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Liu P, Tan XZ, Wan R. An Unusual Cause of Obstructive Jaundice. Gastroenterology 2023; 164:196-197. [PMID: 35932887 DOI: 10.1053/j.gastro.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Peng Liu
- Department of Radiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Hunan, China
| | - Xian-Zheng Tan
- Department of Radiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Hunan, China
| | - Ren Wan
- Department of Radiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Hunan, China.
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Ogiwara S, Fukuda T, Kawakami R, Ojiri H, Fukuda K. Anatomical analysis of inflammation in hand psoriatic arthritis by Dual-Energy CT Iodine Map. Eur J Radiol Open 2021; 8:100383. [PMID: 34703848 PMCID: PMC8526758 DOI: 10.1016/j.ejro.2021.100383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/29/2021] [Accepted: 10/07/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE This study aimed to identify the detailed location of inflammatory lesions and its frequency of hand PsA on DECT Iodine Map with referring the cadaveric specimen. MATERIALS AND METHODS Thirty-eight anatomical landmarks were selected as a potential inflammatory sites in the thumb and middle finger. We included 22 symptomatic PsA patients who underwent contrast enhanced DECT of the hand. MR images and macroscopic specimens of thumb and middle finger were prepared from a cadaver. Two musculoskeletal radiologists evaluated DECT with referring the cadaveric images to determine the precise location of inflammatory sites and its frequency. RESULTS The frequently observed inflammation sites of active PsA patients were either classical or functional entheses, and coincide with the well-known hypothesis that primary inflammatory sites of PsA are enthesis. We have noticed that there was remarkable enhancement around DIP joints (13.6 %-45.5 %). CONCLUSION DECT could assess the detailed anatomical sites of the inflammatory lesion in hand psoriatic arthritis, which coincided with enthesis.
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Affiliation(s)
- Sho Ogiwara
- Corresponding author at: ParkAxis Nakaokachimachi #1002, 3-5-3, Taitou, Taitouku, Tokyo, 110-0016, Japan.
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Di Felice C, Kikano EG, Young B, Gupta A. Indeterminate pulmonary nodule in lung allograft characterized using dual-energy computed tomography. Radiol Case Rep 2021; 16:132-135. [PMID: 33224399 PMCID: PMC7666370 DOI: 10.1016/j.radcr.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022] Open
Abstract
Pulmonary nodules (PNs) arising in the lung transplant recipient pose a diagnostic challenge for providers. Conventional computed tomography (CT) has improved our ability to detect PNs in this population, but establishing a confident diagnosis with imaging alone remains difficult. Dual-energy spectral detector CT is a novel, emerging technology that provides insight into the radiographic behavior of PNs, and has potential in differentiating benign from malignant morphologies. Herein, we report a case of a PN in a lung transplant recipient whose initial diagnostic work-up was inconclusive, but then had the diagnosis rendered using a spectral detector CT.
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Affiliation(s)
- Christopher Di Felice
- Department of Pulmonary and Critical Care Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Elias George Kikano
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Benjamin Young
- Department of Pulmonary and Critical Care Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Amit Gupta
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
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De Vulder N, Chen M, Huysse W, Herregods N, Verstraete K, Jans L. Case Series: Dual-Energy CT in Extra-Articular Manifestations of Gout: Main Teaching Point: Dual-energy CT is a valuable asset in the detection of extra-articular manifestations of gout. J Belg Soc Radiol 2020; 104:27. [PMID: 32524069 DOI: 10.5334/jbsr.2113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Extra-articular manifestations of gout are common. The Achilles tendon is a frequently affected site, and uric acid deposition may have harmful effects on tendon structure and function. Advanced imaging can aid in early diagnosis, follow-up of disease activity and therapy efficacy. This case series highlights the use of dual-energy CT as a tool in diagnosing gout and in detecting extra-articular manifestations.
