgery, Prince of Wales Hospital, Sydney, NSW 2052, Australia
| | - Phoebe A. Phillips
- Pancreatic Cancer Translational Research Group, School of Clinical Medicine, Lowy Cancer Research Centre, UNSW, Sydney, NSW 2052, Australia;
| | - Claudia M. Hillenbrand
- Research Imaging NSW, Division of Research & Enterprise, UNSW, Sydney, NSW 2052, Australia;
| | - Boon H. Chua
- School of Clinical Medicine, Faculty of Medicine & Health, UNSW, Sydney, NSW 2052, Australia; (K.S.H.); (B.H.C.)
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW 2052, Australia
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Dual-energy CT of acute bowel ischemia. Abdom Radiol (NY) 2022; 47:1660-1683. [PMID: 34191075 DOI: 10.1007/s00261-021-03188-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 12/17/2022]
Abstract
Acute bowel ischemia is a condition with high mortality and requires rapid intervention to avoid catastrophic outcomes. Swift and accurate imaging diagnosis is essential because clinical findings are commonly nonspecific. Conventional contrast enhanced CT of the abdomen has been the imaging modality of choice to evaluate suspected acute bowel ischemia. However, subtlety of image findings and lack of non-contrast or arterial phase images can make correct diagnosis challenging. Dual-energy CT provides valuable information toward assessing bowel ischemia. Dual-energy CT exploits the differential X-ray attenuation at two different photon energy levels to characterize the composition of tissues and reveal the presence or absence of faint intravenous iodinated contrast to improve reader confidence in detecting subtle bowel wall enhancement. With the same underlying technique, virtual non-contrast images can help to show non-enhancing hyperdense hemorrhage of the bowel wall in intravenous contrast-enhanced scans without the need to acquire actual non-contrast scans. Dual-energy CT derived low photon energy (keV) virtual monoenergetic images emphasize iodine contrast and provide CT angiography-like images from portal venous phase scans to better evaluate abdominal arterial patency. In Summary, dual-energy CT aids diagnosing acute bowel ischemia in multiple ways, including improving visualization of the bowel wall and mesenteric vasculature, revealing intramural hemorrhage in contrast enhanced scans, or possibly reducing intravenous contrast dose.
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Andreou C, Weissleder R, Kircher MF. Multiplexed imaging in oncology. Nat Biomed Eng 2022; 6:527-540. [PMID: 35624151 DOI: 10.1038/s41551-022-00891-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 09/06/2021] [Indexed: 01/24/2023]
Abstract
In oncology, technologies for clinical molecular imaging are used to diagnose patients, establish the efficacy of treatments and monitor the recurrence of disease. Multiplexed methods increase the number of disease-specific biomarkers that can be detected simultaneously, such as the overexpression of oncogenic proteins, aberrant metabolite uptake and anomalous blood perfusion. The quantitative localization of each biomarker could considerably increase the specificity and the accuracy of technologies for clinical molecular imaging to facilitate granular diagnoses, patient stratification and earlier assessments of the responses to administered therapeutics. In this Review, we discuss established techniques for multiplexed imaging and the most promising emerging multiplexing technologies applied to the imaging of isolated tissues and cells and to non-invasive whole-body imaging. We also highlight advances in radiology that have been made possible by multiplexed imaging.
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Affiliation(s)
- Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Electrical and Computer Engineering, University of Cyprus, Nicosia, Cyprus
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Systems Biology, Harvard Medical School, Boston, MA, USA.
| | - Moritz F Kircher
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, NY, USA.,Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Bicci E, Mastrorosato M, Danti G, Lattavo L, Bertelli E, Cozzi D, Pradella S, Agostini S, Miele V. Dual-Energy CT applications in urinary tract cancers: an update. TUMORI JOURNAL 2022; 109:148-156. [PMID: 35442120 DOI: 10.1177/03008916221088883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Urothelial tumours are the fourth most common cancer in the world and account for the majority of tumours involving the bladder. The symptom that often leads to diagnosis is the presence of haematuria. Diagnosis is made by cystoscopy, which is currently the gold standard in bladder cancer. Computed tomography (CT) performed with pre- and post-contrastographic phases is essential in order to assess the loco-regional and distant extension of disease. The diagnosis and staging of upper tract urothelial cancer (UTUC) are best done with computed tomography urography and flexible ureteroscopy (URS). In the acquisition protocol of this type of tumour, a urographic phase is mandatory, which allows for an accurate diagnostic assessment of the renal pelvis, ureter and bladder, especially in papillary forms. The use of multiple acquisition phases, especially in this type of patient who will have to perform follow-up CTs, leads to the problem of overexposure to ionising radiation, as well as the frequent administration of iodinated contrast medium. For this reason, in recent year, the focus has been put on advanced technologies such as dual-energy CT (DECT), that is a method that can offer some advantages for both radiologist and patient, in the diagnosis of cancer and, in particular, urinary tract disease.
