Does dual-energy CT differentiate benign and malignant ovarian tumours?

Elsherif, Sherif; Zheng, Shu; Ganeshan, Dhakshina Moorthy; Iyer, Revathy B.; Wei, W.; Bhosale, Priyadarshani R.

doi:10.1016/j.crad.2020.03.006

Cited by 20 publications

(22 citation statements)

References 40 publications

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“…Dual-energy CT (DECT) is a promising technique that permits the acquisition of variable data by analysing the attenuation of materials at different energy levels in just one CT acquisition [ 21 , 22 ].…”

Section: Imaging Findings Of Low-grade Ovarian Carcinomamentioning

confidence: 99%

“…Iodine, a component widely used in CT contrast, is highlighted when low kiloelectron volt (KeV) values are used. This property enables distinguishing structures with this compound from others [ 21 , 22 ].…”

Section: Imaging Findings Of Low-grade Ovarian Carcinomamentioning

confidence: 99%

“…Although this preliminary data indicate that DECT has diagnostic potential in evaluating gynaecological cancer, further studies are needed in this area [ 21 , 22 ].…”

Section: Imaging Findings Of Low-grade Ovarian Carcinomamentioning

confidence: 99%

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Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists

Amante

Santos²,

Cunha³

2021

Insights Imaging

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Low-grade serous carcinoma (LGSC) is an infrequent subtype of ovarian cancer, corresponding to 5% of epithelial neoplasms. This subtype of ovarian carcinoma characteristically has molecular features, pathogenesis, clinical behaviour, sensitivity to chemotherapy, and prognosis distinct to high-grade serous carcinoma (HGSC). Knowing the difference between LGSC and other ovarian serous tumours is vital to guide clinical management, which currently is only possible histologically. However, imaging can provide several clues that allow differentiating LGSC from other tumours and enable precise staging and follow-up of ovarian cancer treatment. Characteristically, LGSC appears as mixed lesions with variable papillary projections and solid components, usually in different proportions from those detected in serous borderline tumour and HGSC. Calcified extracellular bodies, known as psammoma bodies, are also a common feature of LGSC, frequently detectable within lymphadenopathies and metastases associated with this type of tumour. In addition, the characterisation of magnetic resonance imaging enhancement also plays an essential role in calculating the probability of malignancy of these lesions. As such, in this review, we discuss and update the distinct radiological modalities features and the clinicopathologic characteristics of LGSC to allow radiologists to be familiarised with them and to narrow the differential diagnosis when facing this type of tumour.

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Section: Imaging Findings Of Low-grade Ovarian Carcinomamentioning

confidence: 99%

Section: Imaging Findings Of Low-grade Ovarian Carcinomamentioning

confidence: 99%

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Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists

Amante

Santos²,

Cunha³

2021

Insights Imaging

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“…Using dual energy computed tomography (DECT) to measure atomic number and electron density in images grants chemical information not available with traditional single‐energy CT. Studies have shown diagnostic potential related to a number of different pathologies, ranging from renal stone characterization to the differentiation of benign and malignant tumors in multiple organ systems 1–9 . Z eff and electron density information also has applications in radiation therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Using dual energy computed tomography (DECT) to measure atomic number and electron density in images grants chemical information not available with traditional single-energy CT. Studies have shown diagnostic potential related to a number of different pathologies, ranging from renal stone characterization to the differentiation of benign and malignant tumors in multiple organ systems. [1][2][3][4][5][6][7][8][9] Z eff and electron density information also has applications in radiation therapy. Studies have shown that stopping power ratios (SPRs) calculated using Z eff and electron density data from DECT are, on average, more accurate than SPR calculated using single energy; reducing proton range uncertainties.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and reproducibility of effective atomic number and electron density measurements from sequential dual energy CT

et al. 2021

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This study assesses the accuracy of effective atomic number (Z eff ) and electron density measurements acquired from dual energy CT and characterizes the response to clinically relevant variables representative of challenges in patient imaging, including: phantom size, material position within the phantom, variation over time, off-center positioning, and large cone beam angle. Methods: The Gammex Multi-Energy CT head and body phantoms were used to measure Z eff and electron density from 35 rod inserts that mimic tissues and varying concentrations of iodine and calcium. Scans were performed on a Canon Aquilion ONE Genesis CT scanner over a period of 6 months using default dual energy protocols appropriate for each phantom size. Theoretical Z eff and electron density values were calculated using data provided by the phantom manufacturer and compared to the measurements. Sources of variance were separated and quantified to identify the influences of random photon statistics, ROI placement, and variation over time. A subset of measurements were repeated with the phantom shifted in the vertical and horizontal directions, and over all slices in the volumetric scan. Results: All measurements showed strong correlation (r > 0.98) with their corresponding theoretical values; however, the system did demonstrate a bias of −0.58 atomic units in the body phantom and 0.28 atomic units in the head phantom for Z eff measurements. The mean absolute percent error (MAPE) was 6.3% for the body phantom and 3.2% for the head phantom. Electron density measurements of the body and head phantoms gave MAPE values of 4.6% and 1.0%, respectively. Z eff and electron density measurements significantly varied within the solid water background, showing a positional dependence within the phantom that dominated the total standard deviation in measurements. Z eff values dropped by 0.2 atomic units when the phantom was off-center; electron density measurements were less affected by phantom position. Along the z-axis, the accuracy drops off markedly at more than 50-60 mm from the central slice. Conclusion:The Canon dual energy system offers an accurate way of measuring the Z eff and electron density of clinically relevant materials. Accuracy could be improved further by calibration to remove bias, careful attention to centering within the FOV, and avoiding measurements at the edges of the cone beam.

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