Dual-energy CT for detection of contrast enhancement or leakage within high-density haematomas in patients with intracranial haemorrhage

Watanabe, Yoshiyuki; Tsukabe, Akio; Kunitomi, Yuki; Nishizawa, Masahiko; Arisawa, Atsuko; Tanaka, Hisashi; Yoshiya, Kazuhisa; Shimazu, Takeshi; Tomiyama, Noriyuki

doi:10.1007/s00234-014-1333-3

Cited by 24 publications

(12 citation statements)

References 15 publications

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“…The heterogeneity in CTA acquisition protocols [8] with lack of consensus on the optimal CTA setting for spot sign detection may account for this inconsistency. Multiple studies show that scan parameters influence CTA quality and spot sign accuracy in predicting hematoma growth [10, 11, 20–22] suggesting the need to harmonize CTA analysis across different centers. The results of our study confirmed the presence of great variability in CTA protocols, and showed that phantom-based iodine calibration may help in standardizing image analysis across multiple sites.…”

Section: Discussionmentioning

confidence: 99%

Phantom-based standardization of CT angiography images for spot sign detection

et al. 2017

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Purpose The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. Methods A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield Unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. Results A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8% vs 38.9% p<0.001). All spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76% vs 52%) but inferior specificity (35% vs 63%) compared with uncalibrated images. Conclusion Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion.

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Section: Discussionmentioning

confidence: 99%

Phantom-based standardization of CT angiography images for spot sign detection

et al. 2017

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“…15,18,19 It has been shown that by using a combined evaluation of the VNC and IM series from DECT, sensitivity and specificity for the detection of an underlying contrast-enhancing mass within a cerebral hemorrhage was as high as 94.4% and 97.4%, 17 with positive or negative predictive values up to 95.7% and 94.1%. 30 With regard to the differentiation between hemorrhage and contrast staining in different intracranial compartments, another study even described a sensitivity of 100%, specificity between 84.4% and 100%, and accuracy between 87.2% and 100%, with some limitations in calcified areas.…”

Section: Discussionmentioning

confidence: 99%

Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be Identified by Dual-Energy CT

Grams¹,

Knoflach²,

Rehwald

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Dual-energy CT features the opportunity to differentiate among up to 3 different materials because the absorption of x-rays depends on the applied tube voltage and the atomic number of the material. For example, it is possible to distinguish between blood-brain barrier disruption and an intracerebral hemorrhage following treatment for a stroke. The aim of this study was to evaluate whether dual-energy CT is capable of distinguishing intra-arterial contrast agent from residually clotted vessels immediately after endovascular stroke therapy.

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“…5). 21,24,[28][29][30][31][32][33][34][35][36][37][38][39][40][41] Spectral Hounsfield unit attenuation curves obtained by region of interest (ROI) analysis are a quantitative graphic representation of the energydependent attenuation changes seen on the VMIs (►Fig. 4).…”

Section: Overview Of Different Dect Reconstructions Virtual Monochrommentioning

confidence: 99%

Advanced Computed Tomography Techniques: Overview of Dual-Energy CT

Forghani

2017

J Pediatr Neurol

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Dual-energy computed tomography (DECT) is an advanced form of computed tomography (CT), in which image acquisition is performed at two different energy spectra, instead of a single-energy spectrum using conventional single-energy CT (SECT). This enables the creation of different reconstructions and quantitative spectral tissue analysis beyond what is possible with SECT. In adults, there are increasing clinical applications of DECT for all organ systems, including neuroimaging and head and neck imaging. However, there are relatively few studies evaluating applications of DECT for pediatric imaging and little to none in neuroimaging or head and neck imaging. The purpose of this article is to provide an overview and familiarize the readers with DECT. This article will review the fundamental principles behind DECT, including different DECT acquisition systems and principles of DECT material characterization. This will be followed by a review of potential applications of DECT, many based on imaging the head and neck. The objectives are to familiarize the readers with this exciting technology and hopefully serve as a primer for investigations and applications of DECT for pediatric neuro and head and neck imaging.

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Dual-energy CT for detection of contrast enhancement or leakage within high-density haematomas in patients with intracranial haemorrhage

Abstract: DECT emphasised the iodine enhancement and facilitated the detection of contrast enhancement or leakage.

Cited by 24 publications

References 15 publications

Phantom-based standardization of CT angiography images for spot sign detection

Phantom-based standardization of CT angiography images for spot sign detection

Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be Identified by Dual-Energy CT

Advanced Computed Tomography Techniques: Overview of Dual-Energy CT

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