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Affiliation(s)
- Eleonora Bicci
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | | | - Ginevra Danti
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Lorenzo Lattavo
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Elena Bertelli
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Diletta Cozzi
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Silvia Pradella
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Simone Agostini
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Florence, Italy
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Yu CH, Zhang RP, Yang XT, Yang Z, Xin L, Zhao ZZ, Wang J, Wang LX. Dual-energy CT perfusion imaging for differentiating invasive thymomas, thymic carcinomas, and lymphomas in adults. Clin Radiol 2022; 77:e417-e424. [PMID: 35365296 DOI: 10.1016/j.crad.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the role of dual-energy computed tomography perfusion (DECTP) imaging in differentiating invasive thymomas (ITs), thymic cancers (TCs), and lymphomas in adults. MATERIALS AND METHODS Ninety-five patients with solid masses in the prevascular mediastinum who underwent DECTP examinations were enrolled in this study. The perfusion parameters (blood flow, BF; blood volume, BV; mean transit time, MTT; permeability surface, PS) and spectral parameters (water concentration, WC; iodine concentration, IC; normalised iodine concentration, NIC; the slope of spectral radiodensity [Hounsfield units] curve, λHU) of the lesions were analysed. RESULTS There were no differences in the MTT or WC values among ITs, TCs, and lymphomas (all p>0.05). The IC, NIC, and λHU values in the optimal arterial and venous phases and PS values of TCs were higher than those of ITs and lymphomas (all p<0.05), and there were no differences between ITs and lymphomas (all p>0.05). The BF and BV values of lymphomas were lower than those of ITs and TCs (all p<0.05), and there were no differences between ITs and TCs (all p>0.05). The cut-off values for BF and BV used to differentiate lymphomas from ITs and TCs were 42.83 ml/min/100 g and 4.66 ml/100 g, respectively (area under the receiver operating characteristic curve: 0.847 and 0.839; sensitivity, 80.6% and 82.1%; specificity, 75% and 71.4%; accuracy, 78.9% and 81.1%). CONCLUSIONS The perfusion and spectral parameters of DECTP imaging help to identify ITs, TCs, and lymphomas, and BF and BV values help to differentiate lymphomas from ITs and TCs.
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Affiliation(s)
- C H Yu
- Department of Radiology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China
| | - R P Zhang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, PR China.
| | - X T Yang
- Department of Radiology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China.
| | - Z Yang
- Department of Radiology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China
| | - L Xin
- Department of Radiology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China
| | - Z Z Zhao
- Department of Radiology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China
| | - J Wang
- Department of Pathology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China
| | - L X Wang
- Department of Pathology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, PR China
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Odedra D, Narayanasamy S, Sabongui S, Priya S, Krishna S, Sheikh A. Dual Energy CT Physics-A Primer for the Emergency Radiologist. FRONTIERS IN RADIOLOGY 2022; 2:820430. [PMID: 37492677 PMCID: PMC10364985 DOI: 10.3389/fradi.2022.820430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/17/2022] [Indexed: 07/27/2023]
Abstract
Dual energy CT (DECT) refers to the acquisition of CT images at two energy spectra and can provide information about tissue composition beyond that obtainable by conventional CT. The attenuation of a photon beam varies depends on the atomic number and density of the attenuating material and the energy of the incoming photon beam. This differential attenuation of the beam at varying energy levels forms the basis of DECT imaging and enables separation of materials with different atomic numbers but similar CT attenuation. DECT can be used to detect and quantify materials like iodine, calcium, or uric acid. Several post-processing techniques are available to generate virtual non-contrast images, iodine maps, virtual mono-chromatic images, Mixed or weighted images and material specific images. Although initially the concept of dual energy CT was introduced in 1970, it is only over the past two decades that it has been extensively used in clinical practice owing to advances in CT hardware and post-processing capabilities. There are numerous applications of DECT in Emergency radiology including stroke imaging to differentiate intracranial hemorrhage and contrast staining, diagnosis of pulmonary embolism, characterization of incidentally detected renal and adrenal lesions, to reduce beam and metal hardening artifacts, in identification of uric acid renal stones and in the diagnosis of gout. This review article aims to provide the emergency radiologist with an overview of the physics and basic principles of dual energy CT. In addition, we discuss the types of DECT acquisition and post processing techniques including newer advances such as photon-counting CT followed by a brief discussion on the applications of DECT in Emergency radiology.
