Quantitative dual-energy CT techniques in the abdomen

Toia, Giuseppe V.; Mileto, Achille; Wang, Carolyn L.; Sahani, Dushyant V.

doi:10.1007/s00261-021-03266-7

Cited by 26 publications

(38 citation statements)

References 150 publications

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“…Postprocessing of dual-energy data may be performed before (projection-space domain) or after (image-space domain) the reconstruction of high- or low-energy images, depending on the scanner ( Figure 4 ) [ 3 , 16 ]. The former has the advantage of reduced beam hardening artifacts but requires a high computational power.…”

Section: Resultsmentioning

confidence: 99%

“…Material-selective information is extracted by material decomposition algorithms, which decompose unknown tissues into selected materials, based on their attenuation plot at different energy levels [ 12 ]. They include two-material (applied to raw data) and three-material decomposition (applied to the image-space domain, respecting the conservation of mass) [ 2 , 3 , 10 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…Iodine may be subtracted from material-specific images, generating VNC images [ 3 , 16 ]. These have shown image quality comparable to true non-contrast images, potentially obviating a true unenhanced acquisition (therefore reducing radiation exposure and scan time) [ 10 , 18 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…It is possible to similarly suppress other tissues such as bone or calcium (useful in angiographic studies and bone marrow evaluation) [ 3 , 6 , 12 ]. Iodine may be color-coded, generating iodine overlay images for quantification [ 10 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

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Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

2023

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Dual-energy computed tomography (DECT) uses different energy spectrum X-ray beams for differentiating materials with similar attenuation at a certain energy. Compared with single-energy CT, it provides images with better diagnostic performance and a potential reduction of contrast agent and radiation doses. There are different commercially available DECT technologies, with machines that may display two X-ray sources and two detectors, a single source capable of fast switching between two energy levels, a specialized detector capable of acquiring high- and low-energy data sets, and a filter splitting the beam into high- and low-energy beams at the output. Sequential acquisition at different tube voltages is an alternative approach. This narrative review describes the DECT technique using a Q&A format and visual representations. Physical concepts, parameters influencing image quality, postprocessing methods, applicability in daily routine workflow, and radiation considerations are discussed. Differences between scanners are described, regarding design, image quality variabilities, and their advantages and limitations. Additionally, current clinical applications are listed, and future perspectives for spectral CT imaging are addressed. Acknowledging the strengths and weaknesses of different DECT scanners is important, as these could be adapted to each patient, clinical scenario, and financial capability. This technology is undoubtedly valuable and will certainly keep improving.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

2023

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“…Computed tomography (CT) is a common method for diagnosing pelvic bone tumors and surgical planning. However, even with CT, the preoperative assessment of these tumors remains a troublesome task because pelvic CT images are often associated with a mixture of obvious noise and artifacts due to the anatomical complexity and the heterogeneous X-ray–attenuating property of the pelvic region ( 6 , 7 ). Applying a higher tube voltage and/or tube current might help reduce the noise and artifacts, but it also increases the radiation dose to patients.…”

Section: Introductionmentioning

confidence: 99%

Development of a 3D-printed pelvic CT phantom combined with fresh pathological tissues of bone tumor

Li¹,

Wu²,

Zou³

et al. 2022

Quant Imaging Med Surg

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Background: Computed tomography (CT) imaging is the most important and common means of detecting and diagnosing pelvic bone tumors. While phantoms with sufficient flexibility and anatomical realism are useful in CT research, using phantoms has been difficult for pelvic bone tumors because of the tumors' relatively large size and highly variable shape. By combining medical 3D printing technology and fresh tumor specimens, this study aimed to design such a hybrid phantom, test its imaging properties, and demonstrate its usefulness in optimizing the CT protocols.Methods: Two phantoms were designed for 2 patients with pelvic bone tumors who underwent surgical resection. One phantom was scanned with a routine pelvic CT protocol and compared against the patient image to test the imaging properties. We optimized the imaging protocol by assessing a series of varied settings on tube voltage (80, 100, 120, and 140 kVp), tube current (80, 120, and 160 to 200 mAs), and pitch factor (0.5, 0.8, 1.1, and 1.4) using the other phantom. These were assessed in comparison to the clinical reference of 140 kVp, 240 mAs, and 1.0 pitch, respectively. Image quality was quantified in terms of CT value, image noise, signal to noise ratio (SNR), and contrast to noise ratio (CNR) in various regions of interest.Results: With the routine protocol, the phantom image showed no significant difference in CT values of the bone and soft tissues and image noise compared to the patient image (all P values >0.05). With a lower tube voltage (80, 100, and 120 kVp) than the reference protocol, the CT value of bone tissue showed significant differences (all P values <0.001). No significant difference was found when applying a reduced tube current (all P values >0.05). With an increased helical pitch, pitches of 0.5, 0.8 and 1.1 were found to be comparable to those using the reference protocol (all P values >0.05). Conclusions:The 3D-printed phantom can simulate the radiological properties of tumors in the pelvis and was successfully used in imaging studies of pelvic bone tumors. According to our preliminary findings, a low-dose pelvic CT protocol with acceptable image quality is achievable using reduced tube current or increased pitch.

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No gadolinium K‐edge detected on the first clinical photon‐counting computed tomography scanner

Baubeta,

Laurin Gadsböll,

Will

et al. 2024

J Applied Clin Med Phys

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PurposeThis study aimed to elucidate whether gadolinium contrast in clinically relevant doses can be used with photon‐counting computed tomography (PCCT) as an alternative contrast agent in clinical applications.Material/methodsA CTDI phantom with 3D printed rods filled with different concentrations of gadolinium and iodine contrast was scanned in a PCCT and an energy‐integrated computed tomography (EICT). Attenuation values at different monoenergetic steps were extracted for each contrast concentration.ResultsFor PCCT, gadolinium reached an attenuation >100 HU (103 HU) at 40 keV with a concentration 5 mmol/L whereas the same level was reached at 50 keV (118 HU) for 10 mmol/L and 90 keV (114 HU) for 25 mmol/L. For iodine, the same level of attenuation was reached at 100 keV (106 HU) with a concentration 8.75 mg I/mL.For EICT the lowest gadolinium contrast concentration needed to reach >100 HU (108 HU) was 10 mmol/L at 50 keV. For 25 mmol/L 100 HU was reached at 100 keV. For iodine contrast 108 HU was reached at 110 keV for 8.75 mg I/mL.ConclusionNo K‐edge potential or difference in attenuation curves between iodine and gadolinium contrast is detected on the first clinical available PCCT. Clinically relevant attenuation levels were barely achieved in this setting with gadolinium concentrations approved for human use. The results of this study suggest that, given current scanning technology, gadolinium is not a clinically useful contrast agent for computed tomography because no K‐edge was detected.

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Quantitative dual-energy CT techniques in the abdomen

Cited by 26 publications

References 150 publications

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

Development of a 3D-printed pelvic CT phantom combined with fresh pathological tissues of bone tumor

No gadolinium K‐edge detected on the first clinical photon‐counting computed tomography scanner

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