1
|
Li H, Zhang D, Pei J, Hu J, Li X, Liu B, Wang L. Dual-energy computed tomography iodine quantification combined with laboratory data for predicting microvascular invasion in hepatocellular carcinoma: a two-centre study. Br J Radiol 2024; 97:1467-1475. [PMID: 38870535 PMCID: PMC11256957 DOI: 10.1093/bjr/tqae116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/16/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVES Microvascular invasion (MVI) is a recognized biomarker associated with poorer prognosis in patients with hepatocellular carcinoma. Dual-energy computed tomography (DECT) is a highly sensitive technique that can determine the iodine concentration (IC) in tumour and provide an indirect evaluation of internal microcirculatory perfusion. This study aimed to assess whether the combination of DECT with laboratory data can improve preoperative MVI prediction. METHODS This retrospective study enrolled 119 patients who underwent DECT liver angiography at 2 medical centres preoperatively. To compare DECT parameters and laboratory findings between MVI-negative and MVI-positive groups, Mann-Whitney U test was used. Additionally, principal component analysis (PCA) was conducted to determine fundamental components. Mann-Whitney U test was applied to determine whether the principal component (PC) scores varied across MVI groups. Finally, a general linear classifier was used to assess the classification ability of each PC score. RESULTS Significant differences were noted (P < .05) in alpha-fetoprotein (AFP) level, normalized arterial phase IC, and normalized portal phase IC between the MVI groups in the primary and validation datasets. The PC1-PC4 accounted for 67.9% of the variance in the primary dataset, with loadings of 24.1%, 16%, 15.4%, and 12.4%, respectively. In both primary and validation datasets, PC3 and PC4 were significantly different across MVI groups, with area under the curve values of 0.8410 and 0.8373, respectively. CONCLUSIONS The recombination of DECT IC and laboratory features based on varying factor loadings can well predict MVI preoperatively. ADVANCES IN KNOWLEDGE Utilizing PCA, the amalgamation of DECT IC and laboratory features, considering diverse factor loadings, showed substantial promise in accurately classifying MVI. There have been limited endeavours to establish such a combination, offering a novel paradigm for comprehending data in related research endeavours.
Collapse
Affiliation(s)
- Huan Li
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
- Medical Imaging Research Center, Anhui Medical University, Hefei, Anhui 230601, China
| | - Dai Zhang
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
- Medical Imaging Research Center, Anhui Medical University, Hefei, Anhui 230601, China
| | - Jinxia Pei
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
- Medical Imaging Research Center, Anhui Medical University, Hefei, Anhui 230601, China
| | - Jingmei Hu
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
- Medical Imaging Research Center, Anhui Medical University, Hefei, Anhui 230601, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Bin Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Longsheng Wang
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
- Medical Imaging Research Center, Anhui Medical University, Hefei, Anhui 230601, China
| |
Collapse
|
2
|
Zhu L, Dong H, Sun J, Wang L, Xing Y, Hu Y, Lu J, Yang J, Chu J, Yan C, Yuan F, Zhong J. Robustness of radiomics among photon-counting detector CT and dual-energy CT systems: a texture phantom study. Eur Radiol 2024:10.1007/s00330-024-10976-1. [PMID: 39048741 DOI: 10.1007/s00330-024-10976-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/18/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES To evaluate the robustness of radiomics features among photon-counting detector CT (PCD-CT) and dual-energy CT (DECT) systems. METHODS A texture phantom consisting of twenty-eight materials was scanned with one PCD-CT and four DECT systems (dual-source, rapid kV-switching, dual-layer, and sequential scanning) at three dose levels twice. Thirty sets of virtual monochromatic images at 70 keV were reconstructed. Regions of interest were delineated for each material with a rigid registration. Ninety-three radiomics were extracted per PyRadiomics. The test-retest repeatability between repeated scans was assessed by Bland-Altman analysis. The intra-system reproducibility between dose levels, and inter-system reproducibility within the same dose level, were evaluated by intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC). Inter-system