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Schoenbeck D, Sacha A, Niehoff JH, Moenninghoff C, Borggrefe J, Kroeger JR, Michael AE. Imaging of hypodense gliotic lesions in photon counting computed tomography using virtual monoenergetic images. Neuroradiol J 2024:19714009241240056. [PMID: 38490750 DOI: 10.1177/19714009241240056] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES Glioses appear as hypodense lesions in non-contrast CT examinations of the head. Photon counting CT (PCCT) enables the calculation of virtual monoenergetic images (VMI). The aim of this study is to investigate in which VMI hypodense gliotic lesions can be delineated best. MATERIALS AND METHODS 35 patients with an MRI-confirmed gliotic lesion and a non-contrast PCCT of the head were retrospectively included. All available VMI from 40 keV to 190 keV were calculated. In a quantitative analysis, conventional image quality parameters were calculated, in particular the contrast-to-noise ratio (CNR) of the hypodense lesion compared to the white matter. In a qualitative analysis, selected VMI were rated by experienced radiologists. RESULTS The absolute maximum of CNR was 8.12 ± 5.64 in the VMI 134 keV, in post hoc testing, there were significant differences in comparison to VMI with keV ≤110 and keV ≥180 (corrected p < .05). In the qualitative analysis, there were only very slight differences in the rating of the VMI with 66 keV, 80 keV, 100 keV, and 134 keV with overall low agreement between the readers. CONCLUSIONS The quantitative superiority of VMI 134 keV for the delineation of hypodense gliotic lesions did not translate into a superiority in the qualitative analysis. Therefore, it remains uncertain if the reconstruction of a high keV VMIs for the detection of hypodense gliotic lesions is useful in everyday clinical practice. However, more studies, are necessary to further assess this issue.
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Affiliation(s)
- Denise Schoenbeck
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
| | - Alexander Sacha
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
| | - Julius Henning Niehoff
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
| | - Christoph Moenninghoff
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
| | - Jan Robert Kroeger
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
| | - Arwed Elias Michael
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany
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Pan C, Dai F, Sheng L, Li K, Qiao W, Kang Z, Zhang X. Clinical application of spectral CT perfusion scanning in evaluating the blood supply source of portal vein tumor thrombus in hepatocellular carcinoma. Front Oncol 2024; 13:1348679. [PMID: 38304029 PMCID: PMC10832025 DOI: 10.3389/fonc.2023.1348679] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/27/2023] [Indexed: 02/03/2024] Open
Abstract
Purpose To evaluate the characteristic of blood supply of liver portal vein tumor thrombus (PVTT) using perfusion indexes and spectral parameters. Methods Between July 2020 and December 2022, the study enrolled 25 liver cancer patients completed with PVTT (male=20, female=5; age 41-74 years (59.48 ± 9.12)) from the Interventional Department of Jiangsu Cancer Hospital. There were 11 cases of type III PVTT, 12 of type II PVTT, and 2 of type I PVTT (Cheng's classification). All patients underwent spectral perfusion scans through dual-layer spectral detector computed tomography. The PVTTs were divided into proximal and distal groups based on the distance between the tumor thrombus and the main portal vein. The perfusion analysis was performed on the 120-kVp conventional images to generate hepatic perfusion index (HPI). The spectral based images (SBIs) during the artery and venous peak phases were extracted from the perfusion data. The iodine map and 40&100-keV virtual monoenergetic image (VMI) were generated from SBI data. HPI, iodine concentration (IC), CT value at 40 and 100-keV, and spectral slope (40-100keV) of the primary lesion, proximal and distal PVTT, and liver parenchyma were measured and compared. The correlation between the primary lesion and proximal and distal PVTT was analyzed. Results The IC and spectral slope during the arterial and venous peak phases and HPI of the primary lesion, proximal PVTT, and distal PVTT were highly correlated (P<0.001). The differences between the IC and spectral slope during the arterial and venous peak phases and HPI of the primary lesion, proximal PVTT were statistically significant (P<0.001). The differences between the IC during venous peak phase and HPI of primary lesion, distal PVTT were statistically significant (P<0.001), and there was no statistically significant difference in arterial phase IC, arterial and venous phase spectral slopes. Conclusion The IC, slope, and HPI of the distal and proximal PVTT were highly correlated with the primary lesion, indicating that PVTT was similar to the primary lesion in the liver that they were both mainly supplied by the hepatic artery. However, there was still significant heterogeneity between the proximal PVTT and the primary lesion, while the difference in the distal PVTT was relatively small.
