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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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Seo JY, Joo I, Yoon JH, Kang HJ, Kim S, Kim JH, Ahn C, Lee JM. Deep learning-based reconstruction of virtual monoenergetic images of kVp-switching dual energy CT for evaluation of hypervascular liver lesions: Comparison with standard reconstruction technique. Eur J Radiol 2022; 154:110390. [PMID: 35724579 DOI: 10.1016/j.ejrad.2022.110390] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/12/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate clinical applicability of deep learning(DL)-based reconstruction of virtual monoenergetic images(VMIs) of arterial phase liver CT obtained by rapid kVp-switching dual-energy CT for evaluation of hypervascular liver lesions. MATERIALS AND METHODS We retrospectively included 109 patients who had available late arterial phase liver CT images of the liver obtained with a rapid switching kVp DECT scanner for suspicious intra-abdominal malignancies. Two VMIs of 70 keV and 40 keV were reconstructed using adaptive statistical iterative reconstruction (ASiR-V) for arterial phase scans. VMIs at 40 keV were additionally reconstructed with a vendor-agnostic DL-based reconstruction technique (ClariCT.AI, ClariPi, DL 40 keV). Qualitative, quantitative image quality and subjective diagnostic acceptability were compared according to reconstruction techniques. RESULTS In qualitative analysis, DL 40 keV images showed less image noise (4.55 vs 3.11 vs 3.95, p < 0.001), better image sharpness (4.75 vs 4.16 vs 4.3, p < 0.001), better image contrast (4.98 vs 4.72 vs 4.19, p < 0.017), better lesion conspicuity (4.61 vs 4.23 vs 3.4, p < 0.001) and diagnostic acceptability (4.59 vs 3.88 vs 4.09, p < 0.001) compared with ASiR-V 40 keV or 70 keV image sets. In quantitative analysis, DL 40 keV significantly reduced image noise relative to ASiR-V 40 keV images (49.9%, p < 0.001) and ASiR-V 70 keV images (85.2%, p = 0.012). DL 40 keV images showed significantly higher CNRlesion to the liver and SNRliver than ASiR-V 40 keV image and 70 keV images (p < 0.001). CONCLUSION DL-based reconstruction of 40 keV images using vendor-agnostic software showed greater noise reduction, better lesion conspicuity, image contrast, image sharpness, and higher overall image diagnostic acceptability than ASiR for 40 keV or 70 keV images in patients with hypervascular liver lesions.
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Affiliation(s)
- June Young Seo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ijin Joo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyo Jin Kang
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sewoo Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jong Hyo Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea; Center for Medical-IT Convergence Technology Research, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea; Research Institute, ClariPi, Seoul, Republic of Korea
| | - Chulkyun Ahn
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea; Research Institute, ClariPi, Seoul, Republic of Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Bette S, Decker JA, Braun FM, Becker J, Haerting M, Haeckel T, Gebhard M, Risch F, Woźnicki P, Scheurig-Muenkler C, Kroencke TJ, Schwarz F. Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI. Diagnostics (Basel) 2022; 12:diagnostics12051231. [PMID: 35626387 PMCID: PMC9140684 DOI: 10.3390/diagnostics12051231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
In dual-energy CT datasets, the conspicuity of liver metastases can be enhanced by virtual monoenergetic imaging (VMI) reconstructions at low keV levels. Our study investigated whether this effect can be reproduced in photon-counting detector CT (PCD-CT) datasets. We analyzed 100 patients with liver metastases who had undergone contrast-enhanced CT of the abdomen on a PCD-CT (n = 50) or energy-integrating detector CT (EID-CT, single-energy mode, n = 50). PCD-VMI-reconstructions were performed at various keV levels. Identical regions of interest were positioned in metastases, normal liver, and other defined locations assessing image noise, tumor-to-liver ratio (TLR), and contrast-to-noise ratio (CNR). Patients were compared inter-individually. Subgroup analyses were performed according to BMI. On the PCD-CT, noise and CNR peaked at the low end of the keV spectrum. In comparison with the EID-CT, PCD-VMI-reconstructions exhibited lower image noise (at 70 keV) but higher CNR (for ≤70 keV), despite similar CTDIs. Comparing high- and low-BMI patients, CTDI-upregulation was more modest for the PCD-CT but still resulted in similar noise levels and preserved CNR, unlike the EID-CT. In conclusion, PCD-CT VMIs in oncologic patients demonstrated reduced image noise–compared to a standard EID-CT–and improved conspicuity of hypovascularized liver metastases at low keV values. Patients with higher BMIs especially benefited from constant image noise and preservation of lesion conspicuity, despite a more moderate upregulation of CTDI.