variability among five scanners was assessed by coefficient of variation (CV) and quartile coefficient of dispersion (QCD). RESULTS The test-retest repeatability analysis presented that 97.1% of features were repeatable between scan-rescans. The mean ± standard deviation ICC and CCC were 0.945 ± 0.079 and 0.945 ± 0.079 for intra-system reproducibility, respectively, and 86.0% and 85.7% of features were with ICC > 0.90 and CCC > 0.90, respectively, between different dose levels. The mean ± standard deviation ICC and CCC were 0.157 ± 0.174 and 0.157 ± 0.174 for inter-system reproducibility, respectively, and none of the features were with ICC > 0.90 or CCC > 0.90 within the same dose level. The inter-system variability suggested that 6.5% and 12.8% of features were with CV < 10% and QCD < 10%, respectively, among five CT systems. CONCLUSION The radiomics features were non-reproducible with significant variability in values among different CT techniques. CLINICAL RELEVANCE STATEMENT Radiomics features are non-reproducible with significant variability in values among photon-counting detector CT and dual-energy CT systems, necessitating careful attention to improve the cross-system generalizability of radiomic features before implementation of radiomics analysis in clinical routine. KEY POINTS CT radiomics stability should be guaranteed before the implementation in the clinical routine. Radiomics robustness was on a low level among photon-counting detectors and dual-energy CT techniques. Limited inter-system robustness of radiomic features may impact the generalizability of models.
Collapse
Affiliation(s)
- Lan Zhu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Haipeng Dong
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jing Sun
- Department of General Surgery, Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lingyun Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Junjie Lu
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Jiarui Yang
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Jingshen Chu
- Department of Science and Technology Development, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Chao Yan
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Fei Yuan
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
| |
Collapse
|
3
|
Zhong J, Wang L, Yan C, Xing Y, Hu Y, Ding D, Ge X, Li J, Lu W, Shi X, Yuan F, Yao W, Zhang H. Deep learning image reconstruction generates thinner slice iodine maps with improved image quality to increase diagnostic acceptance and lesion conspicuity: a prospective study on abdominal dual-energy CT. BMC Med Imaging 2024; 24:159. [PMID: 38926711 PMCID: PMC11201298 DOI: 10.1186/s12880-024-01334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND To assess the improvement of image quality and diagnostic acceptance of thinner slice iodine maps enabled by deep learning image reconstruction (DLIR) in abdominal dual-energy CT (DECT). METHODS This study prospectively included 104 participants with 136 lesions. Four series of iodine maps were generated based on portal-venous scans of contrast-enhanced abdominal DECT: 5-mm and 1.25-mm using adaptive statistical iterative reconstruction-V (Asir-V) with 50% blending (AV-50), and 1.25-mm using DLIR with medium (DLIR-M), and high strength (DLIR-H). The iodine concentrations (IC) and their standard deviations of nine anatomical sites were measured, and the corresponding coefficient of variations (CV) were calculated. Noise-power-spectrum (NPS) and edge-rise-slope (ERS) were measured. Five radiologists rated image quality in terms of image noise, contrast, sharpness, texture, and small structure visibility, and evaluated overall diagnostic acceptability of images and lesion conspicuity. RESULTS The four reconstructions maintained the IC values unchanged in nine anatomical sites (all p > 0.999). Compared to 1.25-mm AV-50, 1.25-mm DLIR-M and DLIR-H significantly reduced CV values (all p < 0.001) and presented lower noise and noise peak (both p < 0.001). Compared to 5-mm AV-50, 1.25-mm images had higher ERS (all p < 0.001). The difference of the peak and average spatial frequency among the four reconstructions was relatively small but statistically significant (both p < 0.001). The 1.25-mm DLIR-M images were rated higher than the 5-mm and 1.25-mm AV-50 images for diagnostic acceptability and lesion conspicuity (all P < 0.001). CONCLUSIONS DLIR may facilitate the thinner slice thickness iodine maps in abdominal DECT for improvement of image quality, diagnostic acceptability, and lesion conspicuity.