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Affiliation(s)
- Chunhan Pan
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
| | - Feng Dai
- Department of Intervention, The Second Hospital of Nanjing, Nanjing, China
| | - Liuli Sheng
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Kang Li
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Qiao
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Zheng Kang
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiuming Zhang
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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Fontana F, Piacentino F, Gnesutta A, Macchi E, Coppola A, Saccomanno A, Gatta T, Recaldini C, Minenna M, Tamborini C, Dossi F, Ascenti V, Barbera S, Cicero G, Carcano G, Ascenti G, Castiglioni B, Venturini M. Transcatheter Aortic Valve Implantation (TAVI) Planning with Dual-Layer Spectral CT Using Virtual Monoenergetic Image (VMI) Reconstructions and 20 mL of Contrast Media. J Clin Med 2024; 13:524. [PMID: 38256659 PMCID: PMC10816911 DOI: 10.3390/jcm13020524] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical implantation and its implementation is progressively increasing worldwide. We routinely perform pre-procedural aortic angiography CT to assess aortic dimensions and vascular anatomy. This study aims to evaluate the image quality of CTA for TAVI planning using dual-layer spectral CT, with virtual monoenergetic image reconstructions at 40 keV. Thirty-one patients underwent a CTA protocol with the injection of 20 mL of contrast media. Image quality was assessed by measuring the mean density in Hounsfield Units (HU), the signal-to-noise ratio, and the contrast-to-noise ratio in VMI reconstructions. Additionally, a blinded subjective analysis was conducted by two observers. The results showed significant enhancement at all sampled vascular levels with a gradual decrease in HU from proximal to distal regions. Favourable subjective ratings were given for all parameters, with greater variability in the evaluation of iliac axes. A significant negative correlation (p < 0.05) was observed between BMI and CA at all vascular levels, indicating reduced contrast enhancement with increasing BMI. Spectral CT, along with reducing iodine load, allows for obtaining high-quality images without a significant increase in noise. The reduction in iodine load can have positive implications in clinical practice, improving patient safety and resource efficiency.
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Affiliation(s)
- Federico Fontana
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
- Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
| | - Filippo Piacentino
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Aroa Gnesutta
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Edoardo Macchi
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Angiola Saccomanno
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Tonia Gatta
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Chiara Recaldini
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Manuela Minenna
- Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
| | - Claudio Tamborini
- Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
| | - Filippo Dossi
- Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
| | - Velio Ascenti
- Postgraduate School of Radiodiagnostics, Policlinico Universitario, University of Milan, 20133 Milano, Italy;
| | - Simone Barbera
- Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
| | - Giuseppe Cicero
- Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
| | - Giulio Carcano
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy;
| | - Giorgio Ascenti
- Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
| | - Battistina Castiglioni
- Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy;
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Kazimierczak W, Kazimierczak N, Serafin Z. Review of Clinical Applications of Dual-Energy CT in Patients after Endovascular Aortic Repair. J Clin Med 2023; 12:7766. [PMID: 38137834 PMCID: PMC10743598 DOI: 10.3390/jcm12247766] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/08/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
Abdominal aortic aneurysms (AAAs) are a significant cause of mortality in developed countries. Endovascular aneurysm repair (EVAR) is currently the leading treatment method for AAAs. Due to the high sensitivity and specificity of post-EVAR complication detection, CT angiography (CTA) is the reference method for imaging surveillance in patients after EVAR. Many studies have shown the advantages of dual-energy CT (DECT) over standard polyenergetic CTA in vascular applications. In this article, the authors briefly discuss the technical principles and summarize the current body of literature regarding dual-energy computed tomography angiography (DECTA) in patients after EVAR. The authors point out the most useful applications of DECTA in this group of patients and its advantages over conventional CTA. To conduct this review, a search was performed using the PubMed, Google Scholar, and Web of Science databases.
