Emergency Abdominal Applications of DECT

Murphy, Kevin P.; Darras, Kathryn E.; Nicolaou, Savvas; McLaughlin, Patrick D.

doi:10.1007/s40134-016-0177-5

Cited by 6 publications

(3 citation statements)

References 68 publications

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“…Unlike water, which demonstrates minimal change in attenuation when imaged by various X-ray spectra, heavy atoms such as cholesterol-containing gallstones possess a CT value that increases with increasing X-ray tube voltage [52]. Therefore, VMI can be used to identify noncalcified gallstones that appear hypoattenuating to surrounding bile at low-keV (40 keV) and hyperattenuating relative to bile at high-keV reconstruction (≥140 keV) [53] (Figure 4).…”

Section: Cholelithiasismentioning

confidence: 99%

Utility of Dual-Energy Computed Tomography in Clinical Conundra

Abu-Omar,

Murray,

Ali

et al. 2024

Diagnostics

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Advancing medical technology revolutionizes our ability to diagnose various disease processes. Conventional Single-Energy Computed Tomography (SECT) has multiple inherent limitations for providing definite diagnoses in certain clinical contexts. Dual-Energy Computed Tomography (DECT) has been in use since 2006 and has constantly evolved providing various applications to assist radiologists in reaching certain diagnoses SECT is rather unable to identify. DECT may also complement the role of SECT by supporting radiologists to confidently make diagnoses in certain clinically challenging scenarios. In this review article, we briefly describe the principles of X-ray attenuation. We detail principles for DECT and describe multiple systems associated with this technology. We describe various DECT techniques and algorithms including virtual monoenergetic imaging (VMI), virtual non-contrast (VNC) imaging, Iodine quantification techniques including Iodine overlay map (IOM), and two- and three-material decomposition algorithms that can be utilized to demonstrate a multitude of pathologies. Lastly, we provide our readers commentary on examples pertaining to the practical implementation of DECT’s diverse techniques in the Gastrointestinal, Genitourinary, Biliary, Musculoskeletal, and Neuroradiology systems.

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Section: Cholelithiasismentioning

confidence: 99%

Utility of Dual-Energy Computed Tomography in Clinical Conundra

Abu-Omar,

Murray,

Ali

et al. 2024

Diagnostics

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“…Although the CT number of water, as well as that of most soft tissues, demonstrates minimal change in attenuation when imaged with varying x-ray spectra, this observation does not apply to other body materials that possess an effective atomic number that is substantially above or below the atomic number for water. This means that for heavy atoms (such as iodine in contrast agents), the CT number decreases with increasing tube voltage; and for carbonand hydrogen-rich materials such as cholesterolcontaining gallstones, the CT value increases with increasing x-ray tube voltage (37,38).…”

Section: Biliary Systemmentioning

confidence: 99%

Dual-Energy CT in Evaluation of the Acute Abdomen

et al. 2019

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Evaluation of the nontraumatic acute abdomen with multidetector CT has long been accepted and validated as the reference standard in the acute setting. Dual-energy CT has emerged as a promising tool, with multiple clinical applications in abdominal imaging already demonstrated. With its ability to allow characterization of materials on the basis of their differential attenuation when imaged at two different energy levels, dual-energy CT can help identify the composition of internal body constituents. Therefore, it is possible to selectively identify iodine to assess the enhancement pattern of an organ, including the identification of hyperenhancement in cases of inflammatory processes, or ischemic changes secondary to vascular compromise. Quantification of iodine uptake with contrast material-enhanced dual-energy CT is also possible, and this quantification has been suggested to be useful in differentiating inflammatory from neoplastic conditions. Dual-energy CT can help determine the composition of gallstones and urolithiasis and can be used to accurately differentiate uric acid urinary calculi from non-uric acid urinary calculi. Moreover, dual-energy CT is capable of substantially reducing artifacts caused by metallic prostheses, to improve the imaging evaluation of abdominopelvic organs. The possibility of creating virtual nonenhanced images in the evaluation of acute aortic syndrome, gastrointestinal hemorrhage and is chemia, or pancreatic pathologic conditions substantially reduces the radiation dose delivered to the patient, by eliminating a true nonenhanced acquisition. Finally, by increasing the iodine conspicuity, contrast-enhanced dual-energy CT can render an area of free active extravasation or endoleak more visible, compared with conventional single-energy CT. This article reviews the basics of dual-energy CT and highlights its main clinical applications in evaluation of the nontraumatic acute abdomen. ©

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“…Therefore, it is possible to decompose these materials using specific software as the Material Decomposition (MD), which can isolate and subtract the Iodine or Calcium from tissues. An application is the possibility to remove iodine material from post-contrast scans, obtaining images without contrast or "virtual non-contrast" [9][10][11][12] when they are required.…”

Section: Introductionmentioning

confidence: 99%

Dual Energy on Dual Source CT in Abdominal Imaging

Francesco

Orlando

Francesco

et al. 2020

JAHC

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Establish whether virtual non-contrast images can replace real non-contrast images, avoiding the preliminary scan, thus saving the patient dose. Forty-one patients were studied on a second-generation dual-source scanner, triphasic were applied on all patients, arterial and venous phase was acquired in dual-energy. HU values of TNC and VNC scans were compared through ROI on liver, spleen, kidneys, aorta, muscle, and fat. Qualitative analysis of the data sets was performed by four readers and the values from 1 to 4 (1. poor, 2. fair, 3. good, 4. excellent.) were assigned to define the diagnostic quality of the images. Then the absorbed dose ratios between the virtual images and the pre-contrast and portal phase images were compared. HU values were analyzed with the t-test and the difference was statistically significant P<0.0001. Image quality was evaluated as excellent or good in 91,3% of TNC and 81,6% of VNC. At last, VNC showed a sensitive dose reduction -46% compared to conventional triphasic protocol. Overall VNC has shown a good image quality comparable to TNC. The dose reduction obtained from the extraction of images without iodine, avoiding further scans, suggests the use of the dual-energy protocol in many exams.

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Emergency Abdominal Applications of DECT

Cited by 6 publications

References 68 publications

Utility of Dual-Energy Computed Tomography in Clinical Conundra

Utility of Dual-Energy Computed Tomography in Clinical Conundra

Dual-Energy CT in Evaluation of the Acute Abdomen

Dual Energy on Dual Source CT in Abdominal Imaging

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