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Affiliation(s)
- Stefanie Bette
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Josua A. Decker
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Franziska M. Braun
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Judith Becker
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Mark Haerting
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Thomas Haeckel
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Michael Gebhard
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Franka Risch
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Piotr Woźnicki
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Christian Scheurig-Muenkler
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Thomas J. Kroencke
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
- Correspondence: ; Tel.: +49-821-400-2441
| | - Florian Schwarz
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
- Medical Faculty, Ludwig Maximilian University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
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Yang L, Sun J, Li J, Peng Y. Dual-energy spectral CT imaging of pulmonary embolism with Mycoplasma pneumoniae pneumonia in children. Radiol Med 2022; 127:154-161. [PMID: 35034318 DOI: 10.1007/s11547-021-01442-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pulmonary embolism (PE) associated with Mycoplasma pneumoniae pneumonia (MPP) in children has already attracted more attention. CT pulmonary angiography (CTPA) has been the preferred method for diagnosing PE, but it has some limitations, especially for children. Dual-energy spectral CT has been used in diagnosing PE in adults. PURPOSE To evaluate the application of dual-energy spectral CT in diagnosing PE in children with MPP. MATERIALS AND METHODS Eighty-three children with MPP and highly suspected PE, underwent CTPA with spectral imaging mode, 25 children were diagnosis with PE. Noise, clot-to-artery contrast-to-noise ratio, image quality and diagnosis confidence were calculated and assessed on nine monochromatic image sets (40 to 80 keV). CTPA images were observed for the presence, localization and embolic degrees of PE. Clots were divided into intra- and extra-consolidation clots. For extra-consolidation clots, iodine concentration (IC) of perfusion defects and normal lung, perfusion defects of four children before and after the treatment were measured and compared. For intra-consolidation clots, IC of consolidation areas with clots and consolidation areas without clot were measured and compared. RESULTS The optimal energy level for detecting PE in children was 55 keV. 116 clots (29 extra-consolidations) were found, IC of defect regions was 0.69 ± 0.28 mg/mL (extra-consolidations) and 0.90 ± 0.23 mg/mL (intra-consolidations), both significantly lower than the 2.76 ± 0.45 mg/mL in normal lungs and 10.25 ± 1.76 mg/mL in consolidations without clots (P < 0.001). Significant difference was found in the presence or absence of perfusion defects between occlusive clots and nonocclusive clots (P < 0.001). IC of the perfusion defects significantly increased after treatment (P < 0.001). CONCLUSIONS In dual-energy spectral CTPA, 55 keV images optimize PE detection for children, and MD images quantify pulmonary blood flow of PE, and may help to detect small clots and quantify embolic degrees.
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Affiliation(s)
- Lixin Yang
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Jihang Sun
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Xicheng District, 100045, Beijing, China
| | | | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Xicheng District, 100045, Beijing, China.
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Lan X, Wang X, Qi J, Chen H, Zeng X, Shi J, Liu D, Shen H, Zhang J. Application of machine learning with multiparametric dual-energy computed tomography of the breast to differentiate between benign and malignant lesions. Quant Imaging Med Surg 2022; 12:810-822. [PMID: 34993120 DOI: 10.21037/qims-21-39] [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: 01/10/2021] [Accepted: 07/30/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Multiparametric dual-energy computed tomography (mpDECT) is widely used to differentiate various kinds of tumors; however, the data regarding its diagnostic performance with machine learning to diagnose breast tumors is limited. We evaluated univariate analysis and machine learning performance with mpDECT to distinguish between benign and malignant breast lesions. METHODS In total, 172 patients with 214 breast lesions (55 benign and 159 malignant) who underwent preoperative dual-phase contrast-enhanced DECT were included in this retrospective study. Twelve quantitative features were extracted for each lesion, including CT attenuation (precontrast, arterial, and venous phases), the arterial-venous phase difference in normalized effective atomic number (nZeff), normalized iodine concentration (NIC), and slope of the spectral Hounsfield unit (HU) curve (λHu). Predictive models were developed using univariate analysis and eight machine learning methods [logistic regression, extreme gradient boosting (XGBoost), stochastic gradient descent (SGD), linear discriminant analysis (LDA), adaptive boosting (AdaBoost), random forest (RF), decision tree, and linear support vector machine (SVM)]. Classification performances were assessed based on the area under the receiver operating characteristic curve (AUROC). The best performances of the conventional univariate analysis and machine learning methods were compared using the Delong test. RESULTS The univariate analysis showed that the venous phase λHu had the highest AUROC (0.88). Machine learning with mpDECT achieved an excellent and stable diagnostic performance, as shown by the mean classification performances in the training dataset (AUROC, 0.88-0.99) and testing (AUROC, 0.83-0.96) datasets. The performance of the AdaBoost model based on mpDECT was more stable than the other machine learning models and superior to the univariate analysis (AUROC, 0.96 vs. 0.88; P<0.001). CONCLUSIONS The performance of the AdaBoost classifier based on mpDECT data achieved the highest mean accuracy compared to the other machine learning models and univariate analysis in differentiating between benign and malignant breast lesions.
