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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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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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Wang DS, Shen J, Majdalany BS, Khaja MS, Bhatti S, Ferencik M, Ganguli S, Gunn AJ, Heitner JF, Johri AM, Obara P, Ohle R, Sadeghi MM, Schermerhorn M, Siracuse JJ, Steenburg SD, Sutphin PD, Vijay K, Waite K, Steigner ML. ACR Appropriateness Criteria® Pulsatile Abdominal Mass, Suspected Abdominal Aortic Aneurysm: 2023 Update. J Am Coll Radiol 2023; 20:S513-S520. [PMID: 38040468 DOI: 10.1016/j.jacr.2023.08.010] [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: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
Abdominal aortic aneurysm (AAA) is defined as abnormal dilation of the infrarenal abdominal aortic diameter to 3.0 cm or greater. The natural history of AAA consists of progressive expansion and potential rupture. Although most AAAs are clinically silent, a pulsatile abdominal mass identified on physical examination may indicate the presence of an AAA. When an AAA is suspected, an imaging study is essential to confirm the diagnosis. This document reviews the relative appropriateness of various imaging procedures for the initial evaluation of suspected AAA. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- David S Wang
- Stanford University Medical Center, Stanford, California.
| | - Jody Shen
- Research Author, Stanford University Medical Center, Stanford, California
| | - Bill S Majdalany
- Panel Chair, University of Vermont Medical Center, Burlington, Vermont
| | - Minhaj S Khaja
- Panel Vice-Chair, University of Michigan, Ann Arbor, Michigan
| | - Salman Bhatti
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Society for Cardiovascular Magnetic Resonance
| | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon; Society of Cardiovascular Computed Tomography
| | - Suvranu Ganguli
- Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Andrew J Gunn
- University of Alabama at Birmingham, Birmingham, Alabama
| | - John F Heitner
- New York University Langone Health, New York, New York; Society for Cardiovascular Magnetic Resonance
| | - Amer M Johri
- Queen's University, Kingston, Ontario, Canada; American Society of Echocardiography
| | - Piotr Obara
- NorthShore University HealthSystem, Evanston, Illinois
| | - Robert Ohle
- Northern Ontario School of Medicine, Sudbury, Ontario, Canada; American College of Emergency Physicians
| | - Mehran M Sadeghi
- Yale School of Medicine, New Haven, Connecticut; American Society of Nuclear Cardiology
| | - Marc Schermerhorn
- Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts; Society for Vascular Surgery
| | - Jeffrey J Siracuse
- Boston Medical Centers, Boston University, and Chobanian and Avedisian School of Medicine, Boston, Massachusetts; Society for Vascular Surgery
| | - Scott D Steenburg
- Indiana University School of Medicine and Indiana University Health, Indianapolis, Indiana; Committee on Emergency Radiology-GSER
| | | | - Kanupriya Vijay
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kathleen Waite
- Duke University Medical Center, Durham, North Carolina, Primary care physician
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Chung R, Dane B, Yeh BM, Morgan DE, Sahani DV, Kambadakone A. Dual-Energy Computed Tomography: Technological Considerations. Radiol Clin North Am 2023; 61:945-961. [PMID: 37758362 DOI: 10.1016/j.rcl.2023.05.002] [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: 10/03/2023]
Abstract
Compared to conventional single-energy CT (SECT), dual-energy CT (DECT) provides additional information to better characterize imaged tissues. Approaches to DECT acquisition vary by vendor and include source-based and detector-based systems, each with its own advantages and disadvantages. Despite the different approaches to DECT acquisition, the most utilized DECT images include routine SECT equivalent, virtual monoenergetic, material density (eg, iodine map), and virtual non-contrast images. These images are generated either through reconstructions in the projection or image domains. Designing and implementing an optimal DECT workflow into routine clinical practice depends on radiologist and technologist input with special considerations including appropriate patient and protocol selection and workflow automation. In addition to better tissue characterization, DECT provides numerous advantages over SECT such as the characterization of incidental findings and dose reduction in radiation and iodinated contrast.
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Affiliation(s)
- Ryan Chung
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
| | - Bari Dane
- Department of Radiology, NYU Langone Health, 660 1st Avenue, New York, NY 10016, USA
| | - Benjamin M Yeh
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, 505 Parnassus Avenue, M391, Box 0628, San Francisco, CA 94143-0628, USA
| | - Desiree E Morgan
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street, South JTN 456, Birmingham, AL 35249-6830, USA
| | - Dushyant V Sahani
- Department of Radiology, University of Washington, 1959 Northeast Pacific Street, RR220, Seattle, WA 98112, USA
| | - Avinash Kambadakone
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, 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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Muroga K, Minochi Y, Fukuzawa A. Improvement in arterial enhancement using diluted injection of contrast medium in CT angiography. Acta Radiol 2023; 64:489-495. [PMID: 35179050 DOI: 10.1177/02841851221077400] [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: 11/16/2022]
Abstract
BACKGROUND Arterial enhancement after contrast injection affects the quality of computed tomography angiography (CTA) images. PURPOSE To evaluate whether the dilution of contrast medium (CM) for CTA increases arterial enhancement after the adjustment of iodine concentration as per the patient's body weight (BW). MATERIAL AND METHODS We retrospectively studied 700 patients who underwent coronary CTA. The first 350 consecutive patients underwent standard CTA with a fixed iodine concentration, whereas the remaining 350 underwent CTA with a diluted CM injection. All patients were classified into three groups according to their BW (<55, 55-65, and 66-73 kg). The mean and proportion of contrast enhancements (CEs) in the ascending aorta of ≥350 Hounsfield units (HUs) (CE350) were compared between the standard CTA and diluted CM injection and among the BW groups. The associations between BW and CE were analyzed using linear regression. RESULTS Receiving diluted CM increased the mean CE in the <55-kg group (403.4 ± 55.4 HU vs. 382.8 ± 59.3 HU; P < 0.01) but not in the groups with heavier BW. The proportion of patients with CE350 increased with BW (<55 kg = 71%, 55-65 kg = 84%, and 66-73 kg = 91%) and increased after dilution (86%, 93%, and 96%, respectively). After CM dilution, the correlation between BW and CE among patients undergoing CTA decreased from 0.37 to 0.22 (P < 0.05). CONCLUSION CM dilution for CTA improves arterial enhancement.
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Affiliation(s)
- Koji Muroga
- Department of Diagnostic Radiology, 26869Nagano Red Cross Hospital, Nagano, Japan
| | - Yoshimi Minochi
- Department of Diagnostic Radiology, 26869Nagano Red Cross Hospital, Nagano, Japan
| | - Akira Fukuzawa
- Department of Diagnostic Radiology, 26869Nagano Red Cross Hospital, Nagano, Japan
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Higashigaito K, Mergen V, Eberhard M, Jungblut L, Hebeisen M, Rätzer S, Zanini B, Kobe A, Martini K, Euler A, Alkadhi H. CT Angiography of the Aorta Using Photon-counting Detector CT with Reduced Contrast Media Volume. Radiol Cardiothorac Imaging 2023; 5:e220140. [PMID: 36860835 PMCID: PMC9969214 DOI: 10.1148/ryct.220140] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/04/2022] [Accepted: 12/14/2022] [Indexed: 01/27/2023]
Abstract
Purpose To develop and evaluate a low-volume contrast media protocol for thoracoabdominal CT angiography (CTA) with photon-counting detector (PCD) CT. Materials and Methods This prospective study included consecutive participants (April-September 2021) who underwent CTA with PCD CT of the thoracoabdominal aorta and previous CTA with energy-integrating detector (EID) CT at equal radiation doses. In PCD CT, virtual monoenergetic images (VMI) were reconstructed in 5-keV intervals from 40 to 60 keV. Attenuation of the aorta, image noise, and contrast-to-noise ratio (CNR) were measured, and subjective image quality was rated by two independent readers. In the first group of participants, the same contrast media protocol was used for both scans. CNR gain in PCD CT compared with EID CT served as the reference for contrast media volume reduction in the second group. Noninferiority analysis was used to test noninferior image quality of the low-volume contrast media protocol with PCD CT. Results The study included 100 participants (mean age, 75 years ± 8 [SD]; 83 men). In the first group (n = 40), VMI at 50 keV provided the best trade-off between objective and subjective image quality, achieving 25% higher CNR compared with EID CT. Contrast media volume in the second group (n = 60) was reduced by 25% (52.5 mL). Mean differences in CNR and subjective image quality between EID CT and PCD CT at 50 keV were above the predefined boundaries of noninferiority (-0.54 [95% CI: -1.71, 0.62] and -0.36 [95% CI: -0.41, -0.31], respectively). Conclusion CTA of the aorta with PCD CT was associated with higher CNR, which was translated into a low-volume contrast media protocol demonstrating noninferior image quality compared with EID CT at the same radiation dose.Keywords: CT Angiography, CT-Spectral, Vascular, Aorta, Contrast Agents-Intravenous, Technology Assessment© RSNA, 2023See also the commentary by Dundas and Leipsic in this issue.
