Purpose: The purpose of this study was to evaluate the diagnostic accuracy when using various base material pairs (BMPs) in dual-energy computed tomography (DECT), and to establish corresponding diagnostic standards for assessing bone status through comparison with quantitative computed tomography (QCT). Methods: This prospective study enrolled a total of 469 patients who underwent both non-enhanced chest CT scans under conventional kVp and abdominal DECT. The bone densities of hydroxyapatite (water), hydroxyapatite (fat), hydroxyapatite (blood), calcium (water), and calcium (fat) (DHAP (water), DHAP (fat), DHAP (blood), DCa (water), and DCa (fat)) in the trabecular bone of vertebral bodies (T11–L1) were measured, along with bone mineral density (BMD) via QCT. Intraclass correlation coefficient (ICC) analysis was used to assess the agreement of the measurements. Spearman’s correlation test was performed to analyze the relationship between the DECT- and QCT-derived BMD. Receiver operator characteristic (ROC) curves were generated to determine the optimal diagnostic thresholds of various BMPs for diagnosing osteopenia and osteoporosis. Results: A total of 1371 vertebral bodies were measured, and QCT identified 393 with osteoporosis and 442 with osteopenia. Strong correlations were observed between DHAP (water), DHAP (fat), DHAP (blood), DCa (water), and DCa (fat) and the QCT-derived BMD. DHAP (water) showed the best predictive capability for osteopenia and osteoporosis. The area under the ROC curve, sensitivity, and specificity for identifying osteopenia were 0.956, 86.88%, and 88.91% with DHAP (water) ≤ 107.4 mg/cm3, respectively. The corresponding values for identifying osteoporosis were 0.999, 99.24%, and 99.53% with DHAP (water) ≤ 89.62 mg/cm3, respectively. Conclusions: Bone density measurement using various BMPs in DECT enables the quantification of vertebral BMD and the diagnosis of osteoporosis, with DHAP (water) having the highest diagnostic accuracy.

Background We evaluated an individualized dual-energy computed tomography (DECT) scan protocol by combining optimal monochromatic images with an appropriate ASIR-V reconstruction strength in computed tomography pulmonary angiography (CTPA) to reduce radiation and iodine doses and superior vena cava (SVC) artifacts. Material/Methods A total of 127 patients who underwent CTPA were prospectively enrolled and randomly divided into a standard (n=63) and individualized group (n=64). The standard group used 120 kVp, 150 mAs, and 60 mL contrast media at an injection rate of 5 mL/s; the individualized group used DECT imaging mode with tube current selected according to patients’ BMI (BMI ≤20 kg/m 2 , 200 mA; 20< BMI ≤23 kg/m 2 , 240 mA; 23< BMI ≤25 kg/m 2 , 280 mA; BMI >25 kg/m 2 , 320 mA). Contrast media intake was 130 mgI/kg with an injection time of 7 s. The data in the individualized group was reconstructed to 55–70 keV (5 keV interval) monochromatic images combined with 40–80% ASIR-V (10% interval). Radiation dose, contrast dose, and image quality were compared between the groups. Results There were no significant differences in patient habitus. Compared with the standard group, the individualized group significantly decreased radiation dose by 33.93% (3.31±0.57 mSv vs 5.01±0.34 mSv) and contrast dose by 56.95% (9.04±1.40 gI vs 21.00±0.00 gI). The 60 keV image with 80%ASIR-V in the individualized group provided the best image quality and further reduced SVC beam-hardening artifacts. Conclusions The use of BMI-dependent DECT protocol in CTPA further reduces radiation dose, contrast agent dose, and SVC artifacts, with the 60 keV images reconstructed using 80%ASiR-V having the best image quality.

Background:This feasibility study aimed to evaluate replacing conventional computed tomography at 120 kVp with low radiation and low iodine dose based on body mass index (BMI)-adapted abdominal computed tomography angiography in 291 patients. Material/Methods:A total of 291 abdominal CTA patients were divided into 3 individualized kVp groups according to their BMI: A1 with 70 kVp (n=57), A2 with 80 kVp (n=49), and A3 with 100 kVp (n=48); and 3 conventional 120 kVp groups: B1 (n=40), B2 (n=53), and B3 (n=44) BMI-matched with group A. The contrast media was 300 mgI/kg for group A and 500 mgI/kg for group B. The CT values and SD of the abdominal aorta and the erector spinae were measured, and the contrast-to-noise ratio (CNR) and figure-of-merit (FOM) were calculated. Imaging quality, radiation, and contrast media dosage were evaluated. Results:The CT and CNR of abdominal aorta in groups A1 and A2 were higher than those in groups B1 and B2 (P<0.05), but there was no significant difference between groups A3 and B3 (P>0.05). FOM of the abdominal aorta in group A was higher than that in group B (P<0.05). Compared with groups B1, B2, and B3, the radiation doses of A1, A2, and A3 groups decreased by 70.61%, 56.72%, and 31.87%, and contrast intake decreased by 39.94%, 38.74%, and 35.09%, respectively (P<0.05). Conclusions:BMI-based individualized kVp abdominal CTA imaging significantly reduced overall radiation dose and contrast media intake while providing excellent image quality.

To explore the value of individualized kVp selection based on the patient's body mass index (BMI, kg/m 2 ) in CT colonography (CTC). Materials and Methods: Seventy-eight patients underwent two CTC scans: conventional 120 kVp in supine position (Group A) with 30% Adaptive statistical iteration algorithm (ASIR-V) and BMI-based lower kV p in prone position (Group B): tube voltage was suggested by an experienced investigator according to the patient's body mass index (BMI; calculated as weight divided by height squared; kg/m (2)).70 kV for BMI < 23 kg/m 2 (Group B1, n = 27), 80 kV for 23 ≤ BMI ≤ 25 kg/m 2 (Group B2, n = 21) and 100 kV for BMI > 25 kg/m 2 (Group B3, n = 30). Group A, corresponding to the BMI value in Group B, was divided into A1, A2, and A3 subgroups for analysis. Groups B used ASIR-V of different weights (30%-90% ASIR-V). The Hounsfield Unit (HU) and SD values of the muscles and the intestinal cavity air were measured, and the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) of images were calculated. Imaging quality was evaluated by two reviewers and statistically compared. Results:The 120 kV scans were preferred more than 50% of the time. All images had excellent quality with good consistency between reviewers (Kappa > 0.75, p < 0.05). The radiation dose was reduced in groups B1, B2 and B3 by 63.62%, 44.63%, and 32.14%, respectively, compared with group A (p < 0.05). The SNR and CNR values between group A1/A2/A3 and B1/B2/B3 + 60%ASIR-V were not statistically significant (p < 0.05). There was no statistically significant difference between the subjective scores of group B combined with 60%ASIR-V and group A (p > 0.05). Conclusion: BMI-based individualized kV CTC imaging significantly reduces overall radiation dose while providing an equal image quality with the conventional 120 kV. K E Y W O R D S colon, computed tomography INTRODUCTIONColorectal cancer (CRC) is one of the most common and deadly malignant tumor types. Its incidence is ris-This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.