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Affiliation(s)
- Xiaosong Lan
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Jun Qi
- Department of Thoracic Surgery, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Huifang Chen
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Xiangfei Zeng
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Jinfang Shi
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Hesong Shen
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
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Yoo J, Lee JM, Yoon JH, Joo I, Lee ES, Jeon SK, Jang S. Comparison of low kVp CT and dual-energy CT for the evaluation of hypervascular hepatocellular carcinoma. Abdom Radiol (NY) 2021; 46:3217-3226. [PMID: 33713160 DOI: 10.1007/s00261-020-02888-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To compare lesion conspicuity and image quality of arterial phase images obtained from low kVp (90-kVp) and dual-energy (DE) scans for the evaluation of hypervascular hepatocellular carcinoma (HCC). METHODS This retrospective study included 229 patients with HCC who underwent either 90 kVp (n = 106) or DE scan (80- and 150-kVp with a tin filter) (n = 123) during the arterial phase. DE scans were reconstructed into a linearly blended image with a mixed ratio of 0.6 (60% 80kVp and 40% 150 kVp) and post-processed for 40 keV and 50 keV images. The contrast-to-noise ratio (CNR) of HCC to the liver and image noise was measured. Lesion conspicuity, liver parenchymal image quality, and overall image preference were assessed qualitatively by three independent radiologists. RESULTS DE 40 keV images had the highest CNR of HCC, and DE blended images had the lowest image noise among four image sets (p = 0.01 and p < 0.001, respectively). There was no significant difference in mean volume CT dose index and dose-length product between DE and low kVp scan (ps > 0.05). For qualitative analyses, DE blended images had the highest scores for image quality and overall image preference (ps < 0.001). CONCLUSION At an equal radiation dose, DE 40 keV showed higher CNR of HCC and DE blended image showed higher image quality and image preference compared with low kVp CT.
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Affiliation(s)
- Jeongin Yoo
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Korea.
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Ijin Joo
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Sun Kyung Jeon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Siwon Jang
- Department of Radiology, Seoul National University Boramae Hospital, Seoul, Korea
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Cao Y, Zhang G, Bao H, Zhang S, Zhang J, Zhao Z, Zhang W, Li W, Yan X, Zhou J. Development of a dual-energy spectral CT based nomogram for the preoperative discrimination of mutated and wild-type KRAS in patients with colorectal cancer. Clin Imaging 2020; 69:205-212. [PMID: 32920468 DOI: 10.1016/j.clinimag.2020.08.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/17/2020] [Accepted: 08/24/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To develop a dual-energy spectral CT (DESCT) nomogram for the preoperative identification of KRAS mutation in patients with colorectal cancer (CRC). METHOD One hundred and twenty-four patients who underwent energy spectrum CT pre-operatively were recruited and split into mutated KRAS group (n = 50) and wild-type KRAS group (n = 74). DESCT parameters, including monochromatic CT value, iodine concentration, water concentration, and effective atomic number were measured independently by two reviewers in the arterial, venous, and delayed phases. Normalized iodine concentration (NIC) and slope k of the spectral HU curve were calculated. Evaluate other imaging features such as ATL/LTL ratio, tumor gross pattern, pericolorectal fat invasion (PFI) was also performed by these reviewers. Independent predictors for KRAS mutation were screened out using logistic regression, and these predictors were presented as a nomogram. The receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to evaluate the clinical usefulness of the nomogram. RESULTS The slope k in the arterial phase, effective atomic number in the arterial phase, NIC in the venous phase, ATL/LTL ratio and PFI were significant independent predictors for KRAS mutation. Based on these independent predictors, a quantitative nomogram was developed to predict individual KRAS mutation probability. The nomogram had excellent performance with an AUC of 0.848 and excellent calibration. DCA showed that our nomogram has outstanding clinical utility. CONCLUSIONS This study demonstrates that a DESCT based nomogram has potential value for individual preoperative identification of KRAS mutation in CRC patients.
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Affiliation(s)
- Yuntai Cao
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China; Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China; Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Guojin Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Haihua Bao
- Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China
| | - Shenghui Zhang
- Department of Physics, University of Illinois at Chicago, Chicago, USA
| | - Jing Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Zhiyong Zhao
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Wenjuan Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Weixia Li
- Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China
| | - Xiaohong Yan
- Department of Critical Medicine, Affiliated Hospital of Qinghai University, Xining, China
| | - Junlin Zhou
- Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China; Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China.
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Kang HJ, Lee JM, Lee SM, Yang HK, Kim RH, Nam JG, Karnawat A, Han JK. Value of virtual monochromatic spectral image of dual-layer spectral detector CT with noise reduction algorithm for image quality improvement in obese simulated body phantom. BMC Med Imaging 2019; 19:76. [PMID: 31462212 PMCID: PMC6714289 DOI: 10.1186/s12880-019-0367-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dual-layer spectral detector CT (SDCT) may provide several theoretical advantages over pre-existing DECT approaches in terms of adjustment-free sampling number and dose modulation, beam hardening correction, and production spectral images by post-processing. In addition, by adopting noise reduction algorithm, high contrast resolution was expected even in low keV level. We surmised that this improvement would be beneficial to obese people. Therefore, our aim of study is to compare image quality of virtual monochromatic spectral images (VMI) and polychromatic images reconstructed from SDCT with different body size and radiation dose using anthropomorphic liver phantom. METHODS One small and one large size of body phantoms, each containing eight (four high- and four low-contrast) simulated focal liver lesions (FLLs) were scanned by SDCT (at 120 kVp) using different Dose Right Indexes (DRIs). VMI were reconstructed from spectral base images from 40 keV to 200 keV. Hybrid iterative reconstruction (iDose4) was used for polychromatic image reconstruction. Image noise and contrast to noise ratio (CNR) were compared. Five radiologists independently rated lesion conspicuity, diagnostic acceptability and subjective noise level in every image sets, and determined optimal keV level in VMI. RESULTS Compare with conventional polychromatic images, VMI showed superior CNR at low keV level regardless of phantom size at every examined DRIs (Ps < 0.05). As body size increased, VMI had more gradual CNR decrease and noise increase than conventional polychromatic images. For low contrast FLLs in large phantom, lesion conspicuities at low radiation dose levels (DRI 16 and 19) were significantly increased in VMI (Ps < 0.05). Subjective image noise and diagnostic acceptabilities were significantly improved at VMI in both phantom size. CONCLUSIONS VMI of dual-layer spectral detector CT with noise reduction algorithm provides improved CNR, noise reduction, and better subjective image quality in imaging of obese simulated liver phantom compared with polychromatic images. This may hold promise for improving detection of liver lesions and improved imaging of obese patients.