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Affiliation(s)
- Devang Odedra
- Department of Radiology, University of Toronto, Toronto, ON, Canada
| | - Sabarish Narayanasamy
- Department of Radiology, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
| | - Sandra Sabongui
- Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada
| | - Sarv Priya
- Department of Radiology, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
| | - Satheesh Krishna
- Department of Medical Imaging, Mount Sinai Hospital, and Women's College Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Adnan Sheikh
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
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Singh T, Gupta P. Role of Dual-Energy Computed Tomography in Gallbladder Disease: A Review. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2022. [DOI: 10.1055/s-0042-1743173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractGallbladder diseases are common and include a spectrum ranging from benign to cancer. Imaging plays an integral role in the diagnosis and in guiding appropriate management. While most patients with gallstone (GS) diseases can be evaluated with ultrasound, those with complicated GS disease, suspicion of cancer, or staging of cancer need additional cross-sectional imaging. Computed tomography (CT) is widely available and is often the imaging test of choice following an equivocal ultrasound or negative ultrasound in patients with unexplained symptoms. Conventional CT has limited sensitivity in detecting GS or common bile duct stones. In other scenarios, including diagnosis of acute cholecystitis (AC) and characterization of gallbladder wall thickening, an increase in accuracy using novel techniques is desirable. Dual-energy computed tomography (DECT) is increasingly incorporated into clinical practice. DECT has shown promising results in the detection of cholesterol stones that otherwise go unnoticed on conventional CT. However, its role beyond GS disease has largely been unexplored. In this review, we discuss the available literature on the DECT in biliary diseases and discuss the potential applications of this technique.
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Affiliation(s)
- Tarvinder Singh
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pankaj Gupta
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Tekin E, Tuncer K, Ozlu I, Sade R, Pirimoglu RB, Polat G. Ultra-low-dose computed tomography and its utility in wrist trauma in the emergency department. Acta Radiol 2022; 63:192-199. [PMID: 33508953 DOI: 10.1177/0284185121989958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed. PURPOSE To evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT). MATERIAL AND METHODS This is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale. RESULTS The effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group (P < 0.01). The CT images in the study group showed no significant differences in the mean image quality score between observer 1 and observer 2 (3.4 and 4.3, respectively; P = 0.58). Both observers could detect all fractures using the ULDCT images. CONCLUSION ULDCT provides high-quality images in wrist traumas while reducing the radiation dose by approximately 98% compared to SDCT without any changes in diagnostic accuracy.
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Affiliation(s)
- Erdal Tekin
- Department of Emergency Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Kutsi Tuncer
- Department of Orthopedics and Traumatology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Ibrahim Ozlu
- Department of Emergency Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Recep Sade
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
- Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, Turkey
| | | | - Gokhan Polat
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
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Assessing the progression of segmental fibrosis in chronic liver disease using extracellular volume fractions. Eur J Radiol 2021; 145:110033. [PMID: 34808581 DOI: 10.1016/j.ejrad.2021.110033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/02/2021] [Accepted: 11/12/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE To assess the segmental difference of liver fibrosis during the progression of chronic liver disease (CLD) using hepatic extracellular volume fractions (fECVs) obtained by dual-energy CT. METHODS A total of 218 patients (92 men and 126 women; mean age, 67.8 ± 11.7 years) with CLD and 85 patients (44 men and 41 women; mean age, 62.8 ± 13.7 years) without CLD as a control underwent dual-energy computed tomography (CT) of the liver (5-min equilibrium phase images). The iodine densities of the lateral, medial, anterior, and posterior segments and the aorta were measured, and fECVs were calculated. Comparisons of the fECV of each segment and for each albumin-bilirubin (ALBI) grade were then statistically analyzed. RESULTS In the control group and ALBI grades 1 and 3, no significant difference in fECV was found between each segment, whereas in ALBI grade 2, the fECVs were significantly larger in the medial and anterior than in the other segments (p < 0.001). The fECVs of the lateral and posterior segments significantly increased with higher ALBI grade (p < 0.001). The fECVs of the medial and anterior segments were significantly increased with higher ALBI grade, up to grade 2 (p < 0.001), but no significant difference was found between ALBI grades 2 and 3. CONCLUSION During the progression of CLD, fibrosis antecedently progressed in the medial and anterior segments, followed by the other liver segments.
