Improving diagnostic accuracy for arteries of lower extremities with dual-energy spectral CT imaging

Jia, Xiaoqian; Li, Xianjun; Li, Jianying; Tian, Qian; Yao, Yue; Zhu, Shumeng; Sun, Jianyong; Li, Yanan; Zhao, Liang; Shi, Yilei; Tong, Wei; Yang, Jian; Guo, Jianxin

doi:10.1016/j.ejrad.2020.109061

Cited by 12 publications

(5 citation statements)

References 18 publications

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“…DE-CTA has been reported to be useful in the diagnosis of lower-extremity arterial stenosis in patients with PAD. DE-CTA that employs the bone and plaque removal technique can improve the diagnostic accuracy [ 3 , 19 , 20 , 23 ]. Our findings revealed a clear improvement in the overall diagnostic performance with DE-SR with APR compared to DE-SR alone.…”

Section: Discussionmentioning

confidence: 99%

“…Smoking and diabetes are two major risk factors for PAD. In patients with coexisting PAD and diabetes, the lesions are more often multilevel, more distal arteries are affected, and the arterial walls are usually more calcified [ 3 , 4 ]. Imaging is critical for the evaluation and planning of endovascular or open surgical intervention in patients with PAD [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among the available modalities, multiplanar reconstruction maximum intensity projection (MIP) generation has been shown to be less time-consuming than standard CTA scans [ 19 ] and provides better visualization and characterization of vascular features. Clinical studies with DE-CTA have revealed promising results [ 3 , 14 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Automatic Plaque Removal Using Dual-Energy Computed Tomography Angiography: Diagnostic Accuracy and Utility in Patients with Peripheral Artery Disease

et al. 2022

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Background and Objectives: This study aimed to evaluate the utility and accuracy of dual-energy automatic plaque removal (DE-APR) in patients with symptomatic peripheral arterial disease (PAD) using digital subtraction angiography (DSA) as the reference standard. Materials and Methods: We retrospectively analyzed 100 patients with PAD who underwent DE computed tomography angiography (DE-CTA) and DSA of the lower extremities. DE-CTA was used to generate APR subtracted images. In the three main arterial segments (aorto-iliac segment, femoro-popliteal segment, and below-the-knee segment), the presence or absence of hemodynamically significant stenosis (>50%) and calcification was assessed using the images. CTA data were analyzed using different imaging approaches (DE-standard reconstruction image (DE-SR), DE-APR maximum intensity projection image (APR), and DE-SR with APR). Results: For all segments evaluated, the sensitivity, specificity, and accuracy for detecting significant stenosis were 98.16%, 81.01%, and 89.58%, respectively, with DE-SR; 97.79%, 83.33%, and 90.56%, respectively, with APR; and 98.16%, 92.25%, and 95.20%, respectively, with DE-SR with APR. DE-SR with APR had greater accuracy than DE-SR or APR alone (p < 0.001 and p < 0.001, respectively). When analyzed based on vascular wall calcification, the accuracy of DE-SR with APR remained greater than 90% regardless of calcification severity, whereas DE-SR showed a considerable reduction in accuracy in moderate to severe calcification. In the case of APR, the degree of vascular wall calcification did not significantly influence the accuracy in the aorto-iliac and femoro-popliteal segments. DE-SR with APR achieved significantly higher diagnostic accuracy for all lower extremity segments in evaluating hemodynamically significant stenosis in patients with symptomatic PAD and transcended the impact of vascular wall calcification compared with DE-SR. Conclusions: APR demonstrated favorable diagnostic performance in the aorto-iliac and femoro-popliteal segments, exhibiting good agreement with DSA even in cases of moderate to severe vascular wall calcification.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Automatic Plaque Removal Using Dual-Energy Computed Tomography Angiography: Diagnostic Accuracy and Utility in Patients with Peripheral Artery Disease

et al. 2022

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“…Spectral computed tomography (CT) can provide multi-contrast imaging information and utilize different attenuation distributions of substances in a multi-energy spectrum to achieve material decomposition and quantification (Jia 2020, Siegel et al 2021. Dual-energy CT (DECT) which utilizes two different energies for material analysis is one of the most common application forms (De Cecco 2010, Terzioglu et al 2024.…”

Section: Introductionmentioning

confidence: 99%

One-step inverse generation network for sparse-view dual-energy CT reconstruction and material imaging

Zhang,

Li,

Wang

et al. 2024

Phys. Med. Biol.

