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Fahrni G, Mingas T, Deliessche A, Hraichi S, Rotzinger DC, Si-Mohamed SA, Boccalini S, Douek P. Low-iodine 40-keV virtual monoenergetic CT angiography of the lower extremities. Front Cardiovasc Med 2023; 10:1276738. [PMID: 37942065 PMCID: PMC10629994 DOI: 10.3389/fcvm.2023.1276738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/25/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction To evaluate a reduced iodine volume protocol for lower extremity CT angiography (CTA) using dual-energy CT (DECT). Methods This retrospective study included consecutive patients who underwent lower extremity CTA from June to December 2022. A 10 ml 1:1 mixed test bolus was performed, followed by a 40 ml full bolus at a 2.5/s injection rate, using 400 mg/ml iodine contrast media. Conventional and 40 keV virtual monoenergetic images (VMI) were reconstructed. For both reconstructions, five main artery segments were assessed with a 3-point image quality score as well as quantitative attenuation, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements with diagnostic quality thresholds (respectively >150 HU and >3). Results Forty patients were included in the study (mean age 68 ± 12 yo). 200 artery segments were assessed. Median qualitative image scores were 3 [IQR, 3, 3] for both reconstructions. 40 keV VMI upgraded qualitative scores for 51 (26%) of patients, including 9 (5%) from nondiagnostic to diagnostic quality. 40 keV VMI obtained attenuation and CNR diagnostic quality for respectively 100% and 100% of segments, compared with 96% and 98% for conventional images (p < 0.001). Distal artery segments showed the most differences between 40 keV VMI and conventional images. Conclusion A low-iodine lower extremity CTA protocol is feasible, with 40 keV virtual monoenergetic spectral reconstruction enabling maintained diagnostic image quality at the distal artery segments.
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Affiliation(s)
- Guillaume Fahrni
- Department of Diagnostic and Interventional Radiology, Cardiothoracic and Vascular Division, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Thomas Mingas
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Arthur Deliessche
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Smail Hraichi
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - David C. Rotzinger
- Department of Diagnostic and Interventional Radiology, Cardiothoracic and Vascular Division, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Salim A. Si-Mohamed
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Sara Boccalini
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Philippe Douek
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Villeurbanne, France
- Department of Radiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
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Fahrni G, Rotzinger DC, Nakajo C, Dehmeshki J, Qanadli SD. Three-Dimensional Adaptive Image Compression Concept for Medical Imaging: Application to Computed Tomography Angiography for Peripheral Arteries. J Cardiovasc Dev Dis 2022; 9:jcdd9050137. [PMID: 35621848 PMCID: PMC9145618 DOI: 10.3390/jcdd9050137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Advances in computed tomography (CT) have resulted in a substantial increase in the size of datasets. We built a new concept of medical image compression that provides the best compromise between compression rate and image quality. The method is based on multiple contexts and regions-of-interest (ROI) defined according to the degree of clinical interest. High priority areas (primary ROIs) are assigned a lossless compression. Other areas (secondary ROIs and background) are compressed with moderate or heavy losses. The method is applied to a whole dataset of CT angiography (CTA) of the lower extremity vasculature. It is compared to standard lossy compression techniques in terms of quantitative and qualitative image quality. It is also compared to standard lossless compression techniques in terms of image size reduction and compression ratio. The proposed compression method met quantitative criteria for high-quality encoding. It obtained the highest qualitative image quality rating score, with a statistically significant difference compared to other methods. The average compressed image size was up to 61% lower compared to standard compression techniques, with a 9:1 compression ratio compared with original non-compressed images. Our new adaptive 3D compression method for CT images can save data storage space while preserving clinically relevant information.
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Affiliation(s)
- Guillaume Fahrni
- Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (D.C.R.); (C.N.); (S.D.Q.)
- Correspondence:
| | - David C. Rotzinger
- Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (D.C.R.); (C.N.); (S.D.Q.)
- Imaging and Image-Guided Therapies Lab (IGT-L), University of Lausanne, 1015 Lausanne, Switzerland
| | - Chiaki Nakajo
- Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (D.C.R.); (C.N.); (S.D.Q.)
| | - Jamshid Dehmeshki
- Department of Computer Science, Kingston University, Kingston-upon-Thames KT1 2QT, UK;
| | - Salah Dine Qanadli
- Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (D.C.R.); (C.N.); (S.D.Q.)
- Imaging and Image-Guided Therapies Lab (IGT-L), University of Lausanne, 1015 Lausanne, Switzerland
- Department of Computer Science, Kingston University, Kingston-upon-Thames KT1 2QT, UK;
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