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Affiliation(s)
- Kai Higashigaito
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Victor Mergen
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Matthias Eberhard
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Lisa Jungblut
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Monika Hebeisen
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Susan Rätzer
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Bettina Zanini
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Adrian Kobe
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Katharina Martini
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - André Euler
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Hatem Alkadhi
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
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Multi-Energy CT Applications. Radiol Clin North Am 2023; 61:1-21. [DOI: 10.1016/j.rcl.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Saleh M, Mujtaba B, Jensen C, Aslam R, Elsayes A, Kuchana V, Bhosale P. Feasibility of half the recommended dose of IV contrast in DECT: image quality evaluation and diagnostic acceptability in cancer patients. Clin Imaging 2022; 88:59-65. [DOI: 10.1016/j.clinimag.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022]
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Deep learning image reconstruction for improving image quality of contrast-enhanced dual-energy CT in abdomen. Eur Radiol 2022; 32:5499-5507. [PMID: 35238970 DOI: 10.1007/s00330-022-08647-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/05/2022] [Accepted: 02/11/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the usefulness of deep learning image reconstruction (DLIR) to improve the image quality of dual-energy computed tomography (DECT) of the abdomen, compared to hybrid iterative reconstruction (IR). METHODS This study included 40 patients who underwent contrast-enhanced DECT of the abdomen. Virtual monochromatic 40-, 50-, and 70-keV and iodine density images were reconstructed using three reconstruction algorithms, including hybrid IR (ASiR-V50%) and DLIR (TrueFidelity) at medium- and high-strength level (DLIR-M and DLIR-H, respectively). The standard deviation of attenuation in liver parenchyma was measured as image noise. The contrast-to-noise ratio (CNR) for the portal vein on portal venous phase CT was calculated. The vessel conspicuity and overall image quality were graded on a 5-point scale ranging from 1 (poor) to 5 (excellent). The comparative scale of lesion conspicuity in 47 abdominal solid lesions was evaluated on a 5-point scale ranging from 0 (best) to -4 (markedly inferior). RESULTS The image noise of virtual monochromatic 40-, 50 -, and 70-keV and iodine density images was significantly decreased by DLIR compared to hybrid IR (p < 0.0001). The CNR was significantly higher in DLIR-H and DLIR-M than in hybrid IR (p < 0.0001). The vessel conspicuity and overall image quality scores were also significantly greater in DLIR-H and DLIR-M than in hybrid IR (p < 0.05). The lesion conspicuity scores for DLIR-M and DLIR-H were significantly higher than those for hybrid IR in the virtual monochromatic image of all energy levels (p ≤ 0.001). CONCLUSIONS DLIR improves vessel conspicuity, CNR, and lesion conspicuity of virtual monochromatic and iodine density images in abdominal contrast-enhanced DECT, compared to hybrid IR. KEY POINTS • Deep learning image reconstruction (DLIR) is useful for reducing image noise and improving the CNR of visual monochromatic 40-, 50-, and 70-keV images in dual-energy CT. • DLIR can improve lesion conspicuity of abdominal solid lesions on virtual monochromatic images compared to hybrid iterative reconstruction. • DLIR can also be applied to iodine density maps and significantly improves their image quality.
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Cester D, Eberhard M, Alkadhi H, Euler A. Virtual monoenergetic images from dual-energy CT: systematic assessment of task-based image quality performance. Quant Imaging Med Surg 2022; 12:726-741. [PMID: 34993114 DOI: 10.21037/qims-21-477] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022]
Abstract
Background To compare task-based image quality (TB-IQ) among virtual monoenergetic images (VMI) and linear-blended images (LBI) from dual-energy CT as a function of contrast task, radiation dose, size, and lesion diameter. Methods A TB-IQ phantom (Mercury Phantom 4.0, Sun Nuclear Corporation) was imaged on a third-generation dual-source dual-energy CT with 100/Sn150 kVp at three volume CT dose levels (5, 10, 15 mGy). Three size sections (diameters 16, 26, 36 cm) with subsections for image noise and spatial resolution analysis were used. High-contrast tasks (e.g., calcium-containing stone and vascular lesion) were emulated using bone and iodine inserts. A low-contrast task (e.g., low-contrast lesion or hematoma) was emulated using a polystyrene insert. VMI at 40-190 keV and LBI were reconstructed. Noise power spectrum (NPS) determined the noise magnitude and texture. Spatial resolution was assessed using the task-transfer function (TTF) of the three inserts. The detectability index (d') served as TB-IQ metric. Results Noise magnitude increased with increasing phantom size, decreasing dose, and decreasing VMI-energy. Overall, noise magnitude was higher for VMI at 40-60 keV compared to LBI (range of noise increase, 3-124%). Blotchier noise texture was found for low and high VMIs (40-60 keV, 130-190 keV) compared to LBI. No difference in spatial resolution was observed for high contrast tasks. d' increased with increasing dose level or lesion diameter and decreasing size. For high-contrast tasks, d' was higher at 40-80 keV and lower at high VMIs. For the low-contrast task, d' was higher for VMI at 70-90 keV and lower at 40-60 keV. Conclusions Task-based image quality differed among VMI-energy and LBI dependent on the contrast task, dose level, phantom size, and lesion diameter. Image quality could be optimized by tailoring VMI-energy to the contrast task. Considering the clinical relevance of iodine, VMIs at 50-60 keV could be proposed as an alternative to LBI.
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Affiliation(s)
- Davide Cester
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Eberhard
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - André Euler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Tarkowski P, Czekajska-Chehab E. Dual-Energy Heart CT: Beyond Better Angiography-Review. J Clin Med 2021; 10:jcm10215193. [PMID: 34768713 PMCID: PMC8584316 DOI: 10.3390/jcm10215193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 12/30/2022] Open
Abstract
Heart CT has undergone substantial development from the use of calcium scores performed on electron beam CT to modern 256+-row CT scanners. The latest big step in its evolution was the invention of dual-energy scanners with much greater capabilities than just performing better ECG-gated angio-CT. In this review, we present the unique features of dual-energy CT in heart diagnostics.
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Majeed NF, Ali SM, Therrien J, Wald C, Wortman JR. Virtual Monoenergetic Spectral Detector CT for Preoperative CT Angiography in Liver Donors. Curr Probl Diagn Radiol 2021; 51:517-523. [PMID: 34839975 DOI: 10.1067/j.cpradiol.2021.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the use of virtual monoenergetic images (VMI) in pre-operative CT angiography of potential donors for living donor adult liver transplantation (LDALT), and to determine the optimal energy level to maximize vascular signal-to-noise and contrast-to-noise ratios (SNR and CNR, respectively). MATERIALS AND METHODS We retrospectively evaluated 29 CT angiography studies performed preoperatively in potential liver donors on a spectral detector CT scanner. All studies included arterial, early venous, and delayed venous phase imaging. Conventional polyenergetic images were generated for each patient, as well as virtual monoenergetic images in 10 keV increments from 40 -100 keV. Arteries (aorta and celiac, superior mesenteric, common hepatic, right and left hepatic arteries) were assessed on arterial phase images; portal venous system branches (splenic, superior mesenteric, main, right, and left portal veins) on early venous phase images; and hepatic veins on late venous phase images. Vascular attenuation, background parenchymal attenuation, and noise were measured on each set of virtual monoenergetic and conventional images. RESULTS Background hepatic and vascular noise decreased with increasing keV, with the lowest noise at 100 keV. Vascular SNR and CNR increased with decreasing keV and were highest at 40 keV, with statistical significance compared with conventional ( P < 0.05). CONCLUSIONS In preoperative CT angiography for potential liver donors, the optimal keV for assessing the vasculature to improve SNR and CNR is 40 keV. Use of low keV VMI in LDALT CT protocols may facilitate detection of vascular anatomical variants that can impact surgical planning.