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Objective. Sparse-view dual-energy spectral computed tomography (DECT) imaging is a challenging inverse problem. Due to the incompleteness of the collected data, the presence of streak artifacts can result in the degradation of reconstructed spectral images. The subsequent material decomposition task in DECT can further lead to the amplification of artifacts and noise. Approach. To address this problem, we propose a novel one-step inverse generation network (OIGN) for sparse-view dual-energy CT imaging, which can achieve simultaneous imaging of spectral images and materials. The entire OIGN consists of five sub-networks that form four modules, including the pre-reconstruction module, the pre-decomposition module, and the following residual filtering module and residual decomposition module. The residual feedback mechanism is introduced to synchronize the optimization of spectral CT images and materials. Main results. Numerical simulation experiments show that the OIGN has better performance on both reconstruction and material decomposition than other state-of-the-art spectral CT imaging algorithms. OIGN also demonstrates high imaging efficiency by completing two high-quality imaging tasks in just 50 seconds. Additionally, anti-noise testing is conducted to evaluate the robustness of OIGN. Significance. These findings have great potential in high-quality multi-task spectral CT imaging in clinical diagnosis.

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“…Unlike traditional CT, spectral CT decomposes the traditional polyenergetic X-ray beam into continuous single energies ranging from 40 to 140 KeV, which may achieve qualitative separation and quantitative determination of substances. [31][32][33][34][35][36] For example, Metin et al 31 found that the conspicuity of primary breast cancer was significantly higher in low KeV virtual monochromatic images. Thus, the combination of spectral CT and high-Z nanomaterials shows potential for the accurate diagnosis of various diseases.…”

Section: Introductionmentioning

confidence: 99%

Functionalized Au@Cu-Sb-S Nanoparticles for Spectral CT/Photoacoustic Imaging-Guided Synergetic Photo-Radiotherapy in Breast Cancer

Hu¹,

Zheng²,

Hou³

et al. 2022

IJN

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Background Radiotherapy (RT) is clinically well-established cancer treatment. However, radioresistance remains a significant issue associated with failure of RT. Phototherapy-induced radiosensitization has recently attracted attention in translational cancer research. Methods Cu-Sb-S nanoparticles (NPs) coated with ultra-small Au nanocrystals (Au@Cu-Sb-S) were synthesized and characterized. The biosafety profiles, absorption of near-infrared (NIR) laser and radiation-enhancing effect of the NPs were evaluated. In vitro and in vivo spectral computed tomography (CT) imaging and photoacoustic (PA) imaging were performed in 4T1 breast cancer-bearing mice. The synergetic radio-phototherapy was assessed by in vivo tumor inhibition studies. Results Au@Cu-Sb-S NPs were prepared by in situ growth of Au NCs on the surface of Cu-Sb-S NPs. The cell viability experiments showed that the combination of Au@Cu-Sb-S+NIR+RT was significantly more cytotoxic to tumor cells than the other treatments at concentrations above 25 ppm Sb. In vitro and in vivo spectral CT imaging demonstrated that the X-ray attenuation ability of Au@Cu-Sb-S NPs was superior to that of the clinically used Iodine, particularly at lower KeV levels. Au@Cu-Sb-S NPs showed a concentration-dependent and remarkable PA signal brightening effect. In vivo tumor inhibition studies showed that the prepared Au@Cu-Sb-S NPs significantly suppressed tumor growth in 4T1 breast cancer-bearing mice treated with NIR laser irradiation and an intermediate X-ray dose (4 Gy). Conclusion These results indicate that Au@Cu-Sb-S integrated with spectral CT, PA imaging, and phototherapy-enhanced radiosensitization is a promising multifunctional theranostic nanoplatform for clinical applications.

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Improving diagnostic accuracy for arteries of lower extremities with dual-energy spectral CT imaging

Cited by 12 publications

References 18 publications

Automatic Plaque Removal Using Dual-Energy Computed Tomography Angiography: Diagnostic Accuracy and Utility in Patients with Peripheral Artery Disease

Automatic Plaque Removal Using Dual-Energy Computed Tomography Angiography: Diagnostic Accuracy and Utility in Patients with Peripheral Artery Disease

One-step inverse generation network for sparse-view dual-energy CT reconstruction and material imaging

Functionalized Au@Cu-Sb-S Nanoparticles for Spectral CT/Photoacoustic Imaging-Guided Synergetic Photo-Radiotherapy in Breast Cancer

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