CT-guided bone biopsy using electron density maps from dual-energy CT

Dual-Layer Spectral CT as Innovative Imaging Guidance in Lung Biopsies: Could Color-Coded Z-Effective Images Allow More Diagnostic Samplings and Biomarkers Information?

“…Furthermore, in the case of the biopsy sample taken from the Z max zone, it was possible for the pathologist to perform a correct biomolecular and immunohistochemical typing in 9 out of 10 cases, while in the biopsy sample taken from the Z min area, this characterization was possible only in 4 out of 10 cases (Table 3) [25,26].…”

“…However, in the literature, there are very few studies specifically addressing this aspect. Yamamoto et al describe a case report on electron density (ED) maps for the detection of bone lesions, specifically in cases of breast carcinoma, on which subsequent biopsies were performed using spectral imaging [25]. A 61-year-old woman with a history of breast cancer surgery underwent a spectral CT-guided bone biopsy of the right ilium using ED maps, which resulted in the diagnosis of breast cancer metastases in the intertrabecular bone.…”

A quantitative analysis of spectral computed tomography characteristics of osseous metastases

“…While current research describing electron density differences in malignancy is not as well explored as that of the parameter of effective atomic number, the potential of electron density as a discriminatory parameter appears similar. For instance, a case report by Yamamoto et al described the use of electron density mapping, which was successfully utilised to guide the CT bone biopsy of a patient's metastatic ilium lesion from a primary breast invasive ductal carcinoma 20 …”

“…For instance, a case report by Yamamoto et al described the use of electron density mapping, which was successfully utilised to guide the CT bone biopsy of a patient's metastatic ilium lesion from a primary breast invasive ductal carcinoma. 20…”

救急外来でdual energy CTによる診断を行った高齢者脊椎骨折の3例(Three cases of vertebral fractures in elderly patients diagnosed by dual energy CT in the emergency department)

“…DECTは脊椎以外での四肢骨折診断に加えて，悪性腫瘍 9), 10)，肺動脈塞栓症 11)，尿酸結石による痛風や関節炎 10), 12), 13)，大動脈ステントグラフト留置後のエンドリーク 12)，COVID–19肺炎の重症度評価 14)に利用され有用性が報告されている。救急外来において，MRIが実施困難な詳細不明の体内金属を有する症例，あるいは長時間の検査が困難な高齢者，疼痛で安静が保持できない症例や循環動態の不安定な症例，通常のCT撮像から再構成できるため，熱源検索など他の目的で撮像した画像を利用できる点はDECTが有用であり，救急外来では汎用性が高いと考えられる。症例1では，典型的な新規の脊椎圧迫骨折が，症例2では体内に金属物のある状況で陳旧性圧迫骨折内の新規骨折が，症例3では見落とされやすい仙骨骨折が，それぞれDECTにより診断できており，MRIを補完する役割を果したと考えられる。症例3は当初仙骨骨折に気づかず，腰椎圧迫骨折疑いにてMRIが追加されている。仙骨骨折は皮質骨に骨折線を認める症例も見落とされることが報告されており，単純X線写真では5～35%の感度，CTでも見落とされることがあると報告されている 15)。DECTにて画像強調されることで診断精度の向上が期待される。…”