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Affiliation(s)
- Noor Fatima Majeed
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA.
| | - Sarah Maria Ali
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
| | - Jaclyn Therrien
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
| | - Christoph Wald
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
| | - Jeremy R Wortman
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
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Noda Y, Nakamura F, Kawai N, Suzuki R, Miyoshi T, Ishihara T, Hyodo F, Kambadakone AR, Matsuo M. Optimized Bolus Threshold for Dual-Energy CT Angiography with Monoenergetic Images: A Randomized Clinical Trial. Radiology 2021; 300:615-623. [PMID: 34128721 DOI: 10.1148/radiol.2021210102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background The bolus-tracking technique from single-energy CT has been applied to dual-energy CT (DECT) without optimization or validation. Further optimization is imperative because of a paucity of literature and differences in the attenuation profile of virtual monoenergetic images (VMIs). Purpose To determine the optimal trigger threshold with bolus-tracking technique for DECT angiography (DECTA) in a phantom study and assess the feasibility of an optimized threshold for bolus-tracking technique in DECTA at 40 keV with a 50% reduced iodine dose in human participants. Materials and Methods A phantom study with rapid kilovoltage-switching DECT was performed to determine the optimal threshold for each kiloelectron-volt VMI. In a prospective study, consecutive participants who underwent whole-body CT angiography (CTA) from August 2018 to July 2019 were randomized into three groups: single-energy CTA (SECTA) with standard iodine dose (600 mg of iodine per kilogram), DECTA with 50% reduced iodine dose (300 mg of iodine per kilogram) by using a conventional threshold, and DECTA with 300 mg of iodine per kilogram by using an optimized threshold. A trigger threshold of 100 HU at 120 kVp was used as a reference for comparison. Injected iodine doses and aortic CT numbers were compared among the three groups using Kruskal-Wallis test. Results Ninety-six participants (mean age ± standard deviation, 72 years ± 9; 80 men) were evaluated (32 participants in each group). The optimized threshold for VMIs at 40 keV was 30 HU. The median iodine dose was lower in the optimized DECTA group (13 g) compared with conventional DECTA (19 g) and SECTA (26 g) groups (P < .017 for each comparison). The median aortic CT numbers were higher in the order corresponding to conventional DECTA (655-769 HU), optimized DECTA (543-610 HU), and SECTA (343-359 HU) groups (P < .001). Conclusion The optimized trigger threshold of 30 HU for bolus-tracking technique during dual-energy CT angiography at 40 keV achieved lower iodine load while maintaining aortic enhancement. ©RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Malayeri in this issue.
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Affiliation(s)
- Yoshifumi Noda
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Fumihiko Nakamura
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Nobuyuki Kawai
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Ryosuke Suzuki
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Toshiharu Miyoshi
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Takuma Ishihara
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Fuminori Hyodo
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Avinash R Kambadakone
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
| | - Masayuki Matsuo
- From the Departments of Radiology (Y.N., F.N., N.K., M.M.) and Frontier Science for Imaging (F.H.), Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Department of Radiology Services (R.S., T.M.) and Innovative and Clinical Research Promotion Center (T.I.), Gifu University Hospital, Gifu, Japan; and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.R.K.)
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Hamid S, Nasir MU, So A, Andrews G, Nicolaou S, Qamar SR. Clinical Applications of Dual-Energy CT. Korean J Radiol 2021; 22:970-982. [PMID: 33856133 PMCID: PMC8154785 DOI: 10.3348/kjr.2020.0996] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 01/05/2023] Open
Abstract
Dual-energy CT (DECT) provides insights into the material properties of tissues and can differentiate between tissues with similar attenuation on conventional single-energy imaging. In the conventional CT scanner, differences in the X-ray attenuation between adjacent structures are dependent on the atomic number of the materials involved, whereas in DECT, the difference in the attenuation is dependent on both the atomic number and electron density. The basic principle of DECT is to obtain two datasets with different X-ray energy levels from the same anatomic region and material decomposition based on attenuation differences at different energy levels. In this article, we discuss the clinical applications of DECT and its potential robust improvements in performance and postprocessing capabilities.
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Affiliation(s)
- Saira Hamid
- Department of Radiology, University of British Columbia Hospital, University of British Columbia, Vancouver, Canada.
| | - Muhammad Umer Nasir
- Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Aaron So
- Department of Medical Biophyics, Schulich School of Medicine and Dentistry Western University London, Ontario, Canada
| | - Gordon Andrews
- Department of Radiology, University of British Columbia Hospital, University of British Columbia, Vancouver, Canada
| | - Savvas Nicolaou
- Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Sadia Raheez Qamar
- Department of Medical Imaging, Sunnybrook Hospital, University of Toronto, Toronto, Canada
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Coles-Black J, Barber T, Bolton D, Chuen J. A systematic review of three-dimensional printed template-assisted physician-modified stent grafts for fenestrated endovascular aneurysm repair. J Vasc Surg 2021; 74:296-306.e1. [PMID: 33677030 DOI: 10.1016/j.jvs.2020.08.158] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/24/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Fenestrated endovascular aneurysm repair has yet to gain widespread adoption owing to the technical complexity and increased risk of complications. Three-dimensional (3D) printed templates to guide fenestrated physician-modified stent grafts (PMSGs) are a novel technique that may have the potential to increase the accuracy of fenestration alignment, and to disrupt both the cost and timing of the current commercial fenestrated endograft supply chain. We have conducted a critical appraisal of the emerging literature to assess this. METHODS A systematic literature search was performed using PubMed and OVID Medline as guided by the PRISMA statement on April 30, 2020. We used "3D printing" and "physician modified" or "surgeon modified" and all related search terms. We identified 50 articles which met our search criteria. None articles were included as being of direct relevance to 3D-printed template-assisted PMSGs for fenestrated endovascular aneurysm repair. Abstracts were screened individually by each investigator to ensure relevance. RESULTS Nine relevant articles were identified for critical analysis. These included one technical report, five case reports or series, two prospective trials, and one letter to the editor. CONCLUSIONS These 3D-printed templates are a promising new avenue to assist with the placement of fenestrations in PMSGs, particularly in urgent or emergent cases where custom fenestrated endografts are unavailable, with larger scale studies warranted. Further work to validate the key stages of the template workflow are required, as well as further investigation into the most suitable manufacturing and distribution methods before the mainstream implementation of this novel technique.
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Affiliation(s)
- Jasamine Coles-Black
- 3dMedLab, Austin Health, The University of Melbourne, Parkville, Australia; Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Australia.
| | - Tracie Barber
- Department of Engineering, University of New South Wales, Kensington, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Australia
| | - Jason Chuen
- 3dMedLab, Austin Health, The University of Melbourne, Parkville, Australia; Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Australia
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Sato K, Kageyama R, Sawatani Y, Takano H, Kayano S, Takane Y, Saito H. Accuracy of spectral curves at different phantom sizes and iodine concentrations using dual-source dual-energy computed tomography. Phys Eng Sci Med 2021; 44:103-116. [PMID: 33528785 DOI: 10.1007/s13246-020-00958-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022]
Abstract
To validate the accuracy of spectral curves obtained by an image-data-based algorithm and clarify the error factors that reduce accuracy. Iodine rods of known composition and different concentrations were inserted into a cylinder or elliptic-cylinder phantom and scanned according to the dual-energy protocol. Spectral curves were obtained by (i) theoretical calculation, (ii) image-data-based 2-material decomposition, and (iii) using a dedicated workstation. Accuracy was verified by comparing the spectral curve obtained by theoretical calculations with those obtained by the image-data-based algorithms or the dedicated workstations. For a quantitative evaluation, the error and relative error (RE) were calculated. In the image-data-based calculation, the errors with respect to the theoretical CT number ranged from - 8.3 to 71.1 HU. For all 192 combinations, 80.7% of the errors were under ± 15 HU, and 97.9% of the REs were under 10%. In the dedicated workstation, the errors ranged from - 94.7 to 26.8 HU. For all combinations, 68.8% of the errors were under ± 15 HU, and 68.2% of the REs were under 10%. By appropriately setting the effective energy corresponding to the CT number of the basis materials, an accurate spectral curve can be obtained. The beam-hardening effect is canceled by the 2-material decomposition process even without beam-hardening correction. Accuracy is primarily reduced by scattered radiation rather than the beam-hardening effect.
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Affiliation(s)
- Kazuhiro Sato
- Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Ryota Kageyama
- Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yuta Sawatani
- Department of Radiology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, Miyagi, 982-8502, Japan
| | - Hirokazu Takano
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Shingo Kayano
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yumi Takane
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Haruo Saito
- Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Lennartz S, Parakh A, Cao J, Zopfs D, Große Hokamp N, Kambadakone A. Inter-scan and inter-scanner variation of quantitative dual-energy CT: evaluation with three different scanner types. Eur Radiol 2021; 31:4438-4451. [PMID: 33443600 DOI: 10.1007/s00330-020-07611-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 03/24/2023]
Abstract
OBJECTIVES To investigate inter-scan and inter-scanner variation of iodine concentration (IC) and attenuation in virtual monoenergetic images at 65 keV (HU65keV) in patients with repeated abdominal examinations on dual-source (dsDECT), rapid kV switching (rsDECT), and dual-layer detector DECT (dlDECT). METHODS We retrospectively included 131 patients who underwent two abdominal DECT examinations on the same scanner (dsDECT: n = 46, rsDECT: n = 45, dlDECT: n = 40). IC and HU65keV were measured by placing regions of interest in the liver, spleen, kidneys, aorta, portal vein, and inferior vena cava. Overall IC and HU65keV for each scanner, their inter-scan differences and proportional variation were calculated and compared between scanner types. RESULTS The three scanner-specific cohorts showed similar weight, body diameter, age, sex, and contrast media injection parameters as well as inter-scan differences hereof (p range: 0.23-0.99). Absolute inter-scan differences of HU65keV and IC were comparable between scanners (p range: 0.08-1.0). Overall inter-scan variation was significantly higher in IC than HU65keV (p < 0.05). For the liver, rsDECT showed significantly lower inter-scan variation of IC compared to dsDECT/dlDECT (p = 0.005/0.01), while for the spleen, this difference was only significant compared to dsDECT (p = 0.015). Normalizing IC of the liver to the portal vein and of the spleen to the aorta did not significantly reduce inter-scan variation (p = 0.97 and 0.50). CONCLUSIONS Iodine measurements across different DECT scanners show inter-scan variation which is higher compared to variation of attenuation values. Inter-scanner differences in longitudinal variation and overall iodine concentration depend on the scanner pairs and organs assessed and should be acknowledged in clinical and scientific DECT applications. KEY POINTS • All scanner types showed comparable inter-scan variation of attenuation, while for iodine, the rapid kV switching DECT showed lower variability in the liver and spleen. • Iodine concentration showed higher inter-scan variation than attenuation measurements; normalization to vessels did not significantly improve inter-scan reproducibility of iodine concentration in parenchymal organs. • Differences between the three scanner types regarding overall iodine concentration and attenuation obtained from both timepoints were within the range of average intra-patient, inter-scan differences for most assessed organs and vessels.
