Utility of virtual unenhanced images and split-bolus injection using spectral multidetector CT for the assessment of renal cell carcinoma conspicuity and radiation dose

Wang, Wei; Liu, Lin; Zeng, Hong; Sun, Changjiang; Huang, Ning; Zhang, Mengchao

doi:10.1111/ijcp.12859

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…Results from previous studies (7,10,11,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) have demonstrated variable attenuation error rates of VNC images, with the majority of these studies demonstrating a good correlation between the VNC and the unenhanced attenuation values of various anatomic regions with differences below 5 HU. However, some studies (21,26,27) have shown differences between VNC and unenhanced attenuation values of up to 10 HU.…”

Section: Discussionmentioning

confidence: 99%

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Virtual Unenhanced Images at Dual-Energy CT: Influence on Renal Lesion Characterization

Meyer¹,

Nelson²,

Vernuccio³

et al. 2019

Radiology

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Background: Dual-energy (DE) CT allows reconstruction of virtual noncontrast (VNC) images from a single-phase contrast agentenhanced examination, potentially reducing the need for multiphasic CT to characterize renal lesions. However, data regarding diagnostic performance of VNC images for the characterization of renal lesions are limited. Purpose: To determine whether renal mass CT performed by using VNC images allows for reliable identification of renal lesions and differentiation of contrast-enhanced from unenhanced lesions, compared with unenhanced images. Materials and Methods: This is a retrospective study of 293 patients (105 women [mean age, 65 years; age range, 18-91 years] and 188 men [mean age, 66 years; age range, 23-90 years] with 379 renal lesions [craniocaudal diameter, 1.0-4.0 cm]) who underwent a single-energy unenhanced CT examination followed by a nephrographic-phase DE CT between June 2013 and October 2017 by using one of four different DE CT platforms from two vendors. VNC images were calculated by using vendor-specific algorithms. Each lesion was classified in a blinded and independent fashion by using the VNC or unenhanced image in combination with the nephrographic images. Attenuation measurements were obtained on the VNC, unenhanced, and nephrographic images. Unenhanced images and pathologic or imaging follow-up for more than 24 months served as reference standard. Results: There was strong overall agreement between VNC and unenhanced images for renal lesion characterization (Cramer V = 0.85). VNC images yielded a high diagnostic performance (area under the receiver operating characteristic curve, 0.91; 95% confidence interval: 0.86, 0.95) for facilitation of differentiation of contrast-enhanced from unenhanced renal lesions. However, there was a reduction in diagnostic performance for depicting contrast-enhanced renal lesions by using VNC compared with unenhanced images (area under the receiver operating characteristic curve, 0.91 [95% confidence interval: 0.86, 0.95] vs 0.96 [95% confidence interval: 0.93, 0.99]; P , .001). Mean absolute difference between the VNC and unenhanced attenuation was 9.2 HU 6 8.7. Conclusion: Virtual noncontrast images enabled accurate renal lesion characterization, albeit with a reduction in diagnostic performance for contrast-enhanced lesion characterization.

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Section: Discussionmentioning

confidence: 99%

“…and VNC images when a second generation or newer DE CT system was used (10,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). The factors for this difference may be multifactorial, including different patient cohorts with different contrast media phases, patient size, and subjective image interpretations.…”

Section: Discussionmentioning

confidence: 99%

Virtual Unenhanced Images at Dual-Energy CT: Influence on Renal Lesion Characterization

Meyer¹,

Nelson²,

Vernuccio³

et al. 2019

Radiology

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“…Continuous variables were analyzed using unpaired t test, and categorical variables were analyzed by Mann-Whitney U test. 16 The Tukey-Kramer post hoc analysis was employed to evaluate the difference among different groups. 17 One-way analysis of variance (ANOVA) was employed to compare variables among more than 2 groups.…”

Section: Discussionmentioning

confidence: 99%

Benefits of Low-Dose CT Scan of Head for Patients With Intracranial Hemorrhage

Wang

Bian

et al. 2020

Dose-Response

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Objectives: For patients with intracranial hemorrhage (ICH), routine follow-up computed tomography (CT) scans are typically required to monitor the progression of intracranial pathology. Remarkable levels of radiation exposure are accumulated during repeated CT scan. However, the effects and associated risks have still remained elusive. This study presented an effective approach to quantify organ-specific radiation dose of repeated CT scans of head for patients with ICH. We also indicated whether a low-dose CT scan may reduce radiation exposure and keep the image quality highly acceptable for diagnosis. Methods: Herein, 72 patients with a history of ICH were recruited. The patients were divided into 4 groups and underwent CT scan of head with different tube current–time products (250, 200, 150, and 100 mAs). Two experienced radiologists visually rated scores of quality of images according to objective image noise, sharpness, diagnostic acceptability, and artifacts due to physiological noise on the same workstation. Organ-/tissue-specific radiation doses were analyzed using Radimetrics. Results: In conventional CT scan group, signal to noise ratio (SNR) and contrast to noise ratio (CNR) of ICH images were significantly higher than those in normal brain structures. Reducing the tube current–time product may decrease the image quality. However, the predilection sites for ICH could be clearly identified. The SNR and CNR in the predilection sites for ICH were notably higher than other areas. The brain, eye lenses, and salivary glands received the highest radiation dose. Reducing tube current–time product from 250 to 100 mA can significantly reduce the radiation dose. Discussion: We demonstrated that low-dose CT scan of head can still provide reasonable images for diagnosing ICH. The radiation dose can be reduced to ∼45% of the conventional CT scan group.

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Comparison of true unenhanced and virtual unenhanced (VUE) attenuation values in abdominopelvic single-source rapid kilovoltage-switching spectral CT

et al. 2016

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Although the correlation between VUE and TNC attenuation values was excellent and mean difference between TNC and VUE attenuation values was negligible (ranging between -5.94 HU for paraspinal muscles to 6.2 HU in aorta), intra-patient analysis showed a considerable number of cases which had >10 HU difference between VUE and TNC. VUE-ven generally offered a better approximation of TNC values. Further optimization of post-processing algorithms might be necessary before complete replacement of TNC with VUE images.

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Utility of virtual unenhanced images and split-bolus injection using spectral multidetector CT for the assessment of renal cell carcinoma conspicuity and radiation dose

Abstract: Conspicuity with virtual unenhanced imaging and split-bolus injection from spectral multidetector CT is better than or equal to the conventional three-phase enhanced CT scan in showing the RCC, renal artery and renal vein, while the radiation dose can be reduced by 28.78%.

Cited by 7 publications

References 28 publications

Virtual Unenhanced Images at Dual-Energy CT: Influence on Renal Lesion Characterization

Virtual Unenhanced Images at Dual-Energy CT: Influence on Renal Lesion Characterization

Benefits of Low-Dose CT Scan of Head for Patients With Intracranial Hemorrhage

Comparison of true unenhanced and virtual unenhanced (VUE) attenuation values in abdominopelvic single-source rapid kilovoltage-switching spectral CT

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