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Editorial Comment: Vital Iodine Tumor Burden on Dual-Energy CT Outperforms Conventional CT Metrics of Response in Patients With GIST Undergoing Tyrosine Kinase Inhibitor Therapy. AJR Am J Roentgenol 2021; 218:669. [PMID: 34704464 DOI: 10.2214/ajr.21.26994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kuniwake H, Nishikawa J, Kanno I, Shimomura K. Correction of X-ray scattering in energy-resolved computed tomography imaging of 20-cm-diameter phantom. J NUCL SCI TECHNOL 2021. [DOI: 10.1080/00223131.2021.1982786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hiroya Kuniwake
- Department of Nuclear Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Junichiro Nishikawa
- Department of Nuclear Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Ikuo Kanno
- Department of Nuclear Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Kohei Shimomura
- Department of Radiological Technology, Faculty of Medical Science, Kyoto College of Medical Science, Kyoto, Japan
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The role of dual energy computed tomography in the differentiation of acute gout flares and acute calcium pyrophosphate crystal arthritis. Clin Rheumatol 2021; 41:223-233. [PMID: 34626261 PMCID: PMC8724058 DOI: 10.1007/s10067-021-05949-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/27/2022]
Abstract
Objectives To analyse the diagnostic impact of dual energy computed tomography (DECT) in acute gout flares and acute calcium pyrophosphate (CPP) crystal arthritis when compared to the gold standard of arthrocentesis with compensated polarised light microscopy. Microscopy results were also compared to musculoskeletal ultrasound (MUS), conventional radiographs, and the suspected clinical diagnosis (SCD). Methods Thirty-six patients with a suspected gout flare (n = 24) or acute CPP crystal arthritis (n = 11, n = 1 suffered from neither) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed DECT images for signs of monosodium urate crystals or calcium pyrophosphate deposition. Results Sensitivity of DECT for gout was 63% (95% CI 0.41–0.81) with a specificity of 92% (0.41–0.81) while sensitivity and specificity for acute CPP arthritis were 55% (0.23–0.83) and 92% (0.74–0.99), respectively. MUS had the highest sensitivity of all imaging modalities with 92% (0.73–0.99) and a specificity of 83% (0.52–0.98) for gout, while sensitivity and specificity for acute CPP crystal arthritis were 91% (0.59–1.00) and 92% (0.74–0.99), respectively. Conclusion DECT is an adequate non-invasive diagnostic tool for acute gout flares but might have a lower sensitivity than described by previous studies. Both MUS and SCD had higher sensitivities than DECT for acute gout flares and acute CPP crystal arthritis. Supplementary Information The online version contains supplementary material available at 10.1007/s10067-021-05949-4.
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Dual-energy CT plaque characteristics of post mortem thin-cap fibroatheroma in comparison to infarct-related culprit lesions. Heart Vessels 2021; 37:400-410. [PMID: 34608510 DOI: 10.1007/s00380-021-01942-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
Improvement of non-invasive identification of high-risk plaque may increase the preventive options of acute coronary syndrome. To describe the characteristics of thin-cap fibroatheroma (TCFA) in a post mortem model in comparison to characteristics of culprit lesions in patients with non-ST-elevation-myocardial-infarction (NSTEMI) using the dual energy computed tomography (DECT). Three post mortem hearts were prepared with iodine-contrast, inserted in a Kyoto phantom and scanned by DECT. Six TCFA were identified using histopathological analysis (cap thickness < 65 μm and necrotic core > 10% of the plaque area). In the NSTEMI group, 29 patients were scheduled to DECT prior to coronary angiography and invasive treatment. Culprit lesions were identified blinded for the patient history by two independent invasive cardiologists using the coronary angiography. The DECT analysis of TCFA and culprit lesions was performed retrospectively with determination of effective atomic number (Effective-Z), Hounsfield Unit (HU), plaque type (non-calcified, predominantly non-calcified, predominantly calcified or calcified), spotty calcification,, plaque length, plaque volume and plaque burden and the remodeling index. The Effective-Z, HU and plaqueburden were significantly different between TCFA and culprit lesions (P < 0.05).The TCFA plaques were more calcified in comparison to culprit lesions (P < 0.05). No significant difference in the other plaque characteristics was observed. The use of DECT demonstrated different Effective-Z values and different characteristics of post mortem TCFA in comparison to in vivo culprit lesions. This finding may highlight, that not all TCFA should be considered as vulnerable.