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Affiliation(s)
- Simon Lennartz
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA.,Institute for Diagnostic and Interventional Radiology, University Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Anushri Parakh
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Jinjin Cao
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - David Zopfs
- Institute for Diagnostic and Interventional Radiology, University Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Nils Große Hokamp
- Institute for Diagnostic and Interventional Radiology, University Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Avinash Kambadakone
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA.
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Nomura T, Niwa T, Ozawa S, Imai Y, Hashimoto J. Visibility of bronchial arteries using virtual and advanced virtual monoenergetic imaging. Acta Radiol 2020; 61:1618-1627. [PMID: 32429673 DOI: 10.1177/0284185120923992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The utility of virtual monoenergetic imaging (VMI) for fine arteries has not been well clarified. PURPOSE To assess bronchial artery visualization using VMI and noise-optimized advanced VMI (VMI+). MATERIAL AND METHODS Eighty-seven patients with esophageal cancer underwent computed tomography (CT) using a third-generation dual-source system before surgery. Tube voltages were set to 90 kVp and 150 kVp, respectively. Images were reconstructed using VMI and VMI+ with energy levels of 40-120 keV (in 10-keV increments); composite images equivalent to CT images at 105 kVp were also generated. The CT attenuation value and contrast-to-noise ratio (CNR) of bronchial arteries using VMI and VMI+ were compared with those obtained using composite imaging. Two radiologists subjectively analyzed bronchial artery visualization with reference to the composite image. RESULTS CT attenuation values for bronchial arteries using VMI at 40-60 keV and VMI+ at 40 keV and 50 keV were significantly higher than those obtained using composite imaging (P < 0.05). CNR using VMI at 40-60 keV was significantly higher than that obtained using composite imaging (P < 0.05), whereas no differences were noted for values obtained using composite imaging between VMI+ at 40 keV and 50 keV. In the subjective analysis, VMI at 40 keV and 50 keV yielded significantly better visibility of bronchial arteries than VMI+ (P < 0.05). CONCLUSION VMI and VMI+ at low voltages (40-50 keV) may be useful for bronchial artery visualization. VMI+ may be less effective for fine vessels as bronchial artery visualization.
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Affiliation(s)
- Takakiyo Nomura
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsu Niwa
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Soji Ozawa
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yutaka Imai
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Jun Hashimoto
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
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Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y. Guideline on the use of iodinated contrast media in patients with kidney disease 2018. Clin Exp Nephrol 2020; 24:1-44. [PMID: 31709463 PMCID: PMC6949208 DOI: 10.1007/s10157-019-01750-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Hiromitsu Hayashi
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazutaka Aonuma
- Cardiology Department, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kent Doi
- Department of Acute Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihide Fujigaki
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hideo Yasuda
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Taichi Sato
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoyuki Fujikura
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Ryohei Kuwatsuru
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroshi Toei
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryusuke Murakami
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | | | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tadateru Takayama
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Watanabe
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yukinobu Yagyu
- Department of Radiology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Nobuhiko Joki
- Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yasuhiro Komatsu
- Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine, Gunma, Japan
| | | | - Yugo Ito
- Department of Nephrology, St. Luke's International Hospital, Tokyo, Japan
| | - Ryo Miyazawa
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Tomonari Ogawa
- Department of Nephrology and Hypertension, Saitama Medical Center, Saitama, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Eri Koshi
- Department of Nephrology, Komaki City Hospital, Aichi, Japan
| | - Tomoki Kosugi
- Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives/Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
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Ji X, Zhang R, Li K, Chen GH. Dual Energy Differential Phase Contrast CT (DE-DPC-CT) Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3278-3289. [PMID: 32340940 PMCID: PMC7584735 DOI: 10.1109/tmi.2020.2990347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When more than two elemental materials are present in a given object, material quantification may not be robust and accurate when the routine two-material decomposition scheme in current dual energy CT imaging is employed. In this work, we present an innovative scheme to accomplish accurate three-material decomposition with measurements from a dual energy differential phase contrast CT (DE-DPC-CT) acquisition. A DE-DPC-CT system was constructed using a grating interferometer and a photon counting CT imaging system with two energy bins. The DE-DPC-CT system can simultaneously measure both the imaginary and the real part of the complex refractive index to enable a three-material decomposition. Physical phantom with 21 material inserts were constructed and measured using DE-DPC-CT system. Results demonstrated excellent accuracy in elemental material quantification. For example, relative root-mean-square errors of 4.5% for calcium and 5.2% for iodine were achieved using the proposed three-material decomposition scheme. Biological tissues with iodine inserts were used to demonstrate the potential utility of the proposed spectral CT imaging method. Experimental results showed that the proposed method correctly differentiates the bony structure, iodine, and the soft tissue in the biological specimen samples. A triple spectra CT scan was also performed to benchmark the performance of the DE-DPC-CT scan. Results demonstrated that the material decomposition from the DE-DPC-CT has a much lower quantification noise than that from the triple spectra CT scan.
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22
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Lee S, Choi YH, Cho YJ, Lee SB, Cheon JE, Kim WS, Ahn CK, Kim JH. Noise reduction approach in pediatric abdominal CT combining deep learning and dual-energy technique. Eur Radiol 2020; 31:2218-2226. [PMID: 33030573 DOI: 10.1007/s00330-020-07349-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/15/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate the image quality of low iodine concentration, dual-energy CT (DECT) combined with a deep learning-based noise reduction technique for pediatric abdominal CT, compared with standard iodine concentration single-energy polychromatic CT (SECT). METHODS From December 2016 to May 2017, DECT with 300 mg•I/mL contrast medium was performed in 29 pediatric patients (17 boys, 12 girls; age, 2-19 years). The DECT images were reconstructed using a noise-optimized virtual monoenergetic reconstruction image (VMI) with and without a deep learning method. SECT images with 350 mg•I/mL contrast medium, performed within the last 3 months before the DECT, served as reference images. The quantitative and qualitative parameters were compared using paired t tests and Wilcoxon signed-rank tests, and the differences in radiation dose and total iodine administration were assessed. RESULTS The linearly blended DECT showed lower attenuation and higher noise than SECT. The 60-keV VMI showed an increase in attenuation and higher noise than SECT. The combined 60-keV VMI plus deep learning images showed low noise, no difference in contrast-to-noise ratios, and overall image quality or diagnostic image quality, but showed a higher signal-to-noise ratio in the liver and lower enhancement of lesions than SECT. The overall image and diagnostic quality of lesions were maintained on the combined noise reduction approach. The CT dose index volume and total iodine administration in DECT were respectively 19.6% and 14.3% lower than those in SECT. CONCLUSION Low iodine concentration DECT, combined with deep learning in pediatric abdominal CT, can maintain image quality while reducing the radiation dose and iodine load, compared with standard SECT. KEY POINTS • An image noise reduction approach combining deep learning and noise-optimized virtual monoenergetic image reconstruction can maintain image quality while reducing radiation dose and iodine load. • The 60-keV virtual monoenergetic image reconstruction plus deep learning images showed low noise, no difference in contrast-to-noise ratio, and overall image quality, but showed a higher signal-to-noise ratio in the liver and a lower enhancement of lesion than single-energy polychromatic CT. • This combination could offer a 19.6% reduction in radiation dose and a 14.3% reduction in iodine load, in comparison with a control group that underwent single-energy polychromatic CT with the standard protocol.
