Dual Energy CT of the Chest

Schenzle, Jan; Sommer, Wieland H.; Neumaier, Klement; Michalski, Gisela; Lechel, Ursula; Nikolaou, Konstantin; Becker, Christoph R.; Reiser, Maximilian; Johnson, Thorsten R. C.

doi:10.1097/rli.0b013e3181df901d

Cited by 192 publications

(105 citation statements)

References 28 publications

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“…Although there is strong evidence that DECT is not associated with an increased radiation dose level [30], the question remains as to whether third generation DSCT scanners might offer the opportunity for dose reduction when operated in dual-energy mode. In a first phantom study using 1st and 2nd generation DSCT scanners, Schenzle et al showed no additional dose burden or compromises in image quality in comparison to a 120 kV standard protocol [19]. Zordo et al systematically compared the radiation dose of second generation DSCT in single-energy mode with dual-energy mode (100/Sn140 kV) and conventional single-source single-energy 128-MDCT at 120 kV and 100 kV in 321 patients with suspected pulmonary embolism [17].…”

Section: Discussionmentioning

confidence: 99%

“…The effective radiation dose of current conventional SSCT protocols for CTPA is estimated at 3.58 to 5.81 mSv when using a conversion factor of 0.018 mSv/mGycm [17,19]. Zordo et al estimated a mean radiation dose of 4.2 mSV in their dual-energy group when using 2nd generation DSCT [17].…”

Section: Discussionmentioning

confidence: 99%

“…As recommended by Schenzle et al, we used a conversion factor of 0.018 mSv/mGycm for estimation of the effective radiation dose [19].…”

Section: Radiation Dosementioning

confidence: 99%

“…However, the potential of the latest (third) generation scanners to further decrease radiation dose while maintaining image quality has scarcely been assessed so far [18]. Concerning first and second generation DSCT scanners, DECT was reported to carry a radiation dose similar to that of conventional single-source CT (SSCT) [10,11,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Petritsch¹,

Kosmala²,

Gassenmaier³

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZiel Das Potential der Dritt-Generation Dual-Source CT (DSCT) in der Lungenemboliediagnostik wurde bis dato noch nicht ausführlich untersucht. Ziel dieser Studie war es, Strahlendosisparameter sowie subjektive und objektive Bildqualität des aktuellsten DSCT Scanners im Single-Energy und Dual-Energy (DE) Modus mit einem herkömmlichen pulmonalen Standard CTA Protokoll am 64-Zeilen CT (SSCT) zu vergleichen. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Material und Methoden▪ Die Dual-Energy CT bietet potentiell zusätzliche Informationen durch die Erstellung von farbcodierten Jod-Karten. ABSTR AC TPurpose To compare radiation dose, subjective and objective image quality of 3 rd generation dual-source CT (DSCT) and dual-energy CT (DECT) with conventional 64-slice singlesource CT (SSCT) for pulmonary CTA.Materials and Methods 180 pulmonary CTA studies were performed in three patient cohorts of 60 patients each. Group 1: conventional SSCT 120 kV (ref.); group 2: single-energy DSCT 100 kV (ref.); group 3: DECT 90/Sn150 kV. CTDIvol, DLP, effective radiation dose were reported, and CT attenuation (HU) was measured on three central and peripheral levels. The signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) were calculated. Two readers assessed subjective image quality according to a five-point scale.Results Mean CTDIvol and DLP were significantly lower in the dual-energy group compared to the SSCT group (p < 0.001 [CTDIvol]; p < 0.001 [DLP]) and the DSCT group (p = 0.003 [CTDIvol]; p = 0.003 [DLP]), respectively. The effective dose in the DECT group was 2.79 ± 0.95 mSv and significantly smaller than in the SSCT group (4.60 ± 1.68 mSv, p < 0.001) and the DSCT group (4.24 ± 2.69 mSv, p = 0.003). The SNR and CNR were significantly higher in the DSCT group (p < 0.001).Subjective image quality did not differ significantly among the three protocols and was rated good to excellent in 75 % (135/180) of cases with an inter-observer agreement of 80 %.Conclusion Dual-energy pulmonary CTA protocols of 3 rd generation dual-source scanners allow for significant reduction of radiation dose while providing excellent image quality and potential additional information by means of perfusion maps. Key Points:▪ Dual-energy CT with 90/Sn150 kV configuration allows for significant dose reduction in pulmonary CTA. ▪ Subjective image quality was similar among the three evaluated CT-protocols (64-slice SSCT, single-energy DSCT, 90/Sn150 kV DECT) and was rated good to excellent in 75% of cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…As recommended by Schenzle et al, we used a conversion factor of 0.018 mSv/mGycm for estimation of the effective radiation dose [19].…”

Section: Radiation Dosementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Petritsch¹,