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Gaddam DS, Dattwyler M, Fleiter TR, Bodanapally UK. Principles and Applications of Dual Energy Computed Tomography in Neuroradiology. Semin Ultrasound CT MR 2021; 42:418-433. [PMID: 34537112 DOI: 10.1053/j.sult.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dual-energy computed tomography (DE CT) is a promising tool with many current and evolving applications. Available DE CT scanners usually consist of one or two tubes, or use layered detectors for spectral separation. Most DE CT scanners can be used in single energy or dual-energy mode, except for the layered detector scanners that always acquire data in dual-energy mode. However, the layered detector scanners can retrospectively integrate the data from two layers to obtain conventional single energy images. DE CT mode enables generation of virtual monochromatic images, blended images, iodine quantification, improving conspicuity of iodinated contrast enhancement, and material decomposition maps or more sophisticated quantitative analysis not possible with conventional SE CT acquisition with an acceptable or even lower dose than the SE CT. This article reviews the basic principles of dual-energy CT and highlights many of its clinical applications in the evaluation of neurological conditions.
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Affiliation(s)
- Durga Sivacharan Gaddam
- Department of Diagnostic Radiology and Nuclear Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD
| | - Matthew Dattwyler
- Department of Diagnostic Radiology and Nuclear Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD
| | - Thorsten R Fleiter
- Department of Diagnostic Radiology and Nuclear Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD
| | - Uttam K Bodanapally
- Department of Diagnostic Radiology and Nuclear Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD.
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Selvaraj S, Niyas N, Renganathan R, Ramasamy R, Anandan RR, Arunachalam VK, Cherian M. Comparison between Conventional Unenhanced and Virtual Unenhanced Imaging of Hepatopancreaticobiliary System with Third-Generation Dual-Source Dual-Energy CT—An Observational Study. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2021. [DOI: 10.1055/s-0041-1730095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Abstract
Objectives The aims of our study were to assess the comparability of conventional unenhanced images (CUIs) of hepatopancreaticobiliary system with virtual unenhanced images (VUIs) derived from arterial and portal venous phases acquired in a third-generation, dual-source, dual-energy CT (DECT), and also to assess the best dataset among these VUIs. We also calculated the radiation effective dose (ED) reduction by eliminating noncontrast acquisition.
Materials and Methods 60 patients were included in our study. Unenhanced images in single energy and contrast-enhanced images in dual-energy mode were acquired. Arterial virtual unenhanced (AVU) and portal virtual unenhanced (PVU) images were generated and compared with CUI, using both objective and subjective methods. The ED was calculated separately for each phase. Statistical significance between difference in mean attenuation values were analyzed using ANOVA and unpaired student t-test.
Results In our study, the difference in mean attenuation of liver, spleen, and pancreas between the three phases—CU, AVU, and PVU—were insignificant with p-value > 0.05. This indicates that the values were comparable. Among the VUI, AVU images were statistically superior in image quality. Elimination of noncontrast CT from triple phase abdominal imaging can achieve an average ED reduction of 39%.
Conclusions We conclude that VUI generated in third-generation, dual-source DECT has diagnostic image quality and can replace the CUI in triple-phase studies, with a mean ED reduction by 39%. The VUI obtained from arterial phase is superior to those obtained from portal venous phase.