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Affiliation(s)
- Hyo-Jin Kang
- Department of Radiology, Seoul National University Hospital, Seoul, 03080 South Korea
- Department of Radiology, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080 South Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, 03080 South Korea
- Department of Radiology, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080 South Korea
- Institute of Radiation Medicine, Seoul National University College Medical Research Center, Seoul, 03080 South Korea
| | - Sang Min Lee
- Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, 14068 South Korea
| | - Hyun Kyung Yang
- Department of Medical imaging, Toronto General hospital, Toronto, Canada
| | - Ri Hyeon Kim
- Department of Radiology, Seoul National University Hospital, Seoul, 03080 South Korea
| | - Ju Gang Nam
- Department of Radiology, Seoul National University Hospital, Seoul, 03080 South Korea
| | - Aruna Karnawat
- Department of Radiology, Nizam’s Institute of Medical Sciences, Hyderabad, 500082 India
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul, 03080 South Korea
- Department of Radiology, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080 South Korea
- Institute of Radiation Medicine, Seoul National University College Medical Research Center, Seoul, 03080 South Korea
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Ma G, Dou Y, Dang S, Yu N, Guo Y, Yang C, Lu S, Han D, Jin C. Influence of Monoenergetic Images at Different Energy Levels in Dual-Energy Spectral CT on the Accuracy of Computer-Aided Detection for Pulmonary Embolism. Acad Radiol 2019; 26:967-973. [PMID: 30803897 DOI: 10.1016/j.acra.2018.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/07/2018] [Accepted: 09/09/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the influence of monoenergetic images of different energy levels in spectral computed tomography (CT) on the accuracy of computer aided detection (CAD) for pulmonary embolism (PE). MATERIALS AND METHODS CT images of 20 PE patients who underwent spectral CT pulmonary angiography were retrospectively analyzed. Nine sets of monochromatic images from 40 to 80 keV at 5 keV interval were reconstructed and then independently analyzed for detecting PE using a commercially available CAD software. Two experienced radiologists reviewed all images and recorded the number of emboli manually, which was used as the reference standard. The CAD findings for the number of PE at different energies were compared with the reference standard to determine the number of true positives and false positives with CAD and to calculate the sensitivity and false positive rate at different energies. RESULT There were 120 true emboli. The total numbers of CAD-detected PE at 40-80 keV were 48, 67, 63, 87, 106, 115, 138, 157, and 226. Images at low energies had low sensitivities and low false positive rates; images at high energies had high sensitivities and high false positive rates. At 60 keV and 65 keV, CAD achieved sensitivity at 81.67% and 84.17%, respectively and false positive rate at 7.55% and 12.17%, respectively to provide the optimum combination of high sensitivity and low false positive rate. CONCLUSION Monochromatic images of different energies in dual-energy spectral CT affect the accuracy of CAD for PE. The combination of CAD with images at 60-65 keV provides the optimum combination of high sensitivity and low false positive rate in detecting PE.
