Spectral CT and its specific values in the staging of patients with non-small cell lung cancer: technical possibilities and clinical impact

Fehrenbach, Uli; Kahn, Johannes; Böning, Georg; Feldhaus, Felix; Merz, K. W.; Frost, Nikolaj; Maurer, Martin; Renz, Diane M.; Hamm, Bernd; Streitparth, Florian

doi:10.1016/j.crad.2019.02.010

Cited by 19 publications

(19 citation statements)

References 37 publications

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“…There are also several studies about iodine content in DESCT related to LN metastases from lung cancers. LN metastases showed lower IC than benign LNs, which was statistically significant (20). λHU at both AP and VP were significantly higher in LN metastasis than in benign LNs, suggesting rapid washout of contrast media in metastatic LNs (31).…”

Section: Malignant Vs Benign Lesionsmentioning

confidence: 76%

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Application of Dual-Energy Spectral Computed Tomography to Thoracic Oncology Imaging

Kim

Park

et al. 2020

Korean J Radiol

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Computed tomography (CT) is an important imaging modality in evaluating thoracic malignancies. The clinical utility of dual-energy spectral computed tomography (DESCT) has recently been realized. DESCT allows for virtual monoenergetic or monochromatic imaging, virtual non-contrast or unenhanced imaging, iodine concentration measurement, and effective atomic number (Zeff map). The application of information gained using this technique in the field of thoracic oncology is important, and therefore many studies have been conducted to explore the use of DESCT in the evaluation and management of thoracic malignancies. Here we summarize and review recent DESCT studies on clinical applications related to thoracic oncology.

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Section: Malignant Vs Benign Lesionsmentioning

confidence: 76%

“…In the evaluation of adrenal metastasis of lung cancer, VNC identified adrenal adenomas with 91% sensitivity and 100% specificity based on their typical imaging features (non-contrast attenuation < 10 HU) (Fig. 7) (20).…”

Section: Evaluation Of Adrenal Massesmentioning

confidence: 99%

Application of Dual-Energy Spectral Computed Tomography to Thoracic Oncology Imaging

Kim

Park

et al. 2020

Korean J Radiol

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“…A dual-energy CT (DE-CT) technique using two types of tube voltages can enable quantification of the iodinerelated attenuation (IRA) of iodinated contrast material in the tumor after intravenous injection without the need for an additional non-contrast CT scan [11][12][13][14], thereby reducing radiation exposure during a CT examination. Several research findings indicate that iodine uptake in the arterial phase on contrast CT of primary lung cancer may be associated with some aspects of tumor histopathology such as angiogenesis, differentiation grade, hypoxic cells, and tumor invasiveness [12,[15][16][17][18]. Moreover, a few studies indicated that iodine uptake of lung cancer correlated with tumor recurrence after radiotherapy and chemoradiotherapy [19,20].…”

Section: Introductionmentioning

confidence: 99%

Iodine-related attenuation in contrast-enhanced dual-energy computed tomography in small-sized solid-type lung cancers is associated with the postoperative prognosis

et al. 2021

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Background To investigate the correlation between iodine-related attenuation in contrast-enhanced dual-energy computed tomography (DE-CT) and the postoperative prognosis of surgically resected solid-type small-sized lung cancers. Methods We retrospectively reviewed the DE-CT findings and postoperative course of solid-type lung cancers ≤3 cm in diameter. After injection of iodinated contrast media, arterial phases were scanned using 140-kVp and 80-kVp tube voltages. Three-dimensional iodine-related attenuation (3D-IRA) of primary tumors at the arterial phase was computed using the “lung nodule” application software. The corrected 3D-IRA normalized to the patient’s body weight and contrast medium concentration was then calculated. Results A total of 120 resected solid-type lung cancers ≤3 cm in diameter were selected for analysis (82 males and 38 females; mean age, 67 years). During the observation period (median, 47 months), 32 patients showed postoperative recurrence. Recurrent tumors had significantly lower 3D-IRA and corrected 3D-IRA at early phase compared to non-recurrent tumors (p = 0.046 and p = 0.027, respectively). The area under the receiver operating characteristic curve for postoperative recurrence was 0.624 for the corrected 3D-IRA at early phase (p = 0.025), and the cutoff value was 5.88. Kaplan–Meier curves for disease-free survival indicated that patients showing tumors with 3D-IRA > 5.88 had a significantly better prognosis than those with tumors showing 3D-IRA < 5.88 (p = 0.017). Conclusions The 3D-IRA of small-sized solid-type lung cancers on contrast-enhanced DE-CT was significantly associated with postoperative prognosis, and low 3D-IRA tumors showed a higher TNM stage and a significantly poorer prognosis.