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Affiliation(s)
- Swathigha Selvaraj
- Department of Radiology, Kovai Medical Center and Hospital, Avanashi Road, Coimbatore, India
| | - N.P. Niyas
- Department of Radiology, Kovai Medical Center and Hospital, Avanashi Road, Coimbatore, India
| | - Rupa Renganathan
- Department of Radiology, Kovai Medical Center and Hospital, Avanashi Road, Coimbatore, India
| | - Rajkumar Ramasamy
- Department of Radiology, Kovai Medical Center and Hospital, Avanashi Road, Coimbatore, India
| | - Rinoy Ram Anandan
- Department of Radiology, Kovai Medical Center and Hospital, Avanashi Road, Coimbatore, India
| | | | - Mathew Cherian
- Department of Radiology, Kovai Medical Center and Hospital, Avanashi Road, Coimbatore, India
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Basso L, Baldi D, Mannelli L, Cavaliere C, Salvatore M, Brancato V. Investigating Dual-Energy CT Post-Contrast Phases for Liver Iron Quantification: A Preliminary Study. Dose Response 2021; 19:15593258211011359. [PMID: 34121963 PMCID: PMC8173994 DOI: 10.1177/15593258211011359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/17/2021] [Accepted: 03/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background and Purpose: Quantification of hepatic virtual iron content (VIC) by using Multidetector Dual Energy Computed Tomography (DECT) has been recently investigated since this technique could offer a good compromise between accuracy and non-invasiveness for liver iron content quantification. The aim of our study is to investigate differences in VIC at different DECT time points (namely baseline and arterial, venous and tardive phases), identifying the most reliable and also exploring the underlying temporal trend of these values. Materials and Methods: Eleven patients who underwent DECT examination and were characterized by low liver fat content were included in this retrospective study. By using the Syngo.via Frontier–DE IronVNC tool, regions of interest (ROI) were placed on the VIC images at 3 hepatic levels, both in left and right liver lobes, at each DECT time point. Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test for post-hoc analysis was performed to assess differences between DECT timepoints. Page’s L test was performed to test the temporal trend of VIC across the 4 examined timepoints. Results: For both liver lobes, Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test revealed that VIC values differed significantly when extracted from ROIs placed at the 4 different timepoints. The Page’s L test for multiple comparison revealed a significant growing trend for VIC, from baseline acquisition to the fourth and last time point post-contrast agent injection. Conclusions: The extraction of hepatic VIC in healthy subjects was found to be significantly influenced by the DECT time point chosen for the extrapolation of the VIC values.
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Bos D, König B, Blex S, Zensen S, Opitz M, Maier S, Forsting M, Zylka W, Kühl H, Wetter A, Guberina N. EXPERIMENTAL EXAMINATION OF RADIATION DOSES OF DUAL- AND SINGLE-ENERGY COMPUTED TOMOGRAPHY IN CHEST AND UPPER ABDOMEN IN A PHANTOM STUDY. RADIATION PROTECTION DOSIMETRY 2021; 193:237-246. [PMID: 33893506 DOI: 10.1093/rpd/ncab052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
The aim of this phantom study is to examine radiation doses of dual- and single-energy computed tomography (DECT and SECT) in the chest and upper abdomen for three different multi-slice CT scanners. A total of 34 CT protocols were examined with the phantom N1 LUNGMAN. Four different CT examination types of different anatomic regions were performed both in single- and dual-energy technique: chest, aorta, pulmonary arteries for suspected pulmonary embolism and liver. Radiation doses were examined for the CT dose index CTDIvol and dose-length product (DLP). Radiation doses of DECT were significantly higher than doses for SECT. In terms of CTDIvol, radiation doses were 1.1-3.2 times higher, and in terms of DLP, these were 1.1-3.8 times higher for DECT compared with SECT. The third-generation dual-source CT applied the lowest dose in 7 of 15 different examination types of different anatomic regions.
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Affiliation(s)
- Denise Bos
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
| | - Britta König
- Faculty of Physical Engineering, Westphalian University, Campus Gelsenkirchen, Neidenburger Str. 43, Gelsenkirchen 45897, Germany
| | - Sebastian Blex
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
| | - Sebastian Zensen
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
| | - Marcel Opitz
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
| | - Sandra Maier
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
| | - Waldemar Zylka
- Faculty of Physical Engineering, Westphalian University, Campus Gelsenkirchen, Neidenburger Str. 43, Gelsenkirchen 45897, Germany
| | - Hilmar Kühl
- Department of Radiology, St. Bernhard-Hospital Kamp-Lintfort GmbH, Bürgermeister-Schmelzing-Str. 90, Kamp-Lintfort 47475, Germany
| | - Axel Wetter
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
- Department of Diagnostic and Interventional Radiology, Neuroradiology, Asklepios Klinikum Harburg, Eißendorfer Pferdeweg 52, Hamburg 21075, Germany
| | - Nika Guberina
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstrasse 55, Essen 45147, Germany
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