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Kaga T, Noda Y, Nagata S, Kawai N, Miyoshi T, Hyodo F, Kato H, Matsuo M. Comparison of image quality, arterial depiction, and radiation dose between two rapid kVp-switching dual-energy CT scanners in CT angiography at 40-keV. Jpn J Radiol 2023; 41:1298-1307. [PMID: 37212946 PMCID: PMC10613589 DOI: 10.1007/s11604-023-01448-5] [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: 12/05/2022] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE To compare the quantitative parameters and qualitative image quality of dual-energy CT angiography (CTA) between two rapid kVp-switching dual-energy CT scanners. MATERIALS AND METHODS Between May 2021 and March 2022, 79 participants underwent whole-body CTA using either Discovery CT750 HD (Group A, n = 38) or Revolution CT Apex (Group B, n = 41). All data were reconstructed at 40-keV and with adaptive statistical iterative reconstruction-Veo of 40%. The two groups were compared in terms of CT numbers of the thoracic and abdominal aorta, and the iliac artery, background noise, signal-to-noise ratio (SNR) of the artery, CT dose-index volume (CTDIvol), and qualitative scores for image noise, sharpness, diagnostic acceptability, and arterial depictions. RESULTS The median CT number of the abdominal aorta (p = 0.04) and SNR of the thoracic aorta (p = 0.02) were higher in Group B than in Group A, while no difference was observed in the other CT numbers and SNRs of the artery (p = 0.09-0.23). The background noises at the thoracic (p = 0.11), abdominal (p = 0.85), and pelvic (p = 0.85) regions were comparable between the two groups. CTDIvol was lower in Group B than in Group A (p = 0.006). All qualitative scores were higher in Group B than in Group A (p < 0.001-0.04). The arterial depictions were nearly identical in both two groups (p = 0.005-1.0). CONCLUSION In dual-energy CTA at 40-keV, Revolution CT Apex improved qualitative image quality and reduced radiation dose.
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Affiliation(s)
- Tetsuro Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Shoma Nagata
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Toshiharu Miyoshi
- Department of Radiology Services, Gifu University Hospital, Gifu, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
- Institute for Advanced Study, Gifu University, Gifu, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
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Hofmann AG, Shoumariyeh T, Domenig C, Skrabal F, Kovarik JJ. Abdominal Aortic Aneurysm Detection in Bioelectrical Impedance Cardiovascular Screenings-A Pilot Study. J Clin Med 2023; 12:jcm12113726. [PMID: 37297921 DOI: 10.3390/jcm12113726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Screening and diagnosing abdominal aortic aneurysms (AAA) are currently dependent on imaging studies such as ultrasound or computed tomography angiography. All imaging studies offer distinct advantages but also suffer from inherent limitations such as examiner dependency or ionizing radiation. Bioelectrical impedance analysis has previously been investigated with respect to its use in the detection of several cardiovascular and renal pathologies. The present pilot study assessed the feasibility of AAA detection based on bioimpedance analysis. In this single-center exploratory pilot study, measurements were conducted among three different cohorts: patients with AAA, end-stage renal disease patients without AAA, and healthy controls. The device used in the study, CombynECG, is an open-market accessible device for segmental bioelectrical impedance analysis. The data was preprocessed and used to train four different machine learning models on a randomized training sample (80% of the full dataset). Each model was then evaluated on a test set (20% of the full dataset). The total sample included 22 patients with AAA, 16 chronic kidney disease patients, and 23 healthy controls. All four models showed strong predictive performance in the test partitions. Specificity ranged from 71.4 to 100%, while sensitivity ranged from 66.7 to 100%. The best-performing model had 100% accuracy for classification when applied to the test sample. Additionally, an exploratory analysis to approximate the maximum AAA diameter was conducted. An association analysis revealed several impedance parameters that might possess predictive ability with respect to aneurysm size. AAA detection via bioelectrical impedance analysis is technically feasible and appears to be a promising technology for large-scale clinical studies and routine clinical screening assessments.