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Affiliation(s)
- Seunghyun Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young Hun Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Yeon Jin Cho
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Seul Bi Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Eun Cheon
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Woo Sun Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Chul Kyun Ahn
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jong Hyo Kim
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Advanced Institutes of Convergence Technology, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
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23
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Lennartz S, Große Hokamp N, Zäske C, Zopfs D, Bratke G, Glauner A, Maintz D, Persigehl T, Chang DH, Hickethier T. Virtual monoenergetic images preserve diagnostic assessability in contrast media reduced abdominal spectral detector CT. Br J Radiol 2020; 93:20200340. [PMID: 32644824 DOI: 10.1259/bjr.20200340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To investigate if low-keV virtual monoenergetic images (VMI40keV) from abdominal spectral detector CT (SDCT) with reduced intravenous contrast media application (RCM) provide abdominal assessment similar to conventional images with standard contrast media (SCM) dose. METHODS 78 patients with abdominal SDCT were retrospectively included: 41 patients at risk for adverse reactions who received 44 RCM examinations with 50 ml and 37 patients who underwent 44 SCM examinations with 100 ml of contrast media (CM) and who were matched for effective body diameters. RCM, SCM images and RCM-VMI40keV were reconstructed. Attenuation and signal-to-noise ratio (SNR) of liver, pancreas, kidneys, lymph nodes, psoas muscle, aorta and portal vein were assessed ROIs-based. Contrast-to-noise ratios (CNR) of lymph nodes vs aorta/portal vein were calculated. Two readers evaluated organ/vessel contrast, lymph node delineation, image noise and overall assessability using 4-point Likert scales. RESULTS RCM were inferior to SCM images in all quantitative/qualitative criteria. RCM-VMI40keV and SCM images showed similar lymph node and muscle attenuation (p = 0.83,0.17), while for all other ROIs, RCM-VMI40keV showed higher attenuation (p ≤ 0.05). SNR was comparable between RCM-VMI40keV and SCM images (p range: 0.23-0.99). CNR of lymph nodes was highest in RCM-VMI40keV (p ≤ 0.05). RCM-VMI40keV received equivalent or higher scores than SCM in all criteria except for organ contrast, overall assessability and image noise, where SCM were superior (p ≤ 0.05). However, RCM-VMI40keV received proper or excellent scores in 88.6/94.2/95.4% of the referring cases. CONCLUSIONS VMI40keV counteract contrast deterioration in CM reduced abdominal SDCT, facilitating diagnostic assessment. ADVANCES IN KNOWLEDGE SDCT-derived VMI40keV provide adequate depiction of vessels, organs and lymph nodes even at notable CM reduction.
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Affiliation(s)
- Simon Lennartz
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.,Department of Radiology, Massachusetts General Hospital, Harvard Medial School, 55 Fruit Street, White 270, Boston, MA 02114, USA.,Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne,Weyertal 115b, 50931, Cologne, Germany
| | - Nils Große Hokamp
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Charlotte Zäske
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - David Zopfs
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Grischa Bratke
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Andreas Glauner
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - De-Hua Chang
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.,Department of Radiology, University Medical Center Heidelberg, Heidelberg, Germany
| | - Tilman Hickethier
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
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24
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Evaluating the Image Quality of Monoenergetic Images From Dual-Energy Computed Tomography With Low-Concentration and Low-Flow-Rate Contrast Media for the Arterials Supply to the Nipple-Areola Complex in Breast Cancer Compared With Conventional Computed Tomography Angiography. J Comput Assist Tomogr 2020; 44:921-927. [PMID: 32649428 PMCID: PMC7668328 DOI: 10.1097/rct.0000000000001063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective The objective of this study was to evaluate the image quality of monoenergetic images (MEIs (+)) acquired from dual-energy computed tomography with low-concentration and low-flow-rate contrast media for the arterial supply to the nipple-areola complex (NAC) in breast cancer compared with conventional computed tomography angiography (CTA). Methods We enrolled 25 patients (MEI (+)300 group, 300 mg/mL and 2.5 mL/s of contrast media) and 23 patients (CTA370 group, 370 mg/mL and 3.5 mL/s of contrast media) for assessing NAC blood supply angiography. The image quality of the 2 groups was evaluated objectively and subjectively. Results The 40 keV MEI (+)300 demonstrated higher attenuation and contrast-to-noise ratio than CTA370 group (P < 0.001). The subjective image quality and visualization of the arteries were comparable between 2 groups. Conclusions The 40 keV MEI (+)300 acquired from dual-energy computed tomography can achieve comparable image quality of arterial supply to NAC with low-concentration and low-flow-rate contrast media in breast cancer compared with CTA370.
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25
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Abstract
Computed tomography angiography (CTA) has become a mainstay for the imaging of vascular diseases, because of high accuracy, availability, and rapid turnaround time. High-quality CTA images can now be routinely obtained with high isotropic spatial resolution and temporal resolution. Advances in CTA have focused on improving the image quality, increasing the acquisition speed, eliminating artifacts, and reducing the doses of radiation and iodinated contrast media. Dual-energy computed tomography provides material composition capabilities that can be used for characterizing lesions, optimizing contrast, decreasing artifact, and reducing radiation dose. Deep learning techniques can be used for classification, segmentation, quantification, and image enhancement.
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Affiliation(s)
- Prabhakar Rajiah
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55904, USA.
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26
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Yoshida M, Nakaura T, Sentaro T, Tanoue S, Inada H, Utsunomiya D, Sakaino N, Harada K, Yamashita Y. Prospective Comparison of 70-kVp Single-Energy CT versus Dual-Energy CT: Which is More Suitable for CT Angiography with Low Contrast Media Dosage? Acad Radiol 2020; 27:e116-e122. [PMID: 31537504 DOI: 10.1016/j.acra.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES To compare the objective and subjective image qualities between single-energy computed tomography (CT) at 70 kVp and virtual monoenergetic imaging (VMI) of dual-source dual-energy CT for CT angiography with 180 mgI/kg. MATERIALS AND METHODS Total 63 patients scanned with 180 mgI/kg were randomly divided into two groups: Group A (32 patients) underwent CT angiography at 70-kVp, and Group B (31 patients) underwent dual-energy CT. VMI sets were generated at 10-keV increments between 40 and 100 keV. We calculated aortic attenuation, contrast-to-noise-ratio (CNR), signal-to-noise-ratio, figure of merit of CNR, and effective dose for each protocol. Three radiologists scored overall image quality and various arteries' visibility using a four-point scale. Quantitative and qualitative comparisons between 70 kVp and VMI with the highest CNR were performed with the two-tailed t test or Kruskal-Wallis test. RESULTS The 40-keV images offered the highest CNR among VMIs. Aortic attenuation at 70 kVp was significantly lower than that at 40 keV (p < 0.001). However, the signal-to-noise-ratio, CNR, and figure of merit of CNR were significantly higher at 70 kVp than those at 40-keV (p < 0.001, p < 0.05, and p < 0.05, respectively). The effective dose of each group was almost equal. The qualitative visibility scores for various arteries, except the ascending and upper-abdominal aorta, were also better at 70 kVp than those at 40 keV. CONCLUSION Aortic attenuation at 70 kVp with 180 mg I/kg was lower than that of VMI at 40 keV, and the objective and subjective image qualities were higher at 70 kVp than those at 40 keV.
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27
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Huang X, Gao S, Ma Y, Lu X, Jia Z, Hou Y. The optimal monoenergetic spectral image level of coronary computed tomography (CT) angiography on a dual-layer spectral detector CT with half-dose contrast media. Quant Imaging Med Surg 2020; 10:592-603. [PMID: 32269920 DOI: 10.21037/qims.2020.02.17] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background To investigate the optimal monoenergetic level of spectral reconstructions in coronary computed tomography angiography (coronary CTA) on a dual-layer spectral detector computed tomography (SDCT) with half-dose contrast media. Methods Two hundred patients with suspected coronary artery disease (CAD) were enrolled in this prospective coronary CTA study and randomly divided into a routine-dose contrast media group and a half-dose contrast media group (each n=100). Coronary CTA was performed using SDCT with prospective electrocardiogram (ECG)-gated mode. A tube voltage of 120 kVp was used, along with an automated tube current modulation. A dose of iodixanol 270 mgI/mL of 0.8 and 0.4 mL/kg was administered to the routine and half-dose groups, respectively. For the routine-dose group, 120 kVp polychromatic images with a model-based iterative reconstruction (IMR) (Group A) were reconstructed. For the half-dose group, three monoenergetic levels of images were reconstructed (Group B, 45 keV; Group C, 50 keV; and Group D, 55 keV). Objective indicators [mean CT values; noise; signal-to-noise ratio (SNR); and contrast-to-noise ratio (CNR)] and subjective indicators (contrast, sharpness, subjective noise, and acceptability) in each group were compared. Results There were no significant differences in demographics or radiation dose (1.83±0.51 vs. 1.80±0.53 mSv, P=0.78) between the routine- and half-dose groups. The average iodine loads were 15.33±2.26 and 7.48±1.14 g, respectively. Mean CT values, SNR, CNR, and subjective contrast in Group C were higher than those in Group A (P<0.05), and there were no significant differences in other indicators between Group C and Group A (P>0.05). The objective and subjective noise in Group B were worse than those in Group A (P<0.05). The contrast, sharpness, and acceptability of Group D were all worse than those of Group A (P<0.05). Conclusions Compared to routine polychromatic images, 50 keV monoenergetic images can provide equivalent or improved coronary image quality in coronary CTA performed on SDCT with half the amount of contrast media.