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Olivia Popnoe D, Ng CS, Zhou S, Cheenu Kappadath S, Pan T, Kyle Jones A. Comparison of enhancement quantification from virtual unenhanced images to true unenhanced images in multiphase renal Dual-Energy computed tomography: A phantom study. J Appl Clin Med Phys 2019; 20:171-179. [PMID: 31423728 PMCID: PMC6698809 DOI: 10.1002/acm2.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 11/17/2022] Open
Abstract
Multiphase computed tomography (CT) exams are a commonly used imaging technique for the diagnosis of renal lesions and involve the acquisition of a true unenhanced (TUE) series followed by one or more postcontrast series. The difference in CT number of the mass in pre- and postcontrast images is used to quantify enhancement, which is an important criterion used for diagnosis. This study sought to assess the feasibility of replacing TUE images with virtual unenhanced (VUE) images derived from Dual-Energy CT datasets in renal CT exams. Eliminating TUE image acquisition could reduce patient dose and improve clinical efficiency. A rapid kVp-switching CT scanner was used to assess enhancement accuracy when using VUE compared to TUE images as the baseline for enhancement calculations across a wide range of clinical scenarios simulated in a phantom study. Three phantoms were constructed to simulate small, medium, and large patients, each with varying lesion size and location. Nonenhancing cystic lesions were simulated using distilled water. Intermediate (10-20 HU [Hounsfield units]) and positively enhancing masses (≥20 HU) were simulated by filling the spherical inserts in each phantom with varied levels of iodinated contrast mixed with a blood surrogate. The results were analyzed using Bayesian hierarchical models. Posterior probabilities were used to classify enhancement measured using VUE compared to TUE images as significantly less, not significantly different, or significantly higher. Enhancement measured using TUE images was considered the ground truth in this study. For simulation of nonenhancing renal lesions, enhancement values were not significantly different when using VUE versus TUE images, with posterior probabilities ranging from 0.23-0.56 across all phantom sizes and an associated specificity of 100%. However, for simulation of intermediate and positively enhancing lesions significant differences were observed, with posterior probabilities < 0.05, indicating significantly lower measured enhancement when using VUE versus TUE images. Positively enhancing masses were categorized accurately, with a sensitivity of 91.2%, when using VUE images as the baseline. For all scenarios where iodine was present, VUE-based enhancement measurements classified lesions with a sensitivity of 43.2%, a specificity of 100%, and an accuracy of 78.1%. Enhancement calculated using VUE images proved to be feasible for classifying nonenhancing and highly enhancing lesions. However, differences in measured enhancement for simulation of intermediately enhancing lesions demonstrated that replacement of TUE with VUE images may not be advisable for renal CT exams.
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Affiliation(s)
- D. Olivia Popnoe
- MD Anderson Cancer Center UT Health Graduate School of Biomedical SciencesHoustonTexas
- Present address:
Department of Imaging Physics, Medical and Radiation Physics, Inc.San AntonioTexas
| | - Chaan S. Ng
- Department of Diagnostic RadiologyMD Anderson Cancer CenterHoustonTexas
| | - Shouhao Zhou
- Department of BiostatisticsMD Anderson Cancer CenterHoustonTexas
| | | | - Tinsu Pan
- Department of Imaging PhysicsMD Anderson Cancer CenterHoustonTexas
| | - A. Kyle Jones
- Department of Imaging PhysicsMD Anderson Cancer CenterHoustonTexas
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Gutjahr R, Polster C, Henning A, Kappler S, Leng S, McCollough CH, Sedlmair MU, Schmidt B, Krauss B, Flohr TG. Dual Energy CT Kidney Stone Differentiation in Photon Counting Computed Tomography. Proc SPIE Int Soc Opt Eng 2017; 10132:1013237. [PMID: 28943700 PMCID: PMC5607022 DOI: 10.1117/12.2252021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study evaluates the capabilities of a whole-body photon counting CT system to differentiate between four common kidney stone materials, namely uric acid (UA), calcium oxalate monohydrate (COM), cystine (CYS),and apatite (APA) ex vivo. Two different x-ray spectra (120 kV and 140 kV) were applied and two acquisition modes were investigated; The macro-mode generates two energy threshold based image-volumes and two energy bin based image-volumes. In the chesspattern-mode, however, four energy thresholds are applied. A virtual low energy image, as well as a virtual high energy image are derived from initial threshold-based images, while considering their statistically correlated nature. The energy bin based images of the macro-mode, as well as the virtual low and high energy image of the chesspattern-mode serve as input for our dual energy evaluation. The dual energy ratio of the individually segmented kidney stones were utilized to quantify the discriminability of the different materials. The dual energy ratios of the two acquisition modes showed high correlation for both applied spectra. Wilcoxon-rank sum tests and the evaluation of the area under the receiver operating characteristics curves suggest that the UA kidney stones are best differentiable from all other materials (AUC = 1.0), followed by CYS (AUC ≈ 0.9 compared against COM and APA). COM and APA, however, are hardly distinguishable (AUC between 0.63 and 0.76). The results hold true for the measurements of both spectra and both acquisition modes.
