Dual-energy CT: theoretical principles and clinical applications

Agostini, Andrea; Borgheresi, Alessandra; Mari, A.; Floridi, Chiara; Bruno, Federico; Carotti, Marina; Schicchi, Nicolò; Barile, Antonio; Maggi, Stefania; Giovagnoni, Andrea

doi:10.1007/s11547-019-01107-8

Cited by 92 publications

(110 citation statements)

References 63 publications

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“…In another study (36) the sensitivity for IPSS was 82% while it was 48% for the high dose dexamethasone test and 70% for the CRH test. When compared with other imaging modalities, IPSS showed a high accuracy: in a study performed on 54 patients (37) the accuracy of IPSS was 88% while the accuracy of MRI was 54%; in another study where 84 patients were enrolled, the sensitivity was 40% for CT (38,39), 50% for MRI and 90% for IPSS (40).The diagnostic accuracy of MRI in differentiating central and ectopic Cushing's syndrome was found to be 58% while the accuracy of IPSS was found to be 100% (35). Several studies showed, however, that the diagnostic accuracy is not absolute and both false-negatives (lack of a central/ peripheral gradient in patients with CD) and false positives (presence of a central/peripheral gradient in patients with ectopic ACTH secretion) occur.…”

Section: Inferior Petrosal Sinus Sampling and Its Rule In The Diagnostic Workupmentioning

confidence: 99%

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Tortora¹,

Negro²,

Briganti³

et al. 2020

Gland Surg

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Cushing's syndrome is a pathological clinical condition caused by an exposure of elevated cortisol levels over a long period of time. It is therefore essential to establish what the cause of hypercortisolism is.In most cases (about 80%) the pathological process is due to adrenocorticotropic hormone (ACTH), while in a minor part of the cases (about 20%) the cause is represented by a pathology of the adrenal glands and therefore not related to ACTH. Most patients with ACTH dependent Cushing's syndrome have a pituitary microadenoma; in the remaining cases (30%), the high level of cortisol is linked to an ectopic secretion of ACTH. Surgical removal of the pituitary adenoma represents the treatment of choice in Cushing's disease (CD) patients; it is therefore necessary to identify and precisely locate the pituitary tumour responsible for the secretion of ACTH. Adequate diagnostic information is very often, even with magnetic resonance imaging (MRI), and in these cases we rely on bilateral inferior petrosal sinuses sampling (BIPSS). This procedure is considered the gold standard method for the diagnosis, but like any other diagnostic method it is not free from erroneous results such as false positives or false negatives.

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Section: Inferior Petrosal Sinus Sampling and Its Rule In The Diagnostic Workupmentioning

confidence: 99%

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Tortora¹,

Negro²,

Briganti³

et al. 2020

Gland Surg

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“…Recent technological advances in head and neck imaging, including facial and oral imaging, and in particular SGs imaging, allowed to improve the multimodality study of this challenging anatomical region (4)(5)(6)(7)(8)(9)(10)(11)(12). The following step is to integrate patients' clinical and histopathology data with imaging biomarkers with the ultimate aim of using imaging biomarkers as decision-support tools to improve pSS diagnostic process and patients' stratification in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Ultra-high frequency ultrasound (UHFUS) applications in Sjogren syndrome: narrative review and current concepts

et al. 2020

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Primary Sjogren's syndrome (SS) is a systemic autoimmune chronic inflammatory disease with predominant involvement of the exocrine glands, particularly the salivary glands (SGs). The role of salivary glands ultrasound (SGUS) in the work-up of patients with primary Sjogren syndrome (SS) is progressively increasing due to its useful support in diagnosis and follow-up as a widely available, repeatable, noninvasive and safe technique. Although SGUS is not yet included in the dominant primary SS classification, several studies supported its inclusion in the American College of Rheumatology/European League Against Rheumatism criteria. In this context, a novel imaging technique, ultra-high frequency ultrasound (UHFUS), is being explored. Compared to the frequencies used in conventional ultrasound (US) (up to 22 MHz), UHFUS operates with higher frequencies (30-100 MHz) allowing for outstanding image resolution, up to 30 µm. UHFUS permits the scan of both major and minor SGs, opening new avenues for the integration of tissue and imaging biomarkers. Although further studies are needed to confirm its role, this novel imaging technique might lead to several potential improvements, including earlier diagnosis, reduction of unnecessary and inadequate biopsies and better management and follow-up of patients with primary SS.

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“…The terms dual-energy CT (DECT) refers to the acquisition of CT attenuation data deriving from two photon energies, in this way the attenuation differences between various materials could provide their characterization (1)(2)(3)(4). Despite the fact that the role of DECT in diagnostic imaging was described in the late 1970, only in the last years, thanks to the emerging technologies, it has become possible to perform two acquisitions almost simultaneously at different tube voltage, avoiding misregistration artefacts between the two imaging sets (5,6).…”

Section: Introductionmentioning

confidence: 99%

Dual energy CT in gland tumors: a comprehensive narrative review and differential diagnosis

Gentili¹,

Guerrini²,

Mazzei³

et al. 2020

Gland Surg

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Dual energy CT (DECT)with image acquisition at two different photon X-ray levels allows the characterization of a specific tissue or material/elements, the extrapolation of virtual unenhanced and monoenergetic images, and the quantification of iodine uptake; such special capabilities make the DECT the perfect technique to support oncological imaging for tumor detection and characterization and treatment monitoring, while concurrently reducing the dose of radiation and iodine and improving the metal artifact reduction. Even though its potential in the field of oncology has not been fully explored yet, DECT is already widely used today thanks to the availability of different CT technologies, such as dual-source, singlesource rapid-switching, single-source sequential, single-source twin-beam and dual-layer technologies.Moreover DECT technology represents the future of the imaging innovation and it is subject to ongoing development that increase according its clinical potentiality, in particular in the field of oncology. This review points out recent state-of-the-art in DECT applications in gland tumors, with special focus on its potential uses in the field of oncological imaging of endocrine and exocrine glands.

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Dual-energy CT: theoretical principles and clinical applications

Cited by 92 publications

References 63 publications

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Ultra-high frequency ultrasound (UHFUS) applications in Sjogren syndrome: narrative review and current concepts

Dual energy CT in gland tumors: a comprehensive narrative review and differential diagnosis

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