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Affiliation(s)
- Guangming Ma
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Yanta Western Road, Xi'an, Shaanxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yuequn Dou
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Shan Dang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Nan Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yanbing Guo
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Chuangbo Yang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Shuanhong Lu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Dong Han
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Chenwang Jin
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Yanta Western Road, Xi'an, Shaanxi 710061, China; Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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The value of single-source dual-energy CT imaging for discriminating microsatellite instability from microsatellite stability human colorectal cancer. Eur Radiol 2019; 29:3782-3790. [PMID: 30903331 DOI: 10.1007/s00330-019-06144-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/22/2019] [Accepted: 03/08/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To demonstrate the value of single-source dual-energy computed tomography (ssDECT) imaging for discriminating microsatellite instability (MSI) from microsatellite stability (MSS) colorectal cancer (CRC). METHODS Thirty-eight and seventy-six patients with pathologically proven MSI and MSS CRC, respectively, were retrospectively selected and compared. These patients underwent contrast-enhanced abdominal ssDECT scans before any anti-cancer treatment. Effective atomic number (Eff-Z) in precontrast phase, slope k of spectral HU curve in precontrast (k-P), arterial (k-A), venous (k-V), and delayed phase (k-D), normalized iodine concentration in arterial (NIC-A), venous (NIC-V), and delayed phase (NIC-D), of tumors in two groups were measured by two reviewers. Consistency of measurements was tested by intra-class correlation coefficients (ICC). Mann-Whitney U test or Student's t test was used to compare above values between MSI and MSS. Multivariate logistic regression was used to analyze multiple parameters. Receiver operating characteristic curves were calculated to assess diagnostic efficacies. RESULTS Interobserver agreement was excellent (ICC > 0.80). MSI CRC had significantly lower values in all measurements (NIC-A, V, D; k-P, A, V, D; Eff-Z) than MSS CRC. For discriminating MSI from MSS CRC, the area under curve (AUC) using k-A was the highest (AUC, 0.803; sensitivity, 72.4%; specificity, 76.3%). The multivariate logistic regression (selection method, Enter) with combined ssDECT parameters (NIC-A, NIC-V, NIC-D, Eff-Z, k-P, k-A, k-V, k-D) significantly improved diagnostic capability with AUC of 0.886 (sensitivity, 81.6%; specificity, 81.6%). CONCLUSIONS The combination of multiple parameters in ssDECT imaging by multivariate logistic regression provides relatively high diagnostic accuracy for discriminating MSI from MSS CRC. KEY POINTS • ssDECT generates multiple parameters for discriminating CRC with MSI from MSS. • ssDECT measurements for MSI CRC were significantly lower than MSS CRC. • Combination of ssDECT parameters further improves diagnostic capability for differentiation.
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Li L, Zhao Y, Luo D, Yang L, Hu L, Zhao X, Wang Y, Liu W. Diagnostic value of single-source dual-energy spectral computed tomography in differentiating parotid gland tumors: initial results. Quant Imaging Med Surg 2018; 8:588-596. [PMID: 30140621 DOI: 10.21037/qims.2018.07.07] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background An accurate preoperative diagnosis that helps distinguish between benign and malignant parotid gland tumors is very important because the results strongly affect surgical procedures. We aimed to evaluate the value of single-source dual-energy computed tomography (ssDECT) in differentiating malignant from benign parotid gland tumors. Methods Fifty patients underwent enhanced neck ssDECT scanning before surgery. The images were analyzed using the gemstone spectral imaging (GSI) viewer software. Results Fifty-two tumors (43 patients) were confirmed histopathologically, comprising of 12 pleomorphic adenomas (PAs), 24 Warthin tumors (WTs) (15 patients), and 16 malignant tumors (MTs). The iodine concentration (IC), normalized iodine concentration to common carotid artery (NICA) and slope value of the spectral curve (λHU) of the WTs were significantly higher than those of MTs and PAs (all P<0.05). The optimal IC, NICA and λHU thresholds for differentiating PAs from MTs were 0.91 mg/mL, 0.15 and 1.09, respectively, achieving sensitivities of 91.7%, 91.7% and 91.7%, specificities of 95.0%, 85.0% and 95.0%, and accuracies of 94.2%, 86.5% and 94.2%, respectively for distinguishing PAs from MTs. The optimal IC, NICA and λHU thresholds for distinguishing WTs from MTs were 1.46 mg/mL, 0.20 and 1.72, achieving sensitivities of 91.7%, 95.8% and 91.7%, and specificities of 89.3%, 85.7% and 89.3%, respectively. The accuracy was 90.4%, 90.4% and 90.4%, respectively. Conclusions The parameters of ssDECT in enhanced CT scans are useful in the differential diagnosis of parotid tumors.
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Affiliation(s)
- Lin Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yanfeng Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Dehong Luo
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Liang Yang
- Department of Diagnostic Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Lei Hu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xinming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yong Wang
- Department of Ultrasonography, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wensheng Liu
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Low kV versus dual-energy virtual monoenergetic CT imaging for proven liver lesions: what are the advantages and trade-offs in conspicuity and image quality? A pilot study. Abdom Radiol (NY) 2018; 43:1404-1412. [PMID: 28983661 DOI: 10.1007/s00261-017-1327-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Single-energy low tube potential (SE-LTP) and dual-energy virtual monoenergetic (DE-VM) CT images both increase the conspicuity of hepatic lesions by increasing iodine signal. Our purpose was to compare the conspicuity of proven liver lesions, artifacts, and radiologist preferences in dose-matched SE-LTP and DE-VM images. METHODS Thirty-one patients with 72 proven liver lesions (21 benign, 51 malignant) underwent full-dose contrast-enhanced dual-energy CT (DECT). Half-dose images were obtained using single tube reconstruction of the dual-source SE-LTP projection data (80 or 100 kV), and by inserting noise into dual-energy projection data, with DE-VM images reconstructed from 40 to 70 keV. Three blinded gastrointestinal radiologists evaluated half-dose SE-LTP and DE-VM images, ranking and grading liver lesion conspicuity and diagnostic confidence (4-point scale) on a per-lesion basis. Image quality (noise, artifacts, sharpness) was evaluated, and overall image preference was ranked on per-patient basis. Lesion-to-liver contrast-to-noise ratio (CNR) was compared between techniques. RESULTS Mean lesion size was 1.5 ± 1.2 cm. Across the readers, the mean conspicuity ratings for 40, 45, and 50 keV half-dose DE-VM images were superior compared to other half-dose image sets (p < 0.0001). Per-lesion diagnostic confidence was similar between half-dose SE-LTP compared to half-dose DE-VM images (p ≥ 0.05; 1.19 vs. 1.24-1.32). However, SE-LTP images had less noise and artifacts and were sharper compared to DE-VM images less than 70 keV (p < 0.05). On a per-patient basis, radiologists preferred SE-LTP images the most and preferred 40-50 keV the least (p < 0.0001). Lesion CNR was also higher in SE-LTP images than DE-VM images (p < 0.01). CONCLUSION For the same applied dose level, liver lesions were more conspicuous using DE-VM compared to SE-LTP; however, SE-LTP images were preferred more than any single DE-VM energy level, likely due to lower noise and artifacts.
