scholarly journals Virtual monoenergetic images from spectral detector computed tomography facilitate washout assessment in arterially hyper-enhancing liver lesions

2020 ◽  
Author(s):  
R. P. Reimer ◽  
N. Große Hokamp ◽  
A. Fehrmann Efferoth ◽  
A. Krauskopf ◽  
D. Zopfs ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Visual Analysis ◽  
Quality Parameters ◽  
Wilcoxon Test ◽  
Liver Lesions ◽  
Diagnostic Confidence ◽  
Virtual Monoenergetic Images ◽  
Noise Ratio ◽  
Monoenergetic Images

Abstract Objectives To investigate whether the increased soft tissue contrast of virtual monoenergetic images (VMIs) obtained from a spectral detector computed tomography (SDCT) system improves washout assessment of arterially hyper-enhancing liver lesions. Methods Fifty-nine arterially hyper-enhancing lesions in 31 patients (age 65 ± 9 years, M/W 20/11) were included in this IRB-approved study. All patients underwent multi-phase SDCT for HCC screening. MRI, CEUS or biopsy within 3 months served as standard of reference to classify lesions as LiRADS 3 or 4/5. VMIs and conventional images (CIs) were reconstructed. Visual analysis was performed on 40, 60, and 80 kiloelectronvolt (keV) and CIs by 3 radiologists. Presence and visibility of washout were assessed; image quality and confidence of washout evaluation were evaluated on 5-point Likert scales. Signal-to-noise ratio (SNR), lesion-to-liver contrast-to-noise ratio (CNR) (|HUlesion–HUliver|/SDliver) and washout (|HUlesion–HUliver|) were calculated. Statistical assessment was performed using ANOVA and Wilcoxon test. Results On subjective lesion analysis, the highest level of diagnostic confidence and highest sensitivity for the detection of lesion washout were found for 40-keV VMIs (40 keV vs. CI, 81.3 vs. 71.3%). Image quality parameters were significantly better in low-kiloelectronvolt VMIs than in CIs (p < 0.05; e.g. SNRliver: 40 keV vs. CIs, 12.5 ± 4.1 vs. 5.6 ± 1.6). In LiRADS 4/5 lesions, CNR and quantitative washout values were significantly higher in 40-keV VMIs compared to CIs (p < 0.05; e.g. CNR and washout in 40 keV vs. CIs, 2.3 ± 1.6 vs. 0.8 ± 0.5 and 29.0 ± 19.1 vs. 12.9 ± 6.9 HU, respectively). Conclusion By increasing lesion contrast, low-kiloelectronvolt VMIs obtained from SDCT improve washout assessment of hyper-enhancing liver lesions with respect to washout visibility and diagnostic confidence. Key Points • Low-kiloelectronvolt virtual monoenergetic images from spectral detector CT facilitate washout assessment in arterially hyper-enhancing liver lesions. • Image quality and quantitative washout parameters as well as subjective washout visibility and diagnostic confidence benefit from low-kiloelectronvolt virtual monoenergetic images.

scholarly journals Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252678
Author(s):  
Robert Peter Reimer ◽  
Nils Große Hokamp ◽  
Julius Niehoff ◽  
David Zopfs ◽  
Simon Lennartz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Microwave Ablation ◽  
Iodine Concentration ◽  
Liver Parenchyma ◽  
Early Assessment ◽  
Diagnostic Confidence ◽  
Virtual Monoenergetic Images ◽  
Monoenergetic Images ◽  
Iodine Maps

