Utilization of virtual mono-energetic images (MonoE) derived from a dual-layer spectral detector CT (SDCT) for the assessment of abdominal arteries in venous contrast phase scans

Hickethier, Tilman; Byrtus, Jonathan; Hauger, Myriam; Iuga, Andra-Iza; Pahn, Gregor; Maintz, David; Haneder, Stefan; Doerner, Jonas

doi:10.1016/j.ejrad.2017.12.007

Cited by 31 publications

(23 citation statements)

References 17 publications

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“…The system applies anti-correlated noise suppression and an iterative algorithm, thus reducing image noise and improving image quality (10)(11)(12). Another advantage that SDCT has over other types of dual-energy CT is that it can generate all spectral datasets without the need to pre-set dual-energy protocols, thereby efficient clinical workflow (13)(14)(15)(16). However, there are still no studies focusing on the application of iodine quantitative parameters from SDCT for the differentiation of benign and malignant SPNs or the pathological classification of malignant nodules.…”

Section: Introductionmentioning

confidence: 99%

The application of dual-layer spectral detector computed tomography in solitary pulmonary nodule identification

Wen

Yue

Shang

et al. 2021

Quant Imaging Med Surg

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Background: Differentiating between malignant solitary pulmonary nodules (SPNs) and other lung diseases remains a substantial challenge. The latest generation of dual-energy computed tomography (CT), which realizes dual-energy technology at the detector level, has clinical potential for distinguishing lung cancer from other benign SPNs. This study aimed to evaluate the performance of dual-layer spectral detector CT (SDCT) for the differentiation of SPNs.Methods: Spectral images of 135 SPNs confirmed by pathology were retrospectively analyzed in both the arterial phase (AP) and the venous phase (VP). Patients were classified into two groups [the malignant group (n=93) and the benign group (n=42)], with the malignant group further divided into small cell lung cancer (SCLC, n=30) and non-small cell lung cancer (NSCLC, n=63) subtypes. The slope of the spectral Hounsfield Unit (HU) curve (λ HU ), normalized iodine concentration (NIC), CT values of 40 keV monochromatic images (CT 40keV ), and normalized arterial enhancement fraction (NAEF) in contrast-enhanced images were calculated and compared between the benign and malignant groups, as well as between the SCLC and NSCLC subgroups. ROC curve analysis was performed to assess the diagnostic performance of the above parameters. Seventy cases were randomly selected and independently measured by two radiologists, and intraclass correlation coefficient (ICC) and Bland-Altman analyses were performed to calculate the reliability of the measurements.Results: Except for NAEF (P=0.23), the values of the parameters were higher in the malignant group than in the benign group (all P<0.05). NIC, λ HU , and CT 40keV performed better in the VP (NIC VP , λ VPHU , and CT VP40keV ) (P<0.001), with an area under the ROC curve (AUC) of 0.93, 0.89, and 0.89 respectively. With respective cutoffs of 0.31, 1.83, and 141.00 HU, the accuracy of NIC VP , λ VPHU , and CT VP40keV was 91.11%, 85.19%, and 88.15%, respectively. In the subgroup differentiating NSCLC and SCLC, the diagnostic performances of NIC AP (AUC =0.89) were greater than other parameters. NIC AP had an accuracy of 86.02% when the cutoff was 0.14. ICC and Bland-Altman analyses indicated that the measurement of SDCT has great reproducibility.Conclusions: Quantitative measures from SDCT can help to differentiate benign from malignant SPNs and may help with the further subclassification of malignant cancer into SCLC and NSCLC.

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Section: Introductionmentioning

confidence: 99%

The application of dual-layer spectral detector computed tomography in solitary pulmonary nodule identification

Wen

Yue

Shang

et al. 2021

Quant Imaging Med Surg

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“…Dual-energy CT (DECT) has been previously reported as a feasible method to provide virtual non-contrast (VNC) images and low-keV virtual monoenergetic images (VMI) as surrogate for true non-contrast images (TNC) and angiographic acquisitions, respectively [7][8][9][10][11][12][13][14]. DECT allows for detection and quantification of iodine, which can be subtracted subsequently from the original image to obtain VNC images.…”

Section: Introductionmentioning

confidence: 99%

Abdominal vessel depiction on virtual triphasic spectral detector CT: initial clinical experience

et al. 2021

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Purpose To evaluate vessel assessment in virtual monoenergetic images (VMI40keV) and virtual-non-contrast images (VNC) derived from venous phase spectral detector computed tomography (SDCT) acquisitions in comparison to arterial phase and true non-contrast (TNC) images. Methods Triphasic abdominal SDCT was performed in 25 patients including TNC, arterial and venous phase. VMI40keV and VNC were reconstructed from the venous phase and compared to conventional arterial-phase images (CIart), TNC and conventional venous-phase images (CIven). Vessel contrast and virtual contrast removal were analyzed with region-of-interest-based measurements and in a qualitative assessment. Results Quantitative analysis revealed no significant attenuation differences between TNC and VNC in arterial vessels (p-range 0.07–0.47) except for the renal artery (p = 0.011). For venous vessels, significant differences between TNC and VNC were found for all veins (p < 0.001) except the inferior vena cava (p = 0.26), yet these differences remained within a 10 HU range in most patients. No significant attenuation differences were found between CIart/VMI40keV in arterial vessels (p-range 0.06–0.86). Contrast-to-noise ratio provided by VMI40keV and CIart was equivalent for all arterial vessels assessed (p-range 0.14–0.91). Qualitatively, VMI40keV showed similar enhancement of abdominal and pelvic arteries as CIart and VNC were rated comparable to TNC. Conclusion Our study suggests that VNC and VMI40keV derived from single venous-phase SDCT offer comparable assessment of major abdominal vessels as provided by routine triphasic examinations, if no dynamic contrast information is required.

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“…This is in line with the quantitative results which revealed the highest SNR for VMI 40keV -a result that can be attributed both to noise anticorrelation facilitated by SDCT and improved image reconstruction techniques that have been broadly implemented in the last years and addressed the issue of increased noise at lowest keV levels. While we did not assess detection of vessel stenosis because the subgroup of patients with stenosis was too small, the improved qualitative vessel assessment we found in VMI 40keV corresponds to previous evidence [30].…”

Section: Tablementioning

confidence: 53%

Value of spectral detector CT for pretherapeutic, locoregional assessment of esophageal cancer

Zopfs

Hokamp

Reimer

et al. 2021

European Journal of Radiology

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Utilization of virtual mono-energetic images (MonoE) derived from a dual-layer spectral detector CT (SDCT) for the assessment of abdominal arteries in venous contrast phase scans

Cited by 31 publications

References 17 publications

The application of dual-layer spectral detector computed tomography in solitary pulmonary nodule identification

The application of dual-layer spectral detector computed tomography in solitary pulmonary nodule identification

Abdominal vessel depiction on virtual triphasic spectral detector CT: initial clinical experience

Value of spectral detector CT for pretherapeutic, locoregional assessment of esophageal cancer

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