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Affiliation(s)
- R Gutjahr
- CAMP, Technical University of Munich, Garching (Munich), Germany
- Siemens Healthcare GmbH, Forchheim, Germany
| | - C Polster
- Siemens Healthcare GmbH, Forchheim, Germany
- Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - A Henning
- Siemens Healthcare GmbH, Forchheim, Germany
| | - S Kappler
- Siemens Healthcare GmbH, Forchheim, Germany
| | - S Leng
- Department of Radiology, Mayo Clinic, Rochester MN, United States of America
| | - C H McCollough
- Department of Radiology, Mayo Clinic, Rochester MN, United States of America
| | | | - B Schmidt
- Siemens Healthcare GmbH, Forchheim, Germany
| | - B Krauss
- Siemens Healthcare GmbH, Forchheim, Germany
| | - T G Flohr
- Siemens Healthcare GmbH, Forchheim, Germany
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Nasirudin RA, Tachibana R, Näppi JJ, Mei K, Kopp FK, Rummeny EJ, Yoshida H, Noël PB. A comparison of material decomposition techniques for dual-energy CT colonography. ACTA ACUST UNITED AC 2015; 9412. [PMID: 25918480 DOI: 10.1117/12.2081982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In recent years, dual-energy computed tomography (DECT) has been widely used in the clinical routine due to improved diagnostics capability from additional spectral information. One promising application for DECT is CT colonography (CTC) in combination with computer-aided diagnosis (CAD) for detection of lesions and polyps. While CAD has demonstrated in the past that it is able to detect small polyps, its performance is highly dependent on the quality of the input data. The presence of artifacts such as beam-hardening and noise in ultra-low-dose CTC may severely degrade detection performances of small polyps. In this work, we investigate and compare virtual monochromatic images, generated by image-based decomposition and projection-based decomposition, with respect to CAD performance. In the image-based method, reconstructed images are firstly decomposed into water and iodine before the virtual monochromatic images are calculated. On the contrary, in the projection-based method, the projection data are first decomposed before calculation of virtual monochromatic projection and reconstruction. Both material decomposition methods are evaluated with regards to the accuracy of iodine detection. Further, the performance of the virtual monochromatic images is qualitatively and quantitatively assessed. Preliminary results show that the projection-based method does not only have a more accurate detection of iodine, but also delivers virtual monochromatic images with reduced beam hardening artifacts in comparison with the image-based method. With regards to the CAD performance, the projection-based method yields an improved detection performance of polyps in comparison with that of the image-based method.
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Affiliation(s)
- Radin A Nasirudin
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Rie Tachibana
- 3D Imaging Research, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Janne J Näppi
- 3D Imaging Research, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kai Mei
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Felix K Kopp
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Hiroyuki Yoshida
- 3D Imaging Research, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Peter B Noël
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
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