Objectives To investigate whether virtual monoenergetic images (VMI) and iodine maps derived from spectral detector computed tomography (SDCT) improve early assessment of technique efficacy in patients who underwent microwave ablation (MWA) for hepatocellular carcinoma (HCC) in liver cirrhosis. Methods This retrospective study comprised 39 patients with 49 HCC lesions treated with MWA. Biphasic SDCT was performed 7.7±4.0 days after ablation. Conventional images (CI), VMI and IM were reconstructed. Signal- and contrast-to-noise ratio (SNR, CNR) in the ablation zone (AZ), hyperemic rim (HR) and liver parenchyma were calculated using regions-of-interest analysis and compared between CI and VMI between 40–100 keV. Iodine concentration and perfusion ratio of HR and residual tumor (RT) were measured. Two readers evaluated subjective contrast of AZ and HR, technique efficacy (complete vs. incomplete ablation) and diagnostic confidence at determining technique efficacy. Results Attenuation of liver parenchyma, HR and RT, SNR of liver parenchyma and HR, CNR of AZ and HR were significantly higher in low-keV VMI compared to CI (all p<0.05). Iodine concentration and perfusion ratio differed significantly between HR and RT (all p<0.05; e.g. iodine concentration, 1.6±0.5 vs. 2.7±1.3 mg/ml). VMI50keV improved subjective AZ-to-liver contrast, HR-to-liver contrast, visualization of AZ margin and vessels adjacent to AZ compared to CI (all p<0.05). Diagnostic accuracy for detection of incomplete ablation was slightly higher in VMI50keV compared to CI (0.92 vs. 0.89), while diagnostic confidence was significantly higher in VMI50keV (p<0.05). Conclusions Spectral detector computed tomography derived low-keV virtual monoenergetic images and iodine maps provide superior early assessment of technique efficacy of MWA in HCC compared to CI.

Minimizing table time in patients with claustrophobia using focused ferumoxytol-enhanced MR angiography (f-FEMRA): a feasibility study

2021 ◽  
Vol 94 (1125) ◽  
pp. 20210430
Author(s):  
Puja Shahrouki ◽  
Kim-Lien Nguyen ◽  
John M. Moriarty ◽  
Adam N. Plotnik ◽  
Takegawa Yoshida ◽  
...  
Keyword(s):  
Image Quality ◽  
Mr Angiography ◽  
Signal To Noise Ratio ◽  
Diagnostic Image Quality ◽  
Diagnostic Confidence ◽  
Motion Artefact ◽  
Scan Time ◽  
Wilcoxon Rank Sum Test ◽  
Significant Difference ◽  
Noise Ratio

Objectives: To assess the feasibility of a rapid, focused ferumoxytol-enhanced MR angiography (f-FEMRA) protocol in patients with claustrophobia. Methods: In this retrospective study, 13 patients with claustrophobia expressed reluctance to undergo conventional MR angiography, but agreed to a trial of up to 10 min in the scanner bore and underwent f-FEMRA. Thirteen matched control patients who underwent gadolinium-enhanced MR angiography (GEMRA) were identified for comparison of diagnostic image quality. For f-FEMRA, the time from localizer image acquisition to completion of the angiographic acquisition was measured. Two radiologists independently scored images on both f-FEMRA and GEMRA for arterial and venous image quality, motion artefact and diagnostic confidence using a 5-point scale, five being best. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aorta and IVC were measured. The Wilcoxon rank-sum test, one-way ANOVA with Tukey correction and two-tailed t tests were utilized for statistical analyses. Results: All scans were diagnostic and assessed with high confidence (scores ≥ 4). Average scan time for f-FEMRA was 6.27 min (range 3.56 to 10.12 min), with no significant difference between f-FEMRA and GEMRA in diagnostic confidence (4.86 ± 0.24 vs 4.69 ± 0.25, p = 0.13), arterial image quality (4.62 ± 0.57 vs 4.65 ± 0.49, p = 0.78) and motion artefact score (4.58 ± 0.49 vs 4.58 ± 0.28, p > 0.99). f-FEMRA scored significantly better for venous image quality than GEMRA (4.62 ± 0.42 vs 4.19 ± 0.56, p = 0.04). CNR in the IVC was significantly higher for steady-state f-FEMRA than GEMRA regardless of the enhancement phase (p < 0.05). Conclusions: Comprehensive vascular MR imaging of the thorax, abdomen and pelvis can be completed in as little as 5 min within the magnet bore using f-FEMRA, facilitating acceptance by patients with claustrophobia and streamlining workflow. Advances in knowledge: A focused approach to vascular imaging with ferumoxytol can be performed in patients with claustrophobia, limiting time in the magnet bore to 10 min or less, while acquiring fully diagnostic images of the thorax, abdomen and pelvis.