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Fang T, Deng W, Law MWM, Luo L, Zheng L, Guo Y, Chen H, Huang B. Comparison of image quality and radiation exposure between conventional imaging and gemstone spectral imaging in abdominal CT examination. Br J Radiol 2018; 91:20170448. [PMID: 29762057 DOI: 10.1259/bjr.20170448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To compare patients' image quality and radiation exposure between gemstone spectral imaging (GSI) with rapid kV switching technique and conventional polychromatic imaging (CPI) performed in abdominal CT examinations. METHODS Adult patients who were referred to abdominal CT from October 2015 to March 2016 were enrolled. Unenhanced CT with CPI mode and tri-phase (arterial/portal/delayed phase) contrast-enhanced scan with GSI mode were performed with different protocols respectively. Regions of interest (ROIs) were drawn on muscle and fat. Parametric results of the image noise, signal-to-noise ratio (SNR) and clinical image quality in these regions between the monochromatic images reconstructed at 65 keV and conventional polychromatic images were compared. Radiation dose was also compared between CPI and GSI. RESULTS 43 patients were recruited. Compared to conventional imaging, the noise level was generally not significantly different between GSI images in arterial phase and portal phase, and significantly higher (around 10%) in delayed phase. The SNR of GSI in portal phase was significantly higher than that of conventional imaging, and was similar between arterial phase/delayed phase and conventional imaging. The clinical image quality between conventional imaging and GSI was generally not significantly different. The dose length product was reduced by 0.3-20.1% in GSI compared to conventional imaging. CONCLUSION GSI reduces the radiation exposure slightly, however maintains or even improves image quality. These results may warrant the application of GSI in patients referred for abdominal CT. Advances in knowledge: Compared to CPI, GSI reduces the radiation exposure slightly, however maintains or even improves image quality in abdominal CT. These findings may warrant the application of GSI in patients referred for abdominal CT.
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Affiliation(s)
- Tianqi Fang
- 1 National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Centre, Shenzhen University , Shenzhen , China
| | - Wei Deng
- 2 Department of Radiology, Guangzhou Panyu Central Hospital , Guangzhou , China.,3 Medical Imaging Institute of Panyu , Guangzhou , China
| | | | - Liangping Luo
- 5 Medical Imaging Center, The First Affiliated Hospital of Jinan University , Guangzhou , China
| | - Liyun Zheng
- 1 National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Centre, Shenzhen University , Shenzhen , China
| | - Ying Guo
- 6 CT Research Centre (CTRC), GE Healthcare , China
| | - Hanwei Chen
- 2 Department of Radiology, Guangzhou Panyu Central Hospital , Guangzhou , China.,3 Medical Imaging Institute of Panyu , Guangzhou , China
| | - Bingsheng Huang
- 1 National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Centre, Shenzhen University , Shenzhen , China.,3 Medical Imaging Institute of Panyu , Guangzhou , China
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Chen A, Liu A, Liu J, Tian S, Wang H, Liu Y. Application of dual-energy spectral CT imaging in differential diagnosis of bladder cancer and benign prostate hyperplasia. Medicine (Baltimore) 2016; 95:e5705. [PMID: 28033269 PMCID: PMC5207565 DOI: 10.1097/md.0000000000005705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to explore the clinical value of dual-energy spectral CT imaging in the differential diagnosis between bladder cancer and benign prostate hyperplasia (BPH).We retrospectively analyzed images of 118 patients who received pelvic dual-energy spectral CT imaging. These patients were later confirmed to have bladder cancer in 61 patients and BPH in 57 patients. CT values of the 2 lesion types from 40 to 140 keV were measured from the monochromatic spectral CT image to generate spectral HU curves. The slope of the spectral curve and the lesion effective atomic number were calculated. The measured parameters were analyzed with independent-sample Mann-Whitney U test.There was a statistically significant difference in CT value between the 2 groups from 40 to 90 keV, with the biggest difference at 40 keV (median and interquartile range: 83.3 HU and 22.9 HU vs 60.6 HU and 16.7 HU, Z = 5.932, P < 0.001). The slope of the spectral HU curve for bladder cancer was markedly higher than that of BPH (median and interquartile range: 0.48 and 0.23 vs 0.26 and 0.22, Z = 5.162, P < 0.001); the difference in effective atomic number (median and interquartile range: 7.99 and 0.21 vs 7.80 and 0.20, Z = 5.233, P < 0.001) was also statistically significant.Dual-energy spectral CT imaging provides high sensitivity and specificity for differentiating bladder cancer from benign prostate hyperplasia.