Kosmala²,

Gassenmaier³

et al. 2017

Fortschr Röntgenstr

View full text Add to dashboard Cite

show abstract

“…The higher temporal resolution of a 128‐section DSCT allows the use of a prospective ECG‐triggered spiral mode at a high pitch factor 12 , 13 . Achenbach et al (13) also reported that prospective ECG‐triggered high‐pitch spiral (HPS) CTCA provided excellent image quality at a consistent dose below 1.0 mSv in nonobese patients with low and stable heart rates.…”

Section: Introductionmentioning

confidence: 99%

Radiation dose and physical image quality in 128‐section dual‐source computed tomographic coronary angiography: a phantom study

Matsubara¹,

Koshida²,

Sakuta³

et al. 2012

J Applied Clin Med Phys

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One‐hundred‐and‐twenty‐eight–section dual X‐ray source computed tomography (CT) systems have been introduced into clinical practice and have been shown to increase temporal resolution. Higher temporal resolution allows low‐dose spiral mode at a high pitch factor during CT coronary angiography. We evaluated radiation dose and physical image qualities in CT coronary angiography by applying high‐pitch spiral, step‐and‐shoot, and low‐pitch spiral modes to determine the optimal acquisition mode for clinical situations. An anthropomorphic phantom, small dosimeters, a calibration phantom, and a microdisc phantom were used to evaluate the radiation doses absorbed by thoracic organs, noise power spectrums, in‐plane and z‐axis modulation transfer functions, slice sensitivity profiles, and number of artifacts for the three acquisition modes. The high‐pitch spiral mode had the advantage of a small absorbed radiation dose, but provided low image quality. The low‐pitch spiral mode resulted in a high absorbed radiation dose of approximately 200 mGy for the heart. Although the absorbed radiation dose was lower in the step‐and‐shoot mode than in the low‐pitch spiral mode, the noise power spectrum was inferior. The quality of the in‐plane modulation transfer function differed, depending on spatial frequency. Therefore, the step‐and‐shoot mode should be applied initially because of its low absorbed radiation dose and superior image quality.PACS numbers: 87.57.‐s; 87.57.C‐; 87.57.cf; 87.57.cm; 87.57.cp; 87.57.Q‐; 87.57.qp; 87.57.uq

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Optimal virtual monoenergetic image in “TwinBeam” dual‐energy CT for organs‐at‐risk delineation based on contrast‐noise‐ratio in head‐and‐neck radiotherapy

Wang

Ghavidel

Beitler

et al. 2019

J Applied Clin Med Phys

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PurposeDual‐energy computed tomography (DECT) using TwinBeam CT (TBCT) is a new option for radiation oncology simulators. TBCT scanning provides virtual monoenergetic images which are attractive in treatment planning since lower energies offer better contrast for soft tissues, and higher energies reduce noise. A protocol is needed to achieve optimal performance of this feature. In this study, we investigated the TBCT scan schema with the head‐and‐neck radiotherapy workflow at our clinic and selected the optimal energy with best contrast‐noise‐ratio (CNR) in organs‐at‐risks (OARs) delineation for head‐and‐neck treatment planning.Methods and materialsWe synthesized monochromatic images from 40 keV to 190 keV at 5 keV increments from data acquired by TBCT. We collected the Hounsfield unit (HU) numbers of OARs (brainstem, mandible, spinal cord, and parotid glands), the HU numbers of marginal regions outside OARs, and the noise levels for each monochromatic image. We then calculated the CNR for the different OARs at each energy level to generate a serial of spectral curves for each OAR. Based on these spectral curves of CNR, the mono‐energy corresponding to the max CNR was identified for each OAR of each patient.ResultsComputed tomography scans of ten patients by TBCT were used to test the optimal monoenergetic image for the CNR of OAR. Based on the maximized CNR, the optimal energy values were 78.5 ± 5.3 keV for the brainstem, 78.0 ± 4.2 keV for the mandible, 78.5 ± 5.7 keV for the parotid glands, and 78.5 ± 5.3 keV for the spinal cord. Overall, the optimal energy for the maximum CNR of these OARs in head‐and‐neck cancer patients was 80 keV.ConclusionWe have proposed a clinically feasible protocol that selects the optimal energy level of the virtual monoenergetic image in TBCT for OAR delineation based on the CNR in head‐and‐neck OAR. This protocol can be applied in TBCT simulation.

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Dual Energy CT of the Chest

Cited by 192 publications

References 28 publications

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Radiation dose and physical image quality in 128‐section dual‐source computed tomographic coronary angiography: a phantom study

Optimal virtual monoenergetic image in “TwinBeam” dual‐energy CT for organs‐at‐risk delineation based on contrast‐noise‐ratio in head‐and‐neck radiotherapy

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