scholarly journals Image Quality and Dose Reduction by Dual Source Computed Tomography Coronary Angiography: Protocol Comparison

Dose-Response ◽  
2018 ◽  
Vol 16 (4) ◽  
pp. 155932581880583 ◽  
Author(s):  
Ernesto Forte ◽  
Serena Monti ◽  
Chiara Anna Parente ◽  
Lukas Beyer ◽  
Roberto De Rosa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Coronary Angiography ◽  
Effective Dose ◽  
Computed Tomography Coronary Angiography ◽  
Correct Selection ◽  
Dual Source ◽  
Group A ◽  
Noise Ratio ◽  
Dual Source Computed Tomography

Purpose: To compare image quality and radiation dose among different protocols in patients who underwent a 128-slice dual source computed tomography coronary angiography (DSCT-CTCA). Methods: Ninety patients were retrospectively grouped according to heart rate (HR): 26 patients (group A) with stable HR ≤60 bpm were acquired using high pitch spiral mode (FLASH); 48 patients (group B) with irregular HR ≤60 bpm or stable HR between 60 and 70 bpm using step and shoot mode; and 16 patients (group C) with irregular HR >60 bpm or stable HR ≥70 bpm by retrospective electrocardiogram pulsing acquisition. Signal to noise ratio (SNR) and contrast to noise ratio (CNR) were measured for the main vascular structures. Moreover, the dose-length product and the effective dose were assessed. Results: Both SNR and CNR were higher in group A compared to group C (18.27 ± 0.32 vs 11.22 ± 0.50 and 16.75 ± 0.32 vs 10.17 ± 0.50; P = .001). The effective dose was lower in groups A and B (2.09 ± 1.27 mSv and 4.60 ± 2.78 mSv, respectively) compared to group C (9.61 ± 5.95 mSv) P < .0001. Conclusion: The correct selection of a low-dose, HR-matched CTCA scan protocol with a DSCT scanner provides substantial reduction of radiation exposure and better SNR and CNR.

Image quality characteristics for virtual monoenergetic images using dual-layer spectral detector CT: Comparison with conventional tube-voltage images

2018 ◽  
Vol 49 ◽  
pp. 5-10 ◽  
Author(s):  
Daisuke Sakabe ◽  
Yoshinori Funama ◽  
Katsuyuki Taguchi ◽  
Takeshi Nakaura ◽  
Daisuke Utsunomiya ◽  
...  
Keyword(s):  
Image Quality ◽  
Quality Characteristics ◽  
Tube Voltage ◽  
Spectral Detector Ct ◽  
Virtual Monoenergetic Images ◽  
Monoenergetic Images

An open label, prospective, multicenter, non-interventional study of iodixanol 270 mg I/mL for use in individuals undergoing computed tomography angiography in real-world clinical practice

2018 ◽  
Vol 60 (2) ◽  
pp. 177-185
Author(s):  
Xiangying Du ◽  
Bin Lu ◽  
Daoyu Hu ◽  
Bin Song ◽  
Kuncheng Li
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Iterative Reconstruction ◽  
Computed Tomography Angiography ◽  
Pulmonary Arteries ◽  
Open Label ◽  
Tube Voltage ◽  
Effective Radiation Dose ◽  
Noise Ratio