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Affiliation(s)
- Amun G Hofmann
- Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, 1090 Vienna, Austria
| | - Tarik Shoumariyeh
- Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, 1090 Vienna, Austria
| | - Christoph Domenig
- Department of General Surgery, Division of Vascular Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Falko Skrabal
- Institute of Cardiovascular & Metabolic Medicine, 8010 Graz, Austria
| | - Johannes J Kovarik
- Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, 1090 Vienna, Austria
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Landi F, O’Higgins P. Applying Geometric Morphometrics to Digital Reconstruction and Anatomical Investigation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1171:55-71. [DOI: 10.1007/978-3-030-24281-7_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging. Insights Imaging 2016; 7:849-856. [PMID: 27628743 PMCID: PMC5110476 DOI: 10.1007/s13244-016-0518-1] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 08/23/2016] [Accepted: 08/29/2016] [Indexed: 12/23/2022] Open
Abstract
Abstract Volume rendering (VR) represents today’s standard three-dimensional (3-D) image post-processing technique, and often is used to visualize complex anatomical information. Recently, a novel 3-D technique for post-processing of computed tomography (CT) image data has been introduced, which is called cinematic rendering (CR). The objective of this review is to illustrate the image appearance and potential value of CR in comparison with conventional VR in a number of various applications and different anatomical regions. Similar to VR, CR best visualizes high density and high contrast structures such as bones and contrast-enhanced vessels, but at the same time provides a more natural and photo-realistic illumination of the rendered data. Further research will be necessary for determining possible advantages of CR over conventional VR and over two-dimensional (2-D) image post-processing for CT image data. Teaching Points • Cinematic rendering is a novel post-processing technique for 3D visualization of CT image data. • Compared to volume rendering, CR results in a more photo-realistic representation of anatomy. • Similar to volume rendering, CR provides best image quality of high density structures.
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Thakor AS, Tanner J, Ong SJ, Hughes-Roberts Y, Ilyas S, Cousins C, See TC, Klass D, Winterbottom AP. Radiological Evaluation of Abdominal Endovascular Aortic Aneurysm Repair. Can Assoc Radiol J 2015; 66:277-90. [PMID: 25978867 DOI: 10.1016/j.carj.2014.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/31/2014] [Accepted: 12/01/2014] [Indexed: 02/07/2023] Open
Abstract
Endovascular aortic aneurysm repair (EVAR) is an alternative to open surgical repair of aortic aneurysms offering lower perioperative mortality and morbidity. As experience increases, clinicians are undertaking complex repairs with hostile aortic anatomy using branched or fenestrated devices or extra components such as chimneys to ensure perfusion to visceral branch vessels whilst excluding the aneurysm. Defining the success of EVAR depends on both clinical and radiographic criteria, but ultimately depends on complete exclusion of the aneurysm from the circulation. Aortic stent grafts are monitored using a combination of imaging modalities including computed tomography angiography (CTA), ultrasonography, magnetic resonance imaging, plain films, and nuclear medicine studies. This article describes when and how to evaluate aortic stent grafts using each of these modalities along with the characteristic features of several of the main stent grafts currently used in clinical practice. The commonly encountered complications from EVAR are also discussed and how they can be detected using each imaging modality. As the radiation burden from serial follow up CTA imaging is now becoming a concern, different follow-up imaging strategies are proposed depending on the complexity of the repair and based on the relative merits and disadvantages of each imaging modality.
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Affiliation(s)
- Avnesh S Thakor
- Department of Interventional Radiology, Stanford University, Stanford University Medical Center, Palo Alto, California, USA
| | - James Tanner
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Shao J Ong
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Ynyr Hughes-Roberts
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Shahzad Ilyas
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Claire Cousins
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Teik C See
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Darren Klass
- Department of Interventional Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew P Winterbottom
- Department of Interventional Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
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Abstract
Patients with abdominal aortic aneurysms (AAAs) are usually treated with endovascular aneurysm repair (EVAR), which has become the standard of care in many hospitals for patients with suitable anatomy. Clinical evidence indicates that EVAR is associated with superior perioperative outcomes and similar long-term survival compared with open repair. Since the randomized, controlled trials that provided this evidence were conducted, however, the stent graft technology for infrarenal AAA has been further developed. Improvements include profile downsizing, optimization of sealing and fixation, and the use of low porosity fabrics. In addition, imaging techniques have improved, enabling better preoperative planning, stent graft placement, and postoperative surveillance. Also in the past few years, fenestrated and branched stent grafts have increasingly been used to manage anatomically challenging aneurysms, and experiments with off-label use of stent grafts have been performed to treat patients deemed unfit or unsuitable for other treatment strategies. Overall, the indications for endovascular management of AAA are expanding to include increasingly complex and anatomically challenging aneurysms. Ongoing studies and optimization of imaging, in addition to technological refinement of stent grafts, will hopefully continue to broaden the utilization of EVAR.
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Affiliation(s)
- Dominique B Buck
- 1] Department of Vascular Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. [2] Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Centre, Harvard Medical School, 110 Francis Street Suite B, Boston, MA 02215, USA
| | - Joost A van Herwaarden
- Department of Vascular Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - Marc L Schermerhorn
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Centre, Harvard Medical School, 110 Francis Street Suite B, Boston, MA 02215, USA
| | - Frans L Moll
- Department of Vascular Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
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