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Affiliation(s)
- Xin Huang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Sizhe Gao
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yue Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xiaomei Lu
- CT Clinical Science, Philips Healthcare, Shenyang 110016, China
| | - Zheng Jia
- CT Clinical Science, Philips Healthcare, Shenyang 110016, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
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28
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Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y. Guideline on the Use of Iodinated Contrast Media in Patients With Kidney Disease 2018. Circ J 2019; 83:2572-2607. [PMID: 31708511 DOI: 10.1253/circj.cj-19-0783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshitaka Isaka
- Japanese Society of Nephrology.,Department of Nephrology, Osaka University Graduate School of Medicine
| | - Hiromitsu Hayashi
- Japan Radiological Society.,Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School
| | - Kazutaka Aonuma
- the Japanese Circulation Society.,Cardiology Department, Institute of Clinical Medicine, University of Tsukuba
| | - Masaru Horio
- Japanese Society of Nephrology.,Kansai Medical Hospital
| | - Yoshio Terada
- Japanese Society of Nephrology.,Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University
| | - Kent Doi
- Japanese Society of Nephrology.,Department of Acute Medicine, The University of Tokyo
| | - Yoshihide Fujigaki
- Japanese Society of Nephrology.,Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine
| | - Hideo Yasuda
- Japanese Society of Nephrology.,First Department of Medicine, Hamamatsu University School of Medicine
| | - Taichi Sato
- Japanese Society of Nephrology.,First Department of Medicine, Hamamatsu University School of Medicine
| | - Tomoyuki Fujikura
- Japanese Society of Nephrology.,First Department of Medicine, Hamamatsu University School of Medicine
| | - Ryohei Kuwatsuru
- Japan Radiological Society.,Department of Radiology, Graduate School of Medicine, Juntendo University
| | - Hiroshi Toei
- Japan Radiological Society.,Department of Radiology, Graduate School of Medicine, Juntendo University
| | - Ryusuke Murakami
- Japan Radiological Society.,Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School
| | - Yoshihiko Saito
- the Japanese Circulation Society.,Department of Cardiovascular Medicine, Nara Medical University
| | - Atsushi Hirayama
- the Japanese Circulation Society.,Department of Cardiology, Osaka Police Hospital
| | - Toyoaki Murohara
- the Japanese Circulation Society.,Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Akira Sato
- the Japanese Circulation Society.,Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Hideki Ishii
- the Japanese Circulation Society.,Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Tadateru Takayama
- the Japanese Circulation Society.,Division of General Medicine, Department of Medicine, Nihon University School of Medicine
| | - Makoto Watanabe
- the Japanese Circulation Society.,Department of Cardiovascular Medicine, Nara Medical University
| | - Kazuo Awai
- Japan Radiological Society.,Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Seitaro Oda
- Japan Radiological Society.,Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Takamichi Murakami
- Japan Radiological Society.,Department of Radiology, Kobe University Graduate School of Medicine
| | - Yukinobu Yagyu
- Japan Radiological Society.,Department of Radiology, Kindai University, Faculty of Medicine
| | - Nobuhiko Joki
- Japanese Society of Nephrology.,Division of Nephrology, Toho University Ohashi Medical Center
| | - Yasuhiro Komatsu
- Japanese Society of Nephrology.,Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine
| | | | - Yugo Ito
- Japanese Society of Nephrology.,Department of Nephrology, St. Luke's International Hospital
| | - Ryo Miyazawa
- Japan Radiological Society.,Department of Radiology, St. Luke's International Hospital
| | - Yoshihiko Kanno
- Japanese Society of Nephrology.,Department of Nephrology, Tokyo Medical University
| | - Tomonari Ogawa
- Japanese Society of Nephrology.,Department of Nephrology & Hypertension, Saitama Medical Center
| | - Hiroki Hayashi
- Japanese Society of Nephrology.,Department of Nephrology, Fujita Health University School of Medicine
| | - Eri Koshi
- Japanese Society of Nephrology.,Department of Nephrology, Komaki City Hospital
| | - Tomoki Kosugi
- Japanese Society of Nephrology.,Nephrology, Nagoya University Graduate School of Medicine
| | - Yoshinari Yasuda
- Japanese Society of Nephrology.,Department of CKD Initiatives/Nephrology, Nagoya University Graduate School of Medicine
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Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y. Guideline on the use of iodinated contrast media in patients with kidney disease 2018. Jpn J Radiol 2019; 38:3-46. [PMID: 31709498 DOI: 10.1007/s11604-019-00850-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Hiromitsu Hayashi
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazutaka Aonuma
- Cardiology Department, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kent Doi
- Department of Acute Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihide Fujigaki
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hideo Yasuda
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Taichi Sato
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoyuki Fujikura
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Ryohei Kuwatsuru
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroshi Toei
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryusuke Murakami
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | | | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tadateru Takayama
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Watanabe
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yukinobu Yagyu
- Department of Radiology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Nobuhiko Joki
- Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yasuhiro Komatsu
- Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine, Gunma, Japan
| | | | - Yugo Ito
- Department of Nephrology, St. Luke's International Hospital, Tokyo, Japan
| | - Ryo Miyazawa
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Tomonari Ogawa
- Department of Nephrology and Hypertension, Saitama Medical Center, Saitama, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Eri Koshi
- Department of Nephrology, Komaki City Hospital, Aichi, Japan
| | - Tomoki Kosugi
- Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives/Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
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Albrecht MH, Vogl TJ, Martin SS, Nance JW, Duguay TM, Wichmann JL, De Cecco CN, Varga-Szemes A, van Assen M, Tesche C, Schoepf UJ. Review of Clinical Applications for Virtual Monoenergetic Dual-Energy CT. Radiology 2019; 293:260-271. [DOI: 10.1148/radiol.2019182297] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Kawahara D, Ozawa S, Yokomachi K, Higaki T, Fujioka C, Mori M, Nagata Y. Improving automatic contrast agent extraction system using monochromatic CT number. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2019; 42:819-826. [DOI: 10.1007/s13246-019-00762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/08/2019] [Indexed: 11/30/2022]
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Baliyan V, Shaqdan K, Hedgire S, Ghoshhajra B. Vascular computed tomography angiography technique and indications. Cardiovasc Diagn Ther 2019; 9:S14-S27. [PMID: 31559151 DOI: 10.21037/cdt.2019.07.04] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Non-invasive cross-sectional imaging techniques play a crucial role in the assessment of the vascular disease processes. Computed tomography angiography (CTA) is an imaging method of choice for a wide range of vascular diseases that span across different vascular territories. A diagnostic quality CTA requires a robust imaging protocol tailored according to the physiologic state and vascular area of interest. This review article is aimed to provide an overview of the technical considerations and clinical applications of CTA.
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Affiliation(s)
- Vinit Baliyan
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Khalid Shaqdan
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandeep Hedgire
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Brian Ghoshhajra
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Han D, Chen X, Lei Y, Ma C, Zhou J, Xiao Y, Yu Y. Iodine load reduction in dual-energy spectral CT portal venography with low energy images combined with adaptive statistical iterative reconstruction. Br J Radiol 2019; 92:20180414. [PMID: 30894009 DOI: 10.1259/bjr.20180414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To study the application of using low energy images combined with adaptive statistical iterative reconstruction (ASiR) in dual-energy spectral CT portal venography (CTPV) to reduce iodine load. METHODS 41 patients for CTPV were prospectively and randomly divided into two groups. Group A ( n = 21) used conventional 120 kVp scanning protocol with contrast dose at 0.6 gI/kg while group B ( n = 20) used dual-energy spectral imaging with reduced contrast dose at 0.3 gI/kg. The 120 kVp images in Group A and 50 keV images in Group B were reconstructed with 40% ASiR. The contrast-to-noise ratio of portal vein was calculated. The image quality and the numbers of intrahepatic portal vein branches were evaluated by two experienced radiologists using a 5-point scoring system. RESULTS Group B reduced iodine load by 52% compared to Group A (17.21 ± 3.30 gI vs 35.80 ± 6.18 gI, p < 0.001). All images in both groups were acceptable for diagnosis. CT values and standard deviations in portal veins of Group B were higher than Group A (all p < 0.05); There were no statistical differences in contrast-to-noise ratio, image quality score and the number of observed portal vein branches between the two groups (all p > 0.05), and the two observers had excellent agreement in image quality assessment (all κ > 0.75). CONCLUSION The use of 50 keV images in dual-energy spectral CTPV with ASiR reduces total iodine load by 52% while maintaining good image quality. ADVANCES IN KNOWLEDGE Spectral CT images combined with ASiR can be used in low contrast dose CTPV portal venography to maintain image quality and reduce contrast dose.