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Ma G, He T, Yu Y, Duan H, Yang C. Improving Image Quality of Bronchial Arteries with Virtual Monochromatic Spectral CT Images. PLoS One 2016; 11:e0150985. [PMID: 26967737 PMCID: PMC4788436 DOI: 10.1371/journal.pone.0150985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/21/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the clinical value of using monochromatic images in spectral CT pulmonary angiography to improve image quality of bronchial arteries. METHODS We retrospectively analyzed the chest CT images of 38 patients who underwent contrast-enhanced spectral CT. These images included a set of 140kVp polychromatic images and the default 70keV monochromatic images. Using the standard Gemstone Spectral Imaging (GSI) viewer on an advanced workstation (AW4.6,GE Healthcare), an optimal energy level (in keV) for obtaining the best contrast-to-noise ratio (CNR) for the artery could be automatically obtained. The signal-to-noise ratio (SNR), CNR and objective image quality score (1-5) for these 3 image sets (140kVp, 70keV and optimal energy level) were obtained and, statistically compared. The image quality score consistency between the two observers was also evaluated using Kappa test. RESULTS The optimal energy levels for obtaining the best CNR were 62.58±2.74keV.SNR and CNR from the 140kVp polychromatic, 70keV and optimal keV monochromatic images were (16.44±5.85, 13.24±5.52), (20.79±7.45, 16.69±6.27) and (24.9±9.91, 20.53±8.46), respectively. The corresponding subjective image quality scores were 1.97±0.82, 3.24±0.75, and 4.47±0.60. SNR, CNR and subjective scores had significant difference among groups (all p<0.001). The optimal keV monochromatic images were superior to the 70keV monochromatic and 140kVp polychromatic images, and there was high agreement between the two observers on image quality score (kappa>0.80). CONCLUSIONS Virtual monochromatic images at approximately 63keV in dual-energy spectral CT pulmonary angiography yielded the best CNR and highest diagnostic confidence for imaging bronchial arteries.
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Affiliation(s)
- Guangming Ma
- Affiliated Hospital of Shannxi University of Traditional Chinese Medicine Radiology Dept, Xianyang City, Shaanxi, China
| | - Taiping He
- Affiliated Hospital of Shannxi University of Traditional Chinese Medicine Radiology Dept, Xianyang City, Shaanxi, China
- * E-mail:
| | - Yong Yu
- Affiliated Hospital of Shannxi University of Traditional Chinese Medicine Radiology Dept, Xianyang City, Shaanxi, China
| | - Haifeng Duan
- Affiliated Hospital of Shannxi University of Traditional Chinese Medicine Radiology Dept, Xianyang City, Shaanxi, China
| | - Chuangbo Yang
- Affiliated Hospital of Shannxi University of Traditional Chinese Medicine Radiology Dept, Xianyang City, Shaanxi, China
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Spectral CT with monochromatic imaging and metal artifacts reduction software for artifacts reduction of ¹²⁵I radioactive seeds in liver brachytherapy. Jpn J Radiol 2015; 33:694-705. [PMID: 26456321 DOI: 10.1007/s11604-015-0482-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/20/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the optimal monochromatic energy for artifacts reduction from (125)I seeds as well as image improvement in the vicinity of seeds on monochromatic images with and without metal artifacts reduction software (MARS) and to compare this with traditional 120-kVp images, so as to evaluate the application value of gemstone spectral imaging for reducing artifacts from (125)I seeds in liver brachytherapy. MATERIALS AND METHODS A total of 45 tumors from 25 patients treated with (125)I seed brachytherapy in the liver were enrolled in this study. Multiphasic spectral computed tomography (CT) scanning was performed for each patient. After a delay time of 15 s of portal vein phase, a traditional 120-kVp scan was performed, focusing on several planes of (125)I seeds only. The artifact index (AI) in the vicinity of seeds and the standard deviation (SD) of the CT density of region of interest in the outside liver parenchyma were calculated. Artifact appearance was evaluated and classified on reconstructed monochromatic S and 120-kVp images. Image quality in the vicinity of seeds of three data sets were evaluated using a 1-5 scale scoring method. The Friedman rank-sum test was used to estimate the scoring results of image quality. RESULTS The greatest noise in monochromatic images was found at 40 keV (SD = 27.38, AI = 206.40). The optimal monochromatic energy was found at 75 keV, which provided almost the least image noise (SD = 10.01) and good performance in artifact reduction (AI = 102.73). Image noise and AI reduction at 75 keV was decreased by 63.44 and 50.23%, compared with at 40 keV. Near-field thick artifacts were obvious in all 45 lesions, in 120-kVp images, and 75-keV images, but basically reduced in 75 keV MARS images and artifacts completely invisible in 7 lesions. The number of diagnosable images (score ≥3) was significantly more in the 75-keV MARS group (28/45), and the 75-keV group (22/45) than in the 120-kVp group (11/45) (p < 0.0167 for both). Compared with 120-kVp images alone, 75-keV images plus 75-keV MARS images can increase tumor visibility around seeds and increase the proportion of diagnostic images to 84.4% (38/45). CONCLUSION Spectral CT producing 75-keV MARS images could substantially reduce near-field thick artifacts caused by (125)I seeds and improve image quality, even to a state of being completely free from artifacts. Spectral CT imaging (with and without MARS) can provide more accurate CT images for estimating efficacy after (125)I seed brachytherapy in the liver.
