Cost-effectiveness of dual-energy CT versus multiphasic single-energy CT and MRI for characterization of incidental indeterminate renal lesions

Patel, Bhavik N.; Boltyenkov, Artem; Martinez, Maria Garcia; Mastrodicasa, Domenico; Marin, Daniele; Jeffrey, R. Brooke; Chung, Benjamin I.; Pandharipande, Pari V.; Kambadakone, Avinash

doi:10.1007/s00261-019-02380-x

Cited by 20 publications

(5 citation statements)

References 52 publications

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“…Quantitative iodine parameters have been considered a promising tool for distinguishing malignant from benign tumors (12)(13)(14)(15). Spectral curves and the effective atomic number (Z eff ) have helped identify benign and malignant tumors, histological type, and differentiation degree (16)(17)(18)(19). Quantitative dualenergy CT (DECT) analysis has distinguished invasive adenocarcinoma from noninvasive or minimally invasive adenocarcinoma among pulmonary ground-glass opacity nodules (13).…”

Section: Introductionmentioning

confidence: 99%

Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules

Jiang¹,

Liu²,

Long³

et al. 2022

Quant Imaging Med Surg

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Background: This study aimed to investigate the ability of quantitative parameter-derived dual-source dual-energy computed tomography (DS-DECT) combined with machine learning to distinguish between benign and malignant thyroid nodules.Methods: Patients with thyroid nodules and pathological surgical results who underwent preoperative DS-DECT were selected. Quantitative parameter-derived DS-DECT was applied to classify benign and malignant nodules. Then, machine learning and binary logistic regression analysis models were constructed using the DS-DECT quantitative parameters to distinguish between benign and malignant nodules. The receiver operating characteristic curve was used to assess the diagnostic performance. The DeLong test was used to compare the diagnostic efficacy. Results: One hundred and thirty patients with 139 confirmed thyroid nodules were involved in the study. The malignant group had a significantly higher iodine concentration nodule (arterial phase) (P=0.001), normalized iodine concentration (arterial phase) (P=0.002), iodine concentration difference (P<0.001), spectral curve slope (nonenhancement) (P=0.007), spectral curve slope (arterial phase) (P=0.001), effective atomic number (nonenhancement) (P<0.001), and effective atomic number (arterial phase) (P=0.039) than the benign group. The binary logistic regression analysis model had an AUC (area under the curve) of 0.76, a sensitivity of 0.821, and a specificity of 0.667. The machine learning model had an AUC of 0.86, a sensitivity of 0.822, specificity of 0.791 in the training cohort, an AUC of 0.84, a sensitivity of 0.727, and specificity of 0.750 in the testing cohort. Conclusions: Multiple quantitative parameters of DS-DECT combined with machine learning could differentiate between benign and malignant thyroid nodules.

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Section: Introductionmentioning

confidence: 99%

Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules

Jiang¹,

Liu²,

Long³

et al. 2022

Quant Imaging Med Surg

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“…In general, costs of abdominal MRI are higher than those of abdominal CT examinations. Cost-effectiveness studies in abdominal imaging focus on the comparison of multiphase contrast-enhanced examinations in both modalities [ 22 ]. However, a recent cost-effectiveness analysis in pediatric patients with suspected appendicitis showed only minimal cost differences of ceCT and non-contrast MRI (full protocol) as initial imaging approach [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative single-sequence (PoSSe) MRI: imaging work-up for CT-guided or endoscopic drainage indication of collections after hepatopancreaticobiliary surgery

et al. 2021

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Purpose Fluid collections due to anastomotic leakage are a common complication after hepatopancreaticobiliary (HPB) surgery and are usually treated with drainage. We conducted a study to evaluate imaging work-up with a postoperative single-sequence (PoSSe) MRI for the detection of collections and indication of drainage. Material and methods Forty-six patients who developed signs of leakage (fever, pain, laboratory findings) after HPB surgery were prospectively enrolled. Each patient was examined by abdominal sonography and our PoSSe MRI protocol (axial T2-weighted HASTE only). PoSSe MRI examination time (from entering to leaving the MR scanner room) was measured. Sonography and MRI were evaluated regarding the detection and localization of fluid collections. Each examination was classified for diagnostic sufficiency and an imaging-based recommendation if CT-guided or endoscopic drainage is reasonable or not was proposed. Imaging work-up was evaluated in terms of feasibility and the possibility of drainage indication. Results Sonography, as first-line modality, detected 21 focal fluid collections and allowed to decide about the need for drainage in 41% of patients. The average time in the scanning room for PoSSe MRI was 9:23 min [7:50–13:32 min]. PoSSe MRI detected 46 focal collections and allowed therapeutic decisions in all patients. Drainage was suggested based on PoSSe MRI in 25 patients (54%) and subsequently indicated and performed in 21 patients (100% sensitivity and 84% specificity). No patient needed further imaging to optimize the treatment. Conclusions The PoSSe MRI approach is feasible in the early and intermediate postoperative setting after HPB surgery and shows a higher detection rate than sonography. Imaging work-up regarding drainage of collections was successful in all patients and our proposed PoSSe MRI algorithm provides an alternative to the standard work-up.

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“…There is paucity of literature on the cost effectiveness of DECT [123,124]. Furthermore, challenges exist for both qualitative and quantitative interpretation of images produced by DECT [125,126].…”

Section: Challenges and Pitfallsmentioning

confidence: 99%

Utility of Dual-Energy Computed Tomography in Clinical Conundra

Abu-Omar,

Murray,

Ali

et al. 2024

Diagnostics

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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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Cost-effectiveness of dual-energy CT versus multiphasic single-energy CT and MRI for characterization of incidental indeterminate renal lesions

Cited by 20 publications

References 52 publications

Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules

Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules

Postoperative single-sequence (PoSSe) MRI: imaging work-up for CT-guided or endoscopic drainage indication of collections after hepatopancreaticobiliary surgery

Utility of Dual-Energy Computed Tomography in Clinical Conundra

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