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Affiliation(s)
- Dong Han
- 1 Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xiaoxia Chen
- 1 Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yuxin Lei
- 1 Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Chunling Ma
- 1 Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Jieli Zhou
- 2 Department of Ultrasound, Xijing Hospital, Xi'an, Shaanxi, China
| | - Yingcong Xiao
- 3 Department of Ultrasound, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yong Yu
- 1 Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
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Reply to “Minimizing IV Iodine Doses for Contrast-Enhanced CT”. AJR Am J Roentgenol 2019; 213:W49. [DOI: 10.2214/ajr.19.21692] [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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Lu X, Lu Z, Yin J, Gao Y, Chen X, Guo Q. Effects of radiation dose levels and spectral iterative reconstruction levels on the accuracy of iodine quantification and virtual monochromatic CT numbers in dual-layer spectral detector CT: an iodine phantom study. Quant Imaging Med Surg 2019; 9:188-200. [PMID: 30976543 DOI: 10.21037/qims.2018.11.12] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background The purpose of this study is to investigate the accuracy of iodine quantification and virtual monochromatic CT numbers obtained with the dual-layer spectral CT (DLCT) using a phantom at different radiation dose levels and spectral iterative reconstruction (IR) levels. Methods An abdomen phantom with seven iodine inserts (2.0, 2.5, 5.0, 7.5, 10.0, 15.0, 20.0 mg/mL) was imaged using a DLCT scanner. Five repeated scans were performed at computed tomography dose index volume (CTDIvol) levels of 5, 10, 15, 20, 25 mGy at tube voltages of 120 and 140 kVp, respectively. Spectral-based images were reconstructed using four spectral IR levels (spectral level of 0, 2, 4, 6). Iodine density images and virtual monochromatic images (VMI) at energy levels of 50, 70 and 120 keV were created. The absolute percentage bias (APB) of the measured iodine concentration and the true iodine concentration, and the measured VMI CT numbers and the theoretical VMI CT numbers were compared to determine the difference of radiation dose levels and different spectral IR levels. Results At CTDIvol levels of 25, 20, 15, 10 mGy, radiation dose levels had no effect on the accuracy of iodine quantitation; at CTDIvol level of 5 mGy, the accuracy of iodine quantification was the poorest, with the mean APBiodine of 4.33% (P<0.05). There was no significant difference in the accuracy of iodine quantitation between 120 and 140 kVp (P=0.648). At energy levels of 50, 70 and 120 keV, there was no significant difference in the accuracy of the VMI CT numbers among the CTDIvol levels of 25, 20 and 15 mGy. However, the accuracy of VMI CT numbers was significantly degraded at the CTDIvol levels of 10 and 5 mGy (P<0.05). At energy level of 50 keV, the accuracy of VMI CT numbers was not affected by tube voltages (kVps) used (P=0.125). At the energy levels of 70 and 120 keV, 140 kVp produced a smaller bias than 120 kVp, with the mean APBHU at 120 and 140 kVp being of 3.62% vs. 2.99% for 70 keV (P<0.01), and 11.65% vs. 9.28% for 120 keV (P<0.01), respectively. Spectral IR levels did not affect the accuracy of iodine quantification and VMI CT numbers (P=0.998, P=0.963). Conclusions The accuracy of iodine quantification and VMI CT numbers was only affected by very low radiation dose levels. At the clinically applied radiation dose levels of >10 mGy, the accuracy of both iodine quantification and VMI CT numbers is relatively stable and high.
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Affiliation(s)
- Xiaomei Lu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Zaiming Lu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Jiandong Yin
- Division of Biomedical Engineering, China Medical University, Shenyang 110001, China
| | - Yuying Gao
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xingbiao Chen
- CT Clinical Science, Philips Healthcare, Shanghai 200233, China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
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Role of dual energy CT to improve diagnosis of non-traumatic abdominal vascular emergencies. Abdom Radiol (NY) 2019; 44:406-421. [PMID: 30143817 DOI: 10.1007/s00261-018-1741-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Computed tomography angiography (CTA) is the modality of choice to evaluate abdominal vascular emergencies (AVE). CTA protocols are often complex and require acquisition of multiple phases to enable a variety of diagnosis such as acute bleeding, pseudoaneurysms, bowel ischemia, and dissection. With single energy CT (SECT), differentiating between calcium, coagulated blood, and contrast agents can be challenging based on their attenuation, especially when in small quantity or present as a mixture. With dual-energy CT (DECT), virtual monoenergetic (VM) and material decomposition (MD) image reconstructions enable more robust tissue characterization, improve contrast-enhancement, and reduce beam hardening artifacts. This article will demonstrate how radiologists can utilize DECT for various clinical scenarios in assessment of non-traumatic AVE.
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Patino M, Parakh A, Lo GC, Agrawal M, Kambadakone AR, Oliveira GR, Sahani DV. Virtual Monochromatic Dual-Energy Aortoiliac CT Angiography With Reduced Iodine Dose: A Prospective Randomized Study. AJR Am J Roentgenol 2019; 212:467-474. [DOI: 10.2214/ajr.18.19935] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Manuel Patino
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - Anushri Parakh
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - Grace C. Lo
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - Mukta Agrawal
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - Avinash R. Kambadakone
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - George R. Oliveira
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - Dushyant V. Sahani
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
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Nagayama Y, Nakaura T, Oda S, Taguchi N, Utsunomiya D, Funama Y, Kidoh M, Namimoto T, Sakabe D, Hatemura M, Yamashita Y. Dual-layer detector CT of chest, abdomen, and pelvis with a one-third iodine dose: image quality, radiation dose, and optimal monoenergetic settings. Clin Radiol 2018; 73:1058.e21-1058.e29. [DOI: 10.1016/j.crad.2018.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/24/2018] [Indexed: 12/12/2022]
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Accuracy of Dual-Energy Virtual Monochromatic CT Numbers: Comparison between the Single-Source Projection-Based and Dual-Source Image-Based Methods. Acad Radiol 2018; 25:1632-1639. [PMID: 29573936 DOI: 10.1016/j.acra.2018.02.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 11/21/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the accuracy of dual-energy virtual monochromatic computed tomography (CT) numbers obtained by two typical hardware and software implementations: the single-source projection-based method and the dual-source image-based method. MATERIALS AND METHODS A phantom with different tissue equivalent inserts was scanned with both single-source and dual-source scanners. A fast kVp-switching feature was used on the single-source scanner, whereas a tin filter was used on the dual-source scanner. Virtual monochromatic CT images of the phantom at energy levels of 60, 100, and 140 keV were obtained by both projection-based (on the single-source scanner) and image-based (on the dual-source scanner) methods. The accuracy of virtual monochromatic CT numbers for all inserts was assessed by comparing measured values to their corresponding true values. Linear regression analysis was performed to evaluate the dependency of measured CT numbers on tissue attenuation, method, and their interaction. RESULTS Root mean square values of systematic error over all inserts at 60, 100, and 140 keV were approximately 53, 21, and 29 Hounsfield unit (HU) with the single-source projection-based method, and 46, 7, and 6 HU with the dual-source image-based method, respectively. Linear regression analysis revealed that the interaction between the attenuation and the method had a statistically significant effect on the measured CT numbers at 100 and 140 keV. CONCLUSIONS There were attenuation-, method-, and energy level-dependent systematic errors in the measured virtual monochromatic CT numbers. CT number reproducibility was comparable between the two scanners, and CT numbers had better accuracy with the dual-source image-based method at 100 and 140 keV.
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Dual-Energy CT Urography With 50% Reduced Iodine Dose Versus Single-Energy CT Urography With Standard Iodine Dose. AJR Am J Roentgenol 2018; 212:117-123. [PMID: 30422713 DOI: 10.2214/ajr.18.19720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare dual-energy CT (DECT) urography with a 50% reduced iodine dose to single-energy CT (SECT) urography with a standard iodine dose with respect to attenuation of renal vascular and urinary tract structures and with respect to image quality. SUBJECTS AND METHODS The study included 62 patients undergoing evaluation of urinary tract lithiasis, tumor, or hematuria. Thirty-one patients underwent DECT urography with a 50% reduced iodine dose and reconstruction at 50 and 77 keV. These subjects were sex, age, and size matched to a group of 31 patients who underwent 120-kVp SECT urography with a standard iodine dose. The mean iodine dose was 22 g for DECT and 44 g for SECT. Attenuation was measured at seven locations in the renal arteries, renal veins, and urinary tract. Two reviewers subjectively scored the image quality parameters image noise, sharpness of urinary tract contours, enhancement of urinary structures, and streak artifacts. RESULTS Mean DECT attenuation at 50 keV was the same as or greater than SECT attenuation at each of the seven locations. Measured image noise was highest at 50-keV DECT but was the same for 77-keV DECT and 120-kVp SECT. Mean subjective scores for DECT image quality parameters were the same as or higher than those of SECT, except for streak artifact and sharpness of urinary tract contours. CONCLUSION DECT urography with a 50% reduced iodine dose may result in measured renal vascular and urinary tract attenuation the same as or higher than and image quality measurements and scores similar to those obtained with 120-kVp SECT urography with a standard iodine dose.
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McCarthy CJ, Kilcoyne A, Li X, Cahalane AM, Liu B, Arellano RS, Uppot RN, Gee MS. Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction. Cardiovasc Intervent Radiol 2018; 41:1935-1942. [PMID: 30132100 DOI: 10.1007/s00270-018-2066-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/17/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses. MATERIALS AND METHODS Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure. RESULTS Tumor ablations were performed with microwave (n = 220), radiofrequency (n = 74) or irreversible electroporation (IRE) (n = 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02-0.9%). No deterministic skin changes were identified in the patient cohort. CONCLUSION The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures.
