Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography

Watanabe, Yoshiyuki; Uotani, Kensuke; Nakazawa, Takahiro; Higashi, Masahiro; Yamada, Naoaki; Hori, Yoshiro; Kanzaki, Suzu; Fukuda, Tsuyoshi; Itoh, Toshihide; Naito, Hiroyuki

doi:10.1007/s00330-008-1213-5

Cited by 114 publications

(63 citation statements)

References 20 publications

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“…They also allow the removal of bone and calcium from the carotid and brain CTA (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Section: Neuroradiological Applicationsmentioning

confidence: 99%

“…In addition, the use of virtual non-contrast images has been reported for the diagnosis of a lipiodol embolism after hepatocellular carcinoma chemoembolization (25). Several articles have compared dualenergy bone removal to automatic bone removal and digital subtraction CTA, and the dual-energy technique was found to be superior to both techniques, particularly at the level of the skull base (26)(27)(28)(29)(30)(31)(32)(33)(34)(35). In addition, the radiation dose was reduced as compared to digital subtraction CTA (26,27,31).…”

Section: Neuroradiological Applicationsmentioning

confidence: 99%

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Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

154

127

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A lthough dual-energy CT (DECT) was first conceived in 1976, it has not been used widely for clinical indications (1-11). Recently, the simultaneous acquisition of dual-energy data has been introduced using multidetector CT (MDCT) with two X-ray tubes and rapid peak kilovoltage (kVp) switching (gemstone spectral imaging, GSI) (12-16). Two major advantages of DECT are material decomposition by the almost simultaneous acquisition of two image series with different kVp (80 and 140 kVp) and the elimination of misregistration artifacts. In general, noncontrast (unenhanced) images can be avoided by using the dual-energy mode for body and neurological applications; iodine can be removed from the image, and a virtual non-contrast (water) image can be acquired. The major advantage of 80-kVp compared to 140-kVp images is a higher image contrast (Fig. 1). Hounsfield unit measurements on DECT are not absolute and can change depending on the kVp used for the acquisition (at different keV). Typically, a combination of 80/140 kVp is used for DECT, but for some applications, 100/140 kVp is preferred. In this study, we summarized the clinical applications of DECT in the brain, chest and abdomen and in the cardiovascular and musculoskeletal systems (Table 1). Technique and principlesThe basic principle of dual-energy is the acquisition of 2 datasets from the same anatomic location with different kVp (usually 80 and 140 kVp) (1,2,17,18). In the early days of CT, consecutive single-slice acquisitions with different kVp were performed as a dual-energy technique, but this method suffered from breathing and partial volume artifacts (1, 2). At present, an entire body can be scanned within seconds using the DECT technique, and thus, misregistration artifacts due to breathing are eliminated.Currently, three systems are capable of the nearly simultaneous acquisition of dual-energy data during a single breath hold (12, 14, 15): 64-slice dual-source CT (Definition, Siemens Medical Systems; Erlangen, Germany), 128-slice dual-source CT (Definition Flash, Siemens Medical Systems) and high-definition 64-MDCT (Discovery 750 HD, GE Healthcare; Milwaukee, Wisconsin, USA). In the two systems available from Siemens, the two tubes (tubes A and B) use different kVp (80 and 140 kVp), and in 64-MDCT, the kVp switches from 80 to 140 kVp in less than 0.5 ms. In dual systems, there is concern regarding the susceptibility of the system to cardiac motion due to the time difference (75 or 83 ms) between the tube A and tube B acquisitions of the dual-energy data, but the dual-source CT and 64-MDCT have not been compared to evaluate this issue. The technical specifications of the DECT systems are summarized in Table 2.The images presented in this article were acquired using a 64-slice dual source CT (Definition, Siemens Medical Systems) and a 64-MDCT (Discovery 750HD, GE Healthcare). The DECT data acquired by both systems can be evaluated with a dedicated workstation using dual-energy software that ABSTRACT Although dual-energy CT (DECT) was first conceived in ...

