Dual-Energy Multidetector CT for the Characterization of Incidental Adrenal Nodules: Diagnostic Performance of Contrast-enhanced Material Density Analysis

Mileto, Achille; Nelson, Rendon C.; Marin, Daniele; Choudhury, Kingshuk Roy; Ho, Lisa M.

doi:10.1148/radiol.14140876

Cited by 79 publications

(37 citation statements)

References 33 publications

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“…Dual-energy computed tomography (DECT) has been used clinically in a variety of applications, such as kidney stone characterization, 1,2 the diagnosis of gout, 3 and the characterization of renal and adrenal lesions. 4,5 Additionally, it provides a pathway to new display and postprocessing techniques that can aid and expedite diagnosis, such as automatic bone removal 6 and virtual noncontrast imaging. 7,8 Another visualization technique possible with DECT is virtual monoenergetic imaging.…”

Section: Introductionmentioning

confidence: 99%

Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

et al. 2016

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“…For adrenal masses >1 cm, the specificity for characterizing a lesion as benign was 100% in a small series of 42 patients with 51 adrenal masses, but subsequent studies have shown slightly lower specificity. However, the use of dual energy CT has not become mainstream due to limited use of dual energy scanners for this purpose worldwide [12][13][14][15].…”

Section: Min a Ast´1 00mentioning

confidence: 99%

Adrenal Imaging

Francis¹,

Mayo-Smith²

2018

IDKD Springer Series

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“…Examples include incidental detection of an adrenal lesion. Such a lesion can be characterized using virtual unenhanced images: if the attenuation of the lesion is significantly low, a diagnosis of lipid-rich adenoma can be made without the need for additional imaging (28,29). Similarly, complex lesions in kidneys, which have high attenuation on conventional arterial phase images, can be further evaluated by using virtual unenhanced images and iodine map (30).…”

Section: Incidental Lesion Characterizationmentioning

confidence: 99%

“…As with other DECT technologies, the opportunity exists for reducing contrast load with SDCT and exploiting the higher attenuation of iodine at lower energies (5,(14)(15)(16)(17). This has (27) Incidental lesion characterization Characterization of incidental nodules, and masses, particularly in Virtual unenhanced, iodine map kidneys, adrenals and lungs (28) CT, computed tomography; CTA, CT angiography; TAVI, transcatheter aortic valve implantation.…”

Section: Impact On Contrast Dose and Radiation Dosementioning

confidence: 99%

Spectral detector CT for cardiovascular applications

Rajiah¹,

Abbara²,

Halliburton³

2017

Diagn Interv Radiol

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In spectral computed tomography (CT), multiple spectrally distinct attenuation data sets are obtained from the same scan, which enables material composition analysis not possible with conventional CT. Dual-energy CT (DECT), where a low and high energy data set are obtained, is currently available in clinical practice using the following approaches: a) Dual source technology: two x-ray tube/detector systems separated by approximately 90 o and operated at different tube potentials (1) (Fig. 1a); b) Rapid tube potential switching technology: the potential applied across a single x-ray tube is switched rapidly between a high and low setting (1, 2) (Fig. 1b); c) Dual-spin technology: the same anatomical region is scanned twice during two consecutive rotations, once with a high potential applied across the x-ray tube and once with a low potential applied (1) (Fig. 1c); d) Split-beam technology: the spectrum emitted from a single tube is split into high and low energy spectra (3).Spectral detector CT (SDCT) (IQon, Philips Healthcare) is a novel technology introduced for clinical DECT data acquisition. A single potential is applied across a single x-ray tube and two layers of detectors separate low and high energy data: the top layer absorbs low energy photons and the bottom layer absorbs high energy photons (Fig. 1d). In addition to conventional (polyenergetic) images, projection data simultaneously obtained from both detector layers can also be utilized to generate spectral images. The spectral images useful for cardiovascular assessment include virtual monoenergetic images (Fig. 2a), iodine density maps (Fig. 2b), virtual unenhanced images (Fig. 2c), and effective atomic number (Z effective ) images (Fig. 2d). An important feature of SDCT technology is that spectral information is available in all patients without a priori selection of a special protocol or exposure to additional radiation. Images are available at full field-of-view and a minimum rotation time of 0.27 seconds (s) with complete temporal and spatial registration.In this paper, we present our initial clinical experience based on the acquisition of data from over 200 patients who underwent cardiovascular studies (i.e., cardiac, aorta, pulmonary veins, pulmonary arteries) using SDCT including the impact of this technology on radiation dose and contrast dose. The creation of spectral images from spectral data is discussed and the utility of these images is demonstrated for specific cardiovascular applications. 187From the Department of Radiology (P.R. ABSTRACTSpectral detector computed tomography (SDCT) is a novel technology that uses two layers of detectors to simultaneously collect low and high energy data. Spectral data is used to generate conventional polyenergetic images as well as dedicated spectral images including virtual monoenergetic and material composition (iodine-only, virtual unenhanced, effective atomic number) images. This paper provides an overview of SDCT technology and a description of some spectral image types. The potential utility o...

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Dual-Energy Multidetector CT for the Characterization of Incidental Adrenal Nodules: Diagnostic Performance of Contrast-enhanced Material Density Analysis

Abstract: Contrast-enhanced dual-energy multidetector CT with material density analysis allows differentiation between adrenal adenomas and nonadenomas, reflecting an improved ability over nonenhanced multidetector CT for diagnosis of lipid-poor adenoma.

Cited by 79 publications

References 33 publications

Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

Adrenal Imaging

Spectral detector CT for cardiovascular applications

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