Collapse
Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Lingyun Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Chao Yan
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Jianying Li
- Computed Tomography Research Center, GE Healthcare, Beijing, 100176, China
| | - Wei Lu
- Computed Tomography Research Center, GE Healthcare, Shanghai, 201203, China
| | - Xiaomeng Shi
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Fei Yuan
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| |
Collapse
|
4
|
Ohira S, Mochizuki J, Niwa T, Endo K, Minamitani M, Yamashita H, Katano A, Imae T, Nishio T, Koizumi M, Nakagawa K. Variation in Hounsfield unit calculated using dual-energy computed tomography: comparison of dual-layer, dual-source, and fast kilovoltage switching technique. Radiol Phys Technol 2024; 17:458-466. [PMID: 38700638 PMCID: PMC11128400 DOI: 10.1007/s12194-024-00802-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/27/2024]
Abstract
The purpose of the study is to investigate the variation in Hounsfield unit (HU) values calculated using dual-energy computed tomography (DECT) scanners. A tissue characterization phantom inserting 16 reference materials were scanned three times using DECT scanners [dual-layer CT (DLCT), dual-source CT (DSCT), and fast kilovoltage switching CT (FKSCT)] changing scanning conditions. The single-energy CT images (120 or 140 kVp), and virtual monochromatic images at 70 keV (VMI70) and 140 keV (VMI140) were reconstructed, and the HU values of each reference material were measured. The difference in HU values was larger when the phantom was scanned using the half dose with wrapping with rubber (strong beam-hardening effect) compared with the full dose without the rubber (reference condition), and the difference was larger as the electron density increased. For SECT, the difference in HU values against the reference condition measured by the DSCT (3.2 ± 5.0 HU) was significantly smaller (p < 0.05) than that using DLCT with 120 kVp (22.4 ± 23.8 HU), DLCT with 140 kVp (11.4 ± 12.8 HU), and FKSCT (13.4 ± 14.3 HU). The respective difference in HU values in the VMI70 and VMI140 measured using the DSCT (10.8 ± 17.1 and 3.5 ± 4.1 HU) and FKSCT (11.5 ± 21.8 and 5.5 ± 10.4 HU) were significantly smaller than those measured using the DLCT120 (23.1 ± 27.5 and 12.4 ± 9.4 HU) and DLCT140 (22.3 ± 28.6 and 13.1 ± 11.4 HU). The HU values and the susceptibility to beam-hardening effects varied widely depending on the DECT scanners.
Collapse
Affiliation(s)
- Shingo Ohira
- Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Junji Mochizuki
- Department of Radiology, Minamino Cardiovascular Hospital, Tokyo, Japan
| | - Tatsunori Niwa
- Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Kazuyuki Endo
- Department of Radiologic Technology, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Masanari Minamitani
- Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hideomi Yamashita
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Atsuto Katano
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshikazu Imae
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Teiji Nishio
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiko Koizumi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keiichi Nakagawa
- Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| |
Collapse
|
5
|
Zhong J, Chen L, Xing Y, Lu J, Shi Y, Wang Y, Deng Y, Jiang R, Lu W, Wang S, Hu Y, Ge X, Ding D, Zhang H, Zhu Y, Yao W. Just give the contrast? Appraisal of guidelines on intravenous iodinated contrast media use in patients with kidney disease. Insights Imaging 2024; 15:77. [PMID: 38499879 PMCID: PMC10948651 DOI: 10.1186/s13244-024-01644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/10/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To appraise the quality of guidelines on intravenous iodinated contrast media (ICM) use in patients with kidney disease, and to compare the recommendations among them. METHODS We searched four literature databases, eight guideline libraries, and ten homepages of radiological societies to identify English and Chinese guidelines on intravenous ICM use in patients with kidney disease published between January 2018 and June 2023. The quality of the guidelines was assessed with the Scientific, Transparent, and Applicable Rankings (STAR) tool. RESULTS Ten guidelines were included, with a median STAR score of 46.0 (range 28.5-61.5). The guidelines performed well in "Recommendations" domain (31/40, 78%), while poor in "Registry" (0/20, 0%) and "Protocol" domains (0/20, 0%). Nine guidelines recommended estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 as the cutoff for referring