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“…They also allow the removal of bone and calcium from the carotid and brain CTA (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Section: Neuroradiological Applicationsmentioning

confidence: 99%

Section: Neuroradiological Applicationsmentioning

confidence: 99%

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

154

127

View full text Add to dashboard Cite

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“…The authors postulated that the sign could potentially be used in risk stratification of carotid plaque characteristics. 48 Though other imaging techniques like MR imaging (MRI) and high-definition dual source CT scanners with spectral imaging may provide far greater detail about plaque characteristics, 49,50 CTA is at present the only imaging tool that is readily available to clinicians in an emergency setting.…”

Section: Computed Tomography Angiography Source Imagesmentioning

confidence: 99%

“…Dual source spectral imaging allows for better neurovascular imaging by removing bone and calcium artifacts, thus providing high-resolution vascular imaging at the skull base and neck. 49,50 A Heuristic Model for Use of CTA in Patients Presenting With Acute Stroke or TIA Based on Our Experience…”

Section: The Problem Of Expertise In Interpreting Ctamentioning

confidence: 99%

Computed Tomography Angiography in the Assessment of Patients With Stroke/TIA

Menon

Demchuk

2011

The Neurohospitalist

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Rapid advance in medical technology has resulted in the availability of numerous tests and treatment strategies in the management of acute stroke. The increasingly evidence-based context of clinical medicine necessitates that clinicians use only appropriate tools to facilitate the diagnostic process and patient management. In this review, we seek to explore the use of computed tomography angiography (CTA) in the diagnosis and management of patients presenting with acute stroke (ischemic and hemorrhagic) or transient ischemic attack (TIA). We present evidence in favor of the use of CTA, highlight the disadvantages of this imaging modality, and present a heuristic model based on our experience at utilizing CTA for decision making in acute stroke and TIAs.

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“…In 3D-CTA, multi-detector CT (MDCT) is used [1]- [4]. 3D-CTA generally consists of the precontrast helical scan to be used as the data for subtraction and arterial phase helical scan that is performed after potent enhancement of the interest artery is confirmed in the fluoroscopic slice at the neck [5] [6]. Recently, multi-detector CT has been developed markedly.…”

Section: Introductionmentioning

confidence: 99%

Discussion about Improvement of Stability of the Scan Timing by Placing Small ROI in Cerebral 3D-CTA

Watanabe¹,

Ino²,

Yoshikawa³

2015

OJRad

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In three-dimensional computed tomography angiography (3D-CTA) in our facility, we usually scan the volume of the brain according to the bolus tracking method. Fluoroscopic slice is placed at the Willis's ring and the timing of scan is determined subjectively by a radiological technologist after strong enhancement of the basal cerebral artery is confirmed. In these procedures, however, variation of scan timing is often problematic. Therefore, we design the surpassing method to place the small region-of-interest (ROI) at the basal cerebral arteries and to start CT scan automatically. In this protocol, the fluoroscopic slices of the distal internal carotid arteries are selected referring to the precontrast volume data, small ROIs are set in bilateral internal carotid arteries, and scan trigger of CT is started automatically at the threshold of 170 HU. The maximum 80 mL of iodine contrast agent 300 mgI/mL is injected intravenously at the rate of 4.0 mL/sec, and the volume of the arterial phase is scanned automatically. We measure ROIs at the internal carotid arteries based on the obtained volume data of arterial phase and estimate the optimal scan timings from the fluoroscopic CT images reformatted at the intervals of 0.1 sec. In 38 of 53 patients, placement of the small ROIs is succeeded and automatic or manual CT scan is performed. In the patients who succeed in placement of the small ROIs, optimal scan timing of the arterial phase is obtained, while in the patients who fail placement of the small ROIs, a large variation is observed in their scan timings. Their results suggest that more stable scanning of the arterial phase is available by means of small ROI placement and automatic scanning. The clinical significance is large because the stability and reproducibility of the examination provide a quantitative analysis and more accurate diagnosis.

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Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography

Cited by 114 publications

References 20 publications

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Computed Tomography Angiography in the Assessment of Patients With Stroke/TIA

Discussion about Improvement of Stability of the Scan Timing by Placing Small ROI in Cerebral 3D-CTA

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