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Affiliation(s)
- Wojciech Kazimierczak
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Natalia Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Zbigniew Serafin
- Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
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Wang Y, Jiang Y, Lu G, Yang L, Shi G, Zhang F, Zhuo J, Hu H, Duan X. Improving visualization of free fibula flap perforators and reducing radiation dose in dual-energy CT angiography. Quant Imaging Med Surg 2023; 13:3066-3079. [PMID: 37179922 PMCID: PMC10167437 DOI: 10.21037/qims-22-734] [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: 07/13/2022] [Accepted: 01/13/2023] [Indexed: 05/15/2023]
Abstract
Background The precise assessment of the perforators of the fibula free flap (FFF) is crucial for minimizing procedure-related complications when harvesting the FFF in patients with maxillofacial lesions. This study aims to investigate the utility of virtual noncontrast (VNC) images for radiation dose saving and to determine the optimal energy level of virtual monoenergetic imaging (VMI) reconstructions in dual-energy computed tomography (DECT) for visualization of the perforators of the fibula free flap (FFF). Methods Data from 40 patients with maxillofacial lesions who received lower extremity DECT examinations in the noncontrast and arterial phase were collected in this retrospective, cross-sectional study. To compare VNC images from the arterial phase with true non-contrast images in a DECT protocol (M_0.5-TNC) and to compare VMI images with 0.5 linear images blending from the arterial phase (M_0.5-C), the attenuation, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality were assessed in different arteries, muscles, and fat tissues. Two readers evaluated the image quality and visualization of the perforators. The dose-length product (DLP) and CT volume dose index (CTDIvol) were used to determine the radiation dose. Results Objective and subjective analyses showed no significant difference between the M_0.5-TNC and VNC images in the arteries and muscles (P>0.09 to P>0.99), and VNC imaging could reduce 50% of the radiation dose (P<0.001). Compared with those of the M_0.5-C images, the attenuation and CNR of VMI reconstructions at 40 kiloelectron volt (keV) and 60 keV were higher (P<0.001 to P=0.04). Noise was similar at 60 keV (all P>0.99) and increased at 40 keV (all P<0.001), and the SNR in arteries was increased at 60 keV (P<0.001 to P=0.02) in VMI reconstructions compared with those in the M_0.5-C images. The subjective scores in VMI reconstructions at 40 and 60 keV was higher than those in M_0.5-C images (all P<0.001). The image quality at 60 keV was superior to that at 40 keV (P<0.001), and there was no difference in the visualization of the perforators between 40 and 60 keV (P=0.31). Conclusions VNC imaging is a reliable technique for replacing M_0.5-TNC and provides radiation dose saving. The image quality of the 40-keV and 60-keV VMI reconstructions was higher than that of the M_0.5-C images, and 60 keV provided the best assessment of perforators in the tibia.
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Affiliation(s)
- Yu Wang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yusong Jiang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guoxiong Lu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingjie Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guangzi Shi
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fang Zhang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiayi Zhuo
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huijun Hu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaohui Duan
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Wang Y, Chen X, Lu G, Su Y, Yang L, Shi G, Zhang F, Zhuo J, Duan X, Hu H. Improving the Visualization of the Adrenal Veins Using Virtual Monoenergetic Images from Dual-Energy Computed Tomography before Adrenal Venous Sampling. Tomography 2023; 9:485-496. [PMID: 36960999 PMCID: PMC10037600 DOI: 10.3390/tomography9020040] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
(1) Background: This study explored the optimal energy level in advanced virtual monoenergetic images (VMI+) from dual-energy computed tomography angiography (DE-CTA) for adrenal veins visualization before adrenal venous sampling (AVS). (2) Methods: Thirty-nine patients were included in this prospective single-center study. The CT value, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in both adrenal veins and abdominal solid organs and were then compared between VMI+ within the range of 40-80 kiloelectron volt (keV). The visualization rate of the adrenal veins and the overall image quality of solid organs were subjectively compared among different keV VMI+. The AVS success rate was recorded for 20 patients. (3) Results: For the adrenal veins, 40 keV VMI+ had the peak CT value, noise and CNR (p < 0.05). Subjectively, the visualization rate was the highest at 40 keV (100% for the right adrenal vein, and 97.4% for the left adrenal vein) (p < 0.05). For solid organs, the CT value, noise and CNR at 50 keV were lower than those at 40 keV (p < 0.05), but the SNR was similar between 40 keV and 50 keV. The overall subjective image quality of solid organs at 50 keV was the best (p < 0.05). The AVS success rate was 95%. (4) Conclusions: For VMI+, 40 keV was the preferential energy level to obtain a high visualization rate of the adrenal veins and a high success rate of AVS, while 50 keV was the favorable energy level for the depiction of abdominal organs.