Background Concern about radiation exposure is leading to an increasing interest in low-concentration contrast medium administration. Purpose To evaluate the image quality and safety profile after administration of iodixanol 270 mg I/mL at 100-kVp tube voltage with iterative reconstruction in subjects undergoing computed tomography angiography (CTA). Material and Methods Patients who completed CTA examination using iodixanol 270 mg I/mL and 100-kVp tube voltage along with iterative reconstruction for coronary, aortic, head and neck, renal, or pulmonary arteries were included. Image quality was qualitatively and quantitatively evaluated. Incidence of adverse events (AEs) and adverse drug reactions (ADRs) within seven days and radiation dose were also analyzed. Results A total of 4513 individuals in 42 centers in China were enrolled, among which 4367 were included in efficacy analysis. The mean image quality score was 4.8 ± 0.45 across all arteries (all above 4.6) and 99.7% of the individuals’ images were classified as evaluable. The CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the regions of interest (ROIs) were 431.79 ± 99.018, 18.29 ± 11.947, and 28.21 ± 19.535 HU, respectively. Of all the participants, 68 (1.5%) and 65 (1.4%) experienced AEs and ADRs, respectively. No serious AEs or AEs leading to discontinuation occurred. The average effective radiation dose was 3.13 ± 2.550 mSv. Conclusion Iodixanol 270 mg I/mL in combination with 100-kVp tube voltage and iterative reconstruction could be safely applied in CTA and yield high-quality and evaluable images with reduced radiation dose.

Quality of Computed Tomography Pulmonary Embolism and Aortic Phase Images Acquired with Power Injection via an Arm Port

2017 ◽  
Vol 22 (2) ◽  
pp. 88-92
Author(s):  
Ryan Verity ◽  
David Leswick ◽  
Brent Burbridge ◽  
Rhonda Bryce ◽  
Hyun Lim
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Image Quality ◽  
Thin Section ◽  
Signal To Noise Ratio ◽  
Contrast Injection ◽  
Signal To Noise ◽  
Streak Artifact ◽  
Noise Ratio

Abstract Background: The safety of power-injectable implanted arm ports is well established, but there is insufficient data to conclude that image quality of computed tomography resulting from contrast introduced via the port is of equal quality to images derived from contrast introduced via traditional peripheral access. The objective of this study was to determine whether the image quality of computed tomography pulmonary embolism and computed tomography aorta studies would differ when injecting contrast via an implanted arm port vs a peripheral intravenous site. We hypothesized that injecting via an implanted arm port would produce better-quality images, the result of more appropriate timing and less streak artifact. Methods: Scans from a provincial database search for patients who underwent a computed tomography pulmonary embolism or aorta study with contrast injection via the implanted arm port and thin section images available, were reviewed (pulmonary embolism studies n = 3, aorta studies n = 3). Only a limited number of patients were available for review because there are currently few patients with these ports in place and we limited evaluation to thin section images. Comparison was made with 6 control patients who did not have a port and had received a peripheral arm intravenous contrast injection for these study types. Objective measurements included signal-to-noise ratio and contrast-to-noise ratio of the pulmonary arteries (4 sites) and aorta (2 sites) as appropriate for scan type. Subjective analysis of image quality was performed by 2 radiologists. Results: Although sample size was limited, the implanted arm port group had similar or higher mean signal-to-noise ratio and contrast-to-noise ratio values at all sites. Subjective assessments showed the implanted arm port group to have similar or better opacification and diagnostic confidence; similar or less streak artifact was also observed at each of the sites. Conclusions: These exploratory results suggest that studies with implanted arm port injection can generate high-quality images on both objective and subjective assessment, similar to, or possibly better than, images generated from usual peripheral intravenous access for contrast injection.

Virtual Monoenergetic Images From a Novel Dual-Layer Spectral Detector Computed Tomography Scanner in Portal Venous Phase

2018 ◽  
Vol 42 (3) ◽  
pp. 350-356 ◽  
Author(s):  
Tilman Hickethier ◽  
Andra-Iza Iuga ◽  
Simon Lennartz ◽  
Myriam Hauger ◽  
Jonathan Byrtus ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
Virtual Monoenergetic Images ◽  
Computed Tomography Scanner ◽  
Monoenergetic Images
Sign in / Sign up

Export Citation Format

Share Document