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Affiliation(s)
- Colin J McCarthy
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Xinhua Li
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Alexis M Cahalane
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Bob Liu
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Ronald S Arellano
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Raul N Uppot
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
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Parakh A, Macri F, Sahani D. Dual-Energy Computed Tomography: Dose Reduction, Series Reduction, and Contrast Load Reduction in Dual-Energy Computed Tomography. Radiol Clin North Am 2018; 56:601-624. [PMID: 29936950 DOI: 10.1016/j.rcl.2018.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Evolution in computed tomography technology and image reconstruction have significantly changed practice. Dual energy computed tomography is being increasingly adopted owing to benefits of material separation, quantification, and improved contrast-to-noise ratio. The radiation dose can match that from single energy computed tomography. Spectral information derived from a polychromatic x-ray beam at different energies yields in image reconstructions that reduce the number of phases in a multiphasic examination and decrease the absolute amount of contrast media. This increased analytical and image processing capability provides new avenues for addressing radiation dose and iodine exposure concerns.
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Affiliation(s)
- Anushri Parakh
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, MA 02114, USA
| | - Francesco Macri
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, MA 02114, USA; Department of Radiology, University Hospital of Nimes, Place di Pr Debre, Nimes 30029, France
| | - Dushyant Sahani
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, MA 02114, USA.
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Improved display of cervical intervertebral discs on water (iodine) images: incidental findings from single-source dual-energy CT angiography of head and neck arteries. Eur Radiol 2018; 29:153-160. [DOI: 10.1007/s00330-018-5603-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/28/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022]
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Toia GV, Kim S, Dighe MK, Mileto A. Dual-Energy Computed Tomography in Body Imaging. Semin Roentgenol 2018; 53:132-146. [PMID: 29861005 DOI: 10.1053/j.ro.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Giuseppe V Toia
- Body Imaging Section, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195
| | - Sooah Kim
- Body Imaging Section, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195
| | - Manjiri K Dighe
- Body Imaging Section, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195
| | - Achille Mileto
- Body Imaging Section, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195.
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Nagayama Y, Nakaura T, Oda S, Utsunomiya D, Funama Y, Iyama Y, Taguchi N, Namimoto T, Yuki H, Kidoh M, Hirata K, Nakagawa M, Yamashita Y. Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol. Eur Radiol 2017; 28:1719-1730. [PMID: 29063254 DOI: 10.1007/s00330-017-5114-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To evaluate the image quality and lesion conspicuity of virtual-monochromatic-imaging (VMI) with dual-layer DECT (DL-DECT) for reduced-iodine-load multiphasic-hepatic CT. METHODS Forty-five adults with renal dysfunction who had undergone hepatic DL-DECT with 300-mgI/kg were included. VMI (40-70-keV, DL-DECT-VMI) was generated at each enhancement phase. As controls, 45 matched patients undergoing standard 120-kVp protocol (120-kVp, 600-mgI/kg, and iterative reconstruction) were included. We compared the size-specific dose estimate (SSDE), image noise, CT attenuation, and contrast-to-noise ratio (CNR) between protocols. Two radiologists scored the image quality and lesion conspicuity. RESULTS SSDE was significantly lower in DL-DECT group (p < 0.01). Image noise of DL-DECT-VMI was almost constant at each keV (differences of ≤15%) and equivalent to or lower than of 120-kVp. As the energy decreased, CT attenuation and CNR gradually increased; the values of 55-60 keV images were almost equivalent to those of standard 120-kVp. The highest scores for overall quality and lesion conspicuity were assigned at 40-keV followed by 45 to 55-keV, all of which were similar to or better than of 120-kVp. CONCLUSIONS For multiphasic-hepatic CT with 50% iodine-load, DL-DECT-VMI at 40- to 55-keV provides equivalent or better image quality and lesion conspicuity without increasing radiation dose compared with standard 120-kVp protocol. KEY POINTS • 40-55-keV yields optimal image quality for half-iodine-load multiphasic-hepatic CT with DL-DECT. • DL-DECT protocol decreases radiation exposure compared with 120-kVp scans with iterative reconstruction. • 40-keV images maximise conspicuity of hepatocellular carcinoma especially at hepatic-arterial phase.
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Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan
| | - Yuji Iyama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Narumi Taguchi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Tomohiro Namimoto
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hideaki Yuki
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kenichiro Hirata
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masataka Nakagawa
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
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Increasing Role of Dual-Energy CT in Noninvasive Vascular Imaging. J Vasc Interv Radiol 2017; 28:1267-1268. [DOI: 10.1016/j.jvir.2017.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 07/10/2017] [Indexed: 11/18/2022] Open
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Kamalian S, Lev MH, Pomerantz SR. Dual-Energy Computed Tomography Angiography of the Head and Neck and Related Applications. Neuroimaging Clin N Am 2017; 27:429-443. [DOI: 10.1016/j.nic.2017.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hou P, Feng X, Liu J, Zhou Y, Jiang Y, Jiang X, Gao J. Iterative reconstruction in single-source dual-energy CT angiography: feasibility of low and ultra-low volume contrast medium protocols. Br J Radiol 2017; 90:20160506. [PMID: 28555508 DOI: 10.1259/bjr.20160506] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility of using contrast medium (CM) of low and ultra-low volumes and injection rates in aortic CT angiography (CTA) through the joint application of single-source dual-energy CT (ssDECT) and adaptive statistical iterative reconstruction (ASIR). METHODS 120 patients with known or suspected aortic dissection underwent aortic CTA and were equally divided into 3 groups. Conventional 120-kVp scan with a CM volume of 70 ml and an injection rate of 5 ml s-1 was performed on Group A. Groups B and C underwent ssDECT scan with CM volumes of 0.6 and 0.4 ml kg-1, respectively. 40% and 50% ASIR algorithms were applied for Groups B and C, respectively. A five-point grading scheme was utilized to subjectively evaluate the image quality, and the CT value and contrast-to-noise ratio were recorded as objective measures. The radiation dose was also evaluated. RESULTS Groups B and C had equivalent subjective scores and CT values as Group A, whereas they had higher or equivalent contrast-to-noise ratios. Group B had 40.1% and 30% reductions on CM volume and injection rate, respectively, than Group A. Group C further resulted in 19.2% and 22% lesser CM volume and injection rate than Group B. The average effective radiation doses for the study groups were 22.5-24.5% lower than the control group. CONCLUSION With the aid of ASIR and ssDECT for aortic CTA, it is feasible to adopt low and ultra-low CM volumes and injection rates while obtaining good quality images. Advances in knowledge: Low and ultra-low CM volumes and injection rates are feasible in CTA through the joint application of ssDECT and ASIR.
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Affiliation(s)
- Ping Hou
- 1 Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiangnan Feng
- 2 Department of Statistics, The Chinese University of Hong Kong, Hong Kong, China
| | - Jie Liu
- 1 Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yue Zhou
- 1 Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yaojun Jiang
- 1 Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaochen Jiang
- 1 Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianbo Gao
- 1 Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Shuman WP, O'Malley RB, Busey JM, Ramos MM, Koprowicz KM. Prospective comparison of dual-energy CT aortography using 70% reduced iodine dose versus single-energy CT aortography using standard iodine dose in the same patient. Abdom Radiol (NY) 2017; 42:759-765. [PMID: 28084544 DOI: 10.1007/s00261-016-1041-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare dual-energy computed tomography (DECT) aortography using a 70% reduced iodine dose to single-energy CT (SECT) aortography using a standard iodine dose in the same patient. METHODS Twenty-one patients with a prior SECT aortography using standard iodine dose had DECT aortography using 70% reduced iodine dose. Section 120 kVp images were compared to DECT images reconstructed at both 50 and 77 keV. Reviewers measured image noise and attenuation in the aorta at eight locations from proximal to distal and subjectively scored vascular enhancement on a four-point scale. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The volume CT dose index (CTDIvol) for each exam was recorded. RESULTS Mean iodine dose was 50 g for SECT and 15 g for DECT (70% reduction). Mean aortic attenuation was similar for section 120 kVp (350 ± 67 HU) and DECT 50 keV (338 ± 57 HU, p = 0.547) but was lower at 77 keV (152 ± 23 HU). Measured image noise was greatest at 50 keV (12 ± 5 HU) and was lowest at 77 keV (7 ± 2 HU, p > 0.001). There was no difference in SNR or CNR between 120 kVp and 50 keV (p > 0.05). Mean subjective vascular enhancement scores for SECT were between good and excellent (3.33-3.69), and for DECT at 50 keV were between moderate and good (2.54-2.93, p < 0.0001). CTDIvol was 13.6 mGy for SECT and 13.1 mGy for DECT (p = 0.637). CONCLUSION 70% Reduced iodine DECT aortography may result in similar aortic attenuation, CNR, SNR, and lower although acceptable subjective image scores when compared to standard iodine SECT aortography in the same patient.
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Affiliation(s)
- William P Shuman
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA.
| | - Ryan B O'Malley
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA
| | - Janet M Busey
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA
| | - Mario M Ramos
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA
| | - Kent M Koprowicz
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA
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