patients to discuss the risk-benefit balance of ICM administration. Three guidelines further suggested that patients with an eGFR < 45 mL/min/1.73 m2 and high-risk factors also need referring. Variable recommendations were seen in the acceptable time interval between renal function test and ICM administration, and that between scan and repeated scan. Nine guidelines recommended to use iso-osmolar or low-osmolar ICM, while no consensus has been reached for the dosing of ICM. Nine guidelines supported hydration after ICM use, but their protocols varied. Drugs or blood purification therapy were not recommended as preventative means. CONCLUSION Guidelines on intravenous ICM use in patients with kidney disease have heterogeneous quality. The scientific societies may consider joint statements on controversial recommendations for variable timing and protocols. CRITICAL RELEVANCE STATEMENT The heterogeneous quality of guidelines, and their controversial recommendations, leave gaps in workflow timing, dosing, and post-administration hydration protocols of contrast-enhanced CT scans for patients with kidney diseases, calling for more evidence to establish a safer and more practicable workflow. KEY POINTS • Guidelines concerning iodinated contrast media use in kidney disease patients vary. • Controversy remains in workflow timing, contrast dosing, and post-administration hydration protocols. • Investigations are encouraged to establish a safer iodinated contrast media use workflow.
Collapse
Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Liwei Chen
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Junjie Lu
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Yuping Shi
- Department of Nephrology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yibin Wang
- Department of Urology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yi Deng
- University of Washington School of Pharmacy, Seattle, WA, 98105, USA
| | - Run Jiang
- Department of Pharmacovigilance, Shanghai Hansoh BioMedical Co., Ltd, Shanghai, 201203, China
| | - Wenjie Lu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Silian Wang
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 200025, China.
| | - Ying Zhu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
| |
Collapse
|
6
|
Duan X, Zhang Y. Establishing quality control action limits for CT number accuracy in spectral images using an American College of Radiology phantom. Med Phys 2023; 50:6071-6078. [PMID: 37475459 DOI: 10.1002/mp.16626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/14/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Computed tomography (CT) number accuracy is important for quality assurance in CT imaging. However, in dual-energy CT imaging, there are no widely used action limits for CT number accuracy in spectral images, information that is urgently needed. PURPOSE To establish action limits for spectral CT images using longitudinal spectral data and an American College of Radiology (ACR) phantom. METHODS An ACR accreditation phantom was scanned routinely as part of a quality control program in our institution. We selected and analyzed 57 continuous weekly scans. The CT numbers or the density values of conventional and spectral images, including virtual monoenergetic images (40, 50, 70, 120, and 200 keV), iodine maps, calcium suppressed, and virtual non-contrast images, were measured in the four inserts (solid water, bone, polyethylene, and acrylic) of the phantom. Longitudinal data were analyzed for correlation using Pearson's correlation coefficient (r) and standard deviation (SD). The SD ratios between spectral images and conventional images were calculated and the action limits for spectral images were established based on the action limits from the ACR. RESULTS Strong to very strong correlations (r > 0.70 or r < -0.70) were found among most spectral image types except the 200 keV images using solid water, polyethylene, and acrylic inserts (r = [-0.45, 0.64]). The SD ratio was highest for the 40 keV images, ranging from 2.8 to 6.5. The action limits of the bone insert were baseline ± 5.3 mg/mL for the iodine map and ranged from baseline ± 23.0 HU to baseline ± 391.9 HU for the other image types. The action limits for solid water ranged from baseline ± 4.1 HU to baseline ± 25.3 HU. The results for the polyethylene and the acrylic insert were close to those for solid water. Baselines can be established using the average of the initial 5∼10 measurements. CONCLUSIONS Using longitudinal data, we estimated the action limits for CT number accuracy in the spectral images. This paves the way for establishing a comprehensive quality control program for spectral CT imaging.