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“…Compared with traditional XCT, X-ray spectral CT can obtain projections of objects under various energy channels in one scan, which makes it possible to distinguish the materials of the objects by extracting energy information. Fehrenbach et al found that spectral CT providing quantitative values such as iodine content, spectral slope analysis, and attenuation increase can not only identify histological non-small cell lung cancer subtypes and signify their grading, but also have diagnostic value for lymph node metastasis assisting the differentiation of benign or malignant [21]. Schlomka et al experimentally proved the feasibility of K-edge spectral CT by means of describing four attenuation processes (photoelectric absorption, Compton scattering, attenuation by iodine and attenuation by gadolinium) to carry out K-edge imaging of medical contrast agents [22].…”

Section: Introductionmentioning

confidence: 99%

Effect of Reconstruction Algorithm on the Identification of 3D Printing Polymers Based on Hyperspectral CT Technology Combined with Artificial Neural Network

Zheng

Wang

et al. 2020

Materials

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Hyperspectral X-ray CT (HXCT) technology provides not only structural imaging but also the information of material components therein. The main purpose of this study is to investigate the effect of various reconstruction algorithms on reconstructed X-ray absorption spectra (XAS) of components shown in the CT image by means of HXCT. In this paper, taking 3D printing polymer as an example, seven kinds of commonly used polymers such as thermoplastic elastomer (TPE), carbon fiber reinforced polyamide (PA-CF), acrylonitrile butadiene styrene (ABS), polylactic acid (PLA), ultraviolet photosensitive resin (UV9400), polyethylene terephthalate glycol (PETG), and polyvinyl alcohol (PVA) were selected as samples for hyperspectral CT reconstruction experiments. Seven kinds of 3D printing polymer and two interfering samples were divided into a training set and test sets. First, structural images of specimens were reconstructed by Filtered Back-Projection (FBP), Algebra Reconstruction Technique (ART) and Maximum-Likelihood Expectation-Maximization (ML-EM). Secondly, reconstructed XAS were extracted from the pixels of region of interest (ROI) compartmentalized in the images. Thirdly, the results of principal component analysis (PCA) demonstrated that the first four principal components contain the main features of reconstructed XAS, so we adopted Artificial Neural Network (ANN) trained by the reconstructed XAS expressed by the first four principal components in the training set to identify that the XAS of corresponding polymers exist in both of test sets from the training set. The result of ANN displays that FBP has the best performance of classification, whose ten-fold cross-validation accuracy reached 99%. It suggests that hyperspectral CT reconstruction is a promising way of getting image features and material features at the same time, which can be used in medical imaging and nondestructive testing.

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Spectral CT and its specific values in the staging of patients with non-small cell lung cancer: technical possibilities and clinical impact

Cited by 19 publications

References 37 publications

Application of Dual-Energy Spectral Computed Tomography to Thoracic Oncology Imaging

Application of Dual-Energy Spectral Computed Tomography to Thoracic Oncology Imaging

Iodine-related attenuation in contrast-enhanced dual-energy computed tomography in small-sized solid-type lung cancers is associated with the postoperative prognosis

Effect of Reconstruction Algorithm on the Identification of 3D Printing Polymers Based on Hyperspectral CT Technology Combined with Artificial Neural Network

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