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Affiliation(s)
- Yu Wang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Xiaohong Chen
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Guoxiong Lu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Yun Su
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Lingjie Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Guangzi Shi
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Fang Zhang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Jiayi Zhuo
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Xiaohui Duan
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Huijun Hu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
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Gökduman A, Yel I, Vogl TJ, Dimitrova M, Grünewald LD, Koch V, Alizadeh LS, Brendlin AS, Othman AE, Martin SS, D'Angelo T, Blandino A, Mazziotti S, Booz C. Diagnosis of an Acute Anterior Wall Infarction in Dual-Energy CT. Diagnostics (Basel) 2023; 13. [PMID: 36832249 DOI: 10.3390/diagnostics13040761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
Due to its high morbidity and mortality, myocardial infarction is the leading cause of death worldwide. Against this background, rapid diagnosis is of immense importance. Especially in case of an atypical course, the correct diagnosis may be delayed and thus lead to increased mortality rates. In this report, we present a complex case of acute coronary syndrome. A triple-rule-out CT examination was performed in dual-energy CT (DECT) mode. While pulmonary artery embolism and aortic dissection could be ruled out with conventional CT series, the presence of anterior wall infarction was only detectable on DECT reconstructions. Subsequently, adequate and rapid therapy was then initiated leading to survival of the patient.
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Greffier J, Frandon J, Sadate A, Akessoul P, Belaouni A, Beregi JP, Dabli D. Impact of four kVp combinations available in a dual-source CT on the spectral performance of abdominal imaging: A task-based image quality assessment on phantom data. J Appl Clin Med Phys 2021; 22:243-254. [PMID: 34312979 PMCID: PMC8364263 DOI: 10.1002/acm2.13369] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 02/17/2021] [Revised: 04/24/2021] [Accepted: 07/11/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose To compare the spectral performance of four combinations of kVp available in a third generation dual‐source CT (DSCT) on abdominal imaging. Methods An image‐quality phantom was scanned with a DSCT using four kVp pairs (tube “A” voltage/tube “B” voltage): 100/Sn150 kVp, 90/Sn150 kVp, 80/Sn150 kVp, and 70/Sn150 kVp, classic parameters and dose level for abdomen examination (CTDIvol: 11 mGy). The noise power spectrum (NPS) and the task‐based transfer function (TTF) of two inserts were computed on virtual monochromatic images (VMIs) at 40/50/60/70 keV and for mixed, low‐, and high‐kVp images. Detectability index (d’) was computed on VMIs and mixed images to model the detection task of liver metastasis (LM) and hepatocellular carcinoma (HCC). Iodine quantification accuracy was assessed using the Root Mean Square Deviation (RMSDiodine) and the iodine bias (IB). Results Noise magnitude decreased by −55%± 0% between 40 and 70 keV for all kVp pairs. Compared to 70/Sn150 kVp, noise magnitude was increased by 9% ± 0% with 80/Sn150 kVp, by 16% ± 1% with 90/Sn150 kVp and by 24%± 1% with 100/Sn150 kVp. The average NPS spatial frequency (fav) shifted toward higher frequencies as energy level increased for all kVp pairs. Lowest fav values were found for 70/Sn150 kVp and highest for 100/Sn150 kVp. The value of TTF at 50% (f50) shifted toward lower frequencies with increasing energy level. The highest f50 values occurred for 100/Sn150 kVp and the lowest for 80/Sn150 kVp. For both lesions, d’ was highest for 70/Sn150 kVp and lowest for 100/Sn150 kVp. Compared to 70/Sn150 kVp, d’ decreased by −6% ± 3% with 80/Sn150 kVp, by −11% ± 2% with 90/Sn150 kVp and by −13%± 2% with 100/Sn150 kVp. For all acquisitions, the RSMDiodine and IB were the lowest for 100/Sn150 kVp (0.29 ± 0.10 mg/ml and 0.88 ± 0.30 mg/ml, respectively) and increased when the tube “A” voltage decreased (2.34 ± 0.29 mg/ml for 70/Sn150 kVp and 7.42 ± 0.51 mg/ml respectively). Conclusion 70/Sn150 kVp presented the lowest image noise and highest detectability in VMIs of two small focal liver lesions. 100/Sn150 kVp presented the lowest image noise on mixed images and highest accuracy of iodine quantification in iodine images.