Collapse
Affiliation(s)
- Xinhui Duan
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Yue Zhang
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
7
|
Zhong J, Wang L, Shen H, Li J, Lu W, Shi X, Xing Y, Hu Y, Ge X, Ding D, Yan F, Du L, Yao W, Zhang H. Improving lesion conspicuity in abdominal dual-energy CT with deep learning image reconstruction: a prospective study with five readers. Eur Radiol 2023; 33:5331-5343. [PMID: 36976337 DOI: 10.1007/s00330-023-09556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/07/2023] [Accepted: 02/17/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To evaluate image quality, diagnostic acceptability, and lesion conspicuity in abdominal dual-energy CT (DECT) using deep learning image reconstruction (DLIR) compared to those using adaptive statistical iterative reconstruction-V (Asir-V) at 50% blending (AV-50), and to identify potential factors impacting lesion conspicuity. METHODS The portal-venous phase scans in abdominal DECT of 47 participants with 84 lesions were prospectively included. The raw data were reconstructed to virtual monoenergetic image (VMI) at 50 keV using filtered back-projection (FBP), AV-50, and DLIR at low (DLIR-L), medium (DLIR-M), and high strength (DLIR-H). A noise power spectrum (NPS) was generated. CT number and standard deviation values of eight anatomical sites were measured. Signal-to-noise (SNR), and contrast-to-noise ratio (CNR) values were calculated. Five radiologists assessed image quality in terms of image contrast, image noise, image sharpness, artificial sensation, and diagnostic acceptability, and evaluated the lesion conspicuity. RESULTS DLIR further reduced image noise (p < 0.001) compared to AV-50 while better preserved the average NPS frequency (p < 0.001). DLIR maintained CT number values (p > 0.99) and improved SNR and CNR values compared to AV-50 (p < 0.001). DLIR-H and DLIR-M showed higher ratings in all image quality analyses than AV-50 (p < 0.001). DLIR-H provided significantly better lesion conspicuity than AV-50 and DLIR-M regardless of lesion size, relative CT attenuation to surrounding tissue, or clinical purpose (p < 0.05). CONCLUSIONS DLIR-H could be safely recommended for routine low-keV VMI reconstruction in daily contrast-enhanced abdominal DECT to improve image quality, diagnostic acceptability, and lesion conspicuity. KEY POINTS • DLIR is superior to AV-50 in noise reduction, with less shifts of the average spatial frequency of NPS towards low frequency, and larger improvements of NPS noise, noise peak, SNR, and CNR values. • DLIR-M and DLIR-H generate better image quality in terms of image contrast, noise, sharpness, artificial sensation, and diagnostic acceptability than AV-50, while DLIR-H provides better lesion conspicuity than AV-50 and DLIR-M. • DLIR-H could be safely recommended as a new standard for routine low-keV VMI reconstruction in contrast-enhanced abdominal DECT to provide better lesion conspicuity and better image quality than the standard AV-50.