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Multiple instance learning for computer aided detection and diagnosis of gastric cancer with dual-energy CT imaging. J Biomed Inform 2015; 57:358-68. [DOI: 10.1016/j.jbi.2015.08.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/27/2015] [Accepted: 08/14/2015] [Indexed: 12/13/2022]
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Li C, Lin X, Hui C, Lam KM, Zhang S. Computer-Aided Diagnosis for Distinguishing Pancreatic Mucinous Cystic Neoplasms From Serous Oligocystic Adenomas in Spectral CT Images. Technol Cancer Res Treat 2014; 15:44-54. [PMID: 25520271 DOI: 10.1177/1533034614563013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 11/10/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This preliminary study aims to verify the effectiveness of the additional information provided by spectral computed tomography (CT) with the proposed computer-aided diagnosis (CAD) scheme to differentiate pancreatic serous oligocystic adenomas (SOAs) from mucinous cystic neoplasms of pancreas cystic lesions. MATERIALS AND METHODS This study was conducted from January 2010 to October 2013. Twenty-three patients (5 men and 18 women; mean age, 43.96 years old) with SOA and 19 patients (3 men and 16 women; mean age, 41.74 years old) with MCN were included in this retrospective study. Two types of features were collected by dual-energy spectral CT imaging as follows: conventional and additional quantitative spectral CT features. Classification results of the CAD scheme were compared using the conventional features and full feature data set. Important features were selected using support vector machine classification method combined with feature-selection technique. The optimal cutoff values of selected features were determined through receiver-operating characteristic curve analyses. RESULTS Combining conventional features with additional spectral CT features improved the overall accuracy from 88.37% to 93.02%. The selected features of the proposed CAD scheme were tumor size, contour, location, and low-energy CT values (43 keV). Iodine-water basis material pair densities in both arterial phase (AP) and portal venous phase (PP) were important factors for differential diagnosis of SOA and MCN. The optimal cutoff values of long axis, short axis, 40 keV monochromatic CT value in AP, iodine (water) density in AP, 43 keV monochromatic CT value in PP, and iodine (water) density in PP were 3.4 mm, 3.1 mm, 35.7 Hu, 0.32533 mg/mL, 39.4 Hu, and 0.348 mg/mL, respectively. CONCLUSION The combination of conventional features and additional information provided by dual-energy spectral CT shows a high accuracy in the CAD scheme. The quantitative information of spectral CT may prove useful in the diagnosis and classification of SOAs and MCNs with machine learning algorithms.
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Affiliation(s)
- Chao Li
- Department of Biomedical Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaozhu Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun Hui
- Department of Biomedical Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Kin Man Lam
- Department of Electronic and Information Engineering, Centre for Signal Processing, the Hong Kong Polytechnic University, Hong Kong, China
| | - Su Zhang
- Department of Biomedical Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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Gao SY, Zhang XP, Cui Y, Sun YS, Tang L, Li XT, Zhang XY, Shan J. Fused monochromatic imaging acquired by single source dual energy CT in hepatocellular carcinoma during arterial phase: an initial experience. Chin J Cancer Res 2014; 26:437-43. [PMID: 25232217 DOI: 10.3978/j.issn.1000-9604.2014.08.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 07/27/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) during arterial phase. METHODS Fifty-seven patients with HCC who underwent ssDECT scanning at Beijing Cancer Hospital were enrolled retrospectively. Twenty-one sets of monochromatic images from 40 to 140 keV were reconstructed at 5 keV intervals in arterial phase. The optimal contrast-noise ratio (CNR) monochromatic images of the liver tumor and the lowest-noise monochromatic images were selected for image fusion. We evaluated the image quality of the optimal-CNR monochromatic images, the lowest-noise monochromatic images and the fused monochromatic images, respectively. The evaluation indicators included the spatial resolution of the anatomical structure, the noise level, the contrast and CNR of the tumor. RESULTS In arterial phase, the anatomical structure of the liver can be displayed most clearly in the 65-keV monochromatic images, with the lowest image noise. The optimal-CNR monochromatic images of HCC tumor were 50-keV monochromatic images in which the internal structural features of the liver tumors were displayed most clearly and meticulously. For tumor detection, the fused monochromatic images and the 50-keV monochromatic images had similar performances, and were more sensitive than 65-keV monochromatic images. CONCLUSIONS We achieved good arterial phase images by fusing the optimal-CNR monochromatic images of the HCC tumor and the lowest-noise monochromatic images. The fused images displayed liver tumors and anatomical structures more clearly, which is potentially helpful for identifying more and smaller HCC tumors.
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Affiliation(s)
- Shun-Yu Gao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiao-Peng Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yong Cui
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Lei Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiao-Ting Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiao-Yan Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jun Shan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
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