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Affiliation(s)
- Joël Greffier
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
| | - Julien Frandon
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
| | - Alexandre Sadate
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
| | - Philippe Akessoul
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
| | - Asmaa Belaouni
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
| | - Jean-Paul Beregi
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
| | - Djamel Dabli
- Department of medical imaging, Nîmes Medical Imaging Group, CHU Nimes, Univ Montpellier, Nimes, France
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9
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Abstract
Transcatheter pulmonary valve implantation (TPVI) is now an established alternative to surgery in patients with congenital heart disease and dysfunctional right ventricular outflow tract (RVOT) conduit. However, there is recognition of a higher incidence of infective endocarditis in the patients after TPVI. Transthoracic and transesophageal echocardiography is limited in the evaluation of prosthetic pulmonary valve endocarditis secondary to a metallic artifact and degenerative calcified conduit. Additionally, the anterior position of RVOT also limits evaluation by echocardiography. Conventional single-energy CTA can also be sub-optimal in evaluating prosthetic pulmonary valve stent frame due to streak artifacts from the metallic cage and poor contrast to noise ratio if higher kV is used for single-energy CTA to avoid metallic artifacts. Dual-energy CTA can overcome these limitations using reconstructed virtual monoenergetic and iodine-only images for metal artifact reduction and improve intra-stent luminal visualization. Reconstructed iodine perfusion maps may also help differentiate vegetation from a thrombus. In this case report, we discuss the diagnostic utility of dual-energy cardiac CT in the evaluation of endocarditis after TPVI and discuss the imaging protocol.
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Affiliation(s)
- Sarv Priya
- Radiology, University of Iowa Hospitals & Clinics, Iowa City, USA
| | - Prashant Nagpal
- Cardiothoracic Radiology, University of Iowa Hospitals & Clinics, Iowa City, USA
| | - Aditi Vidholia
- Hematopathology, University of Iowa Hospitals & Clinics, Iowa City, USA
| | | | - Ravi Ashwath
- Pediatric Cardiology, University of Iowa Stead Family Children's Hospital, Iowa City, USA
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10
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Zhou W, Michalak G, Weaver J, Ferrero A, Gong H, Fetterly KA, McCollough CH, Leng S. Determination of iodine detectability in different types of multiple-energy images for a photon-counting detector computed tomography system. J Med Imaging (Bellingham) 2019; 6:043501. [PMID: 31620546 DOI: 10.1117/1.jmi.6.4.043501] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 09/16/2019] [Indexed: 11/14/2022] Open
Abstract
In addition to low-energy-threshold images (TLIs), photon-counting detector (PCD) computed tomography (CT) can generate virtual monoenergetic images (VMIs) and iodine maps. Our study sought to determine the image type that maximizes iodine detectability. Adult abdominal phantoms with iodine inserts of various concentrations and lesion sizes were scanned on a PCD-CT system. TLIs, VMIs at 50 keV, and iodine maps were generated, and iodine contrast-to-noise ratio (CNR) was measured. A channelized Hotelling observer was used to determine the area under the receiver-operating-characteristic curve (AUC) for iodine detectability. Iodine map CNR ( 0.57 ± 0.42 ) was significantly higher ( P < 0.05 ) than for TLIs ( 0.46 ± 0.26 ) and lower ( P < 0.001 ) than for VMIs at 50 keV ( 0.74 ± 0.33 ) for 0.5 mgI/cc and a 35-cm phantom. For the same condition and an 8-mm lesion, iodine detectability from iodine maps ( AUC = 0.95 ± 0.01 ) was significantly lower ( P < 0.001 ) than both TLIs ( AUC = 0.99 ± 0.00 ) and VMIs ( AUC = 0.99 ± 0.01 ). VMIs at 50 keV had similar detectability to TLIs and both outperformed iodine maps. The lowest detectable iodine concentration was 0.5 mgI/cc for an 8-mm lesion and 1.0 mgI/cc for a 4-mm lesion.
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Affiliation(s)
- Wei Zhou
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Gregory Michalak
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Jayse Weaver
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Andrea Ferrero
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Hao Gong
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Kenneth A Fetterly
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States.,Mayo Clinic, Department of Cardiovascular Medicine, Rochester, Minnesota, United States
| | | | - Shuai Leng
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
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