Collapse
Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Lingyun Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Hailin Shen
- Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, 215028, China
| | - Jianying Li
- Computed Tomography Research Center, GE Healthcare, Beijing, 100176, China
| | - Wei Lu
- Computed Tomography Research Center, GE Healthcare, Shanghai, 201203, China
| | - Xiaomeng Shi
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lianjun Du
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| |
Collapse
|
8
|
Zhong J, Shen H, Chen Y, Xia Y, Shi X, Lu W, Li J, Xing Y, Hu Y, Ge X, Ding D, Jiang Z, Yao W. Evaluation of Image Quality and Detectability of Deep Learning Image Reconstruction (DLIR) Algorithm in Single- and Dual-energy CT. J Digit Imaging 2023; 36:1390-1407. [PMID: 37071291 PMCID: PMC10406981 DOI: 10.1007/s10278-023-00806-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 04/19/2023] Open
Abstract
This study is aimed to evaluate effects of deep learning image reconstruction (DLIR) on image quality in single-energy CT (SECT) and dual-energy CT (DECT), in reference to adaptive statistical iterative reconstruction-V (ASIR-V). The Gammex 464 phantom was scanned in SECT and DECT modes at three dose levels (5, 10, and 20 mGy). Raw data were reconstructed using six algorithms: filtered back-projection (FBP), ASIR-V at 40% (AV-40) and 100% (AV-100) strength, and DLIR at low (DLIR-L), medium (DLIR-M), and high strength (DLIR-H), to generate SECT 120kVp images and DECT 120kVp-like images. Objective image quality metrics were computed, including noise power spectrum (NPS), task transfer function (TTF), and detectability index (d'). Subjective image quality evaluation, including image noise, texture, sharpness, overall quality, and low- and high-contrast detectability, was performed by six readers. DLIR-H reduced overall noise magnitudes from FBP by 55.2% in a more balanced way of low and high frequency ranges comparing to AV-40, and improved the TTF values at 50% for acrylic inserts by average percentages of 18.32%. Comparing to SECT 20 mGy AV-40 images, the DECT 10 mGy DLIR-H images showed 20.90% and 7.75% improvement in d' for the small-object high-contrast and large-object low-contrast tasks, respectively. Subjective evaluation showed higher image quality and better detectability. At 50% of the radiation dose level, DECT with DLIR-H yields a gain in objective detectability index compared to full-dose AV-40 SECT images used in daily practice.
Collapse
Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| | - Hailin Shen
- Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, 215028 China
| | - Yong Chen
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Yihan Xia
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Xiaomeng Shi
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ UK
| | - Wei Lu
- Computed Tomography Research Center, GE Healthcare, Shanghai, 201203 China
| | - Jianying Li
- Computed Tomography Research Center, GE Healthcare, Beijing, 100176 China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| | - Zhenming Jiang
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Changning District, No. 1111 Xianxia Road, Shanghai, 200336 China
| |
Collapse
|
9
|
Diagnostic Effectiveness of Dual Source Dual Energy Computed Tomography for Benign and Malignant Thyroid Nodules. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2257304. [PMID: 36034942 PMCID: PMC9402342 DOI: 10.1155/2022/2257304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
Objective To evaluate the diagnostic effectiveness of dual source dual energy computed tomography (DS-DECT) for benign and malignant thyroid nodules. Methods Between January 2019 and December 2021, 60 patients with surgically and pathologically verified thyroid nodules treated at our institution were recruited. DS-DECT was administered to all patients. The iodine content of lesioned and normal tissues, the normalized iodine concentration (NIC) and standardized CT values of benign and malignant nodules, the consistency of examination results and pathological findings, and diagnostic effectiveness were all investigated. Results The diagnosis accuracy was the same as that of surgical pathology, producing a 100% accuracy for the 60 patients with thyroid nodules (42 were benign and 18 were malignant). The iodine content of lesioned solid tissue differed significantly from that of normal tissue, as did the iodine content of malignant and benign nodules (P < 0.05). In the arterial phase, no significant difference was found in NIC and standardized CT values between benign and malignant nodules (P > 0.05). The optimal critical NIC for differentiating benign and malignant nodules in the venous phase was 0.74 and the standardized CT value was 0.79 HU according to the receiver operating characteristics (ROC) curve. Malignant nodules were diagnosed when the NIC was <0.74 and the standardized CT value was <0.79 HU, with AUC values of 0.89 and 0.93, respectively, where the sensitivity and specificity of the differential diagnosis of NIC were 90.48% (38/42) and 88.89% (16/18), respectively, and those of the differential diagnosis of standardized CT value were 92.86% (39/ 42) and 94.44% (17/18), respectively. The diagnosis accuracy of DS-DECT was 100%, and the diagnostic results of morphological characteristics and pathological testing were consistent. The sensitivity and specificity of the NIC values and standardized CT values in the venous phase differential diagnosis of benign and malignant nodules were compatible with the morphological differential diagnosis. Conclusion DS-DECT is highly accurate in determining the benignity and malignancy of thyroid nodules and has a strong potential for clinical promotion to allow for prompt treatment.
Collapse
|