scholarly journals Dual-Energy Computed Tomography Compared to Lung Perfusion Scintigraphy to Assess Pulmonary Perfusion in Patients Screened for Endoscopic Lung Volume Reduction

Respiration ◽  
2021 ◽  
pp. 1-10
Author(s):  
Hester A. Gietema ◽  
Kim H.M. Walraven ◽  
Rein Posthuma ◽  
Cristina Mitea ◽  
Dirk-Jan Slebos ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Dual Energy ◽  
Lung Perfusion ◽  
Ct Scans ◽  
Pulmonary Perfusion ◽  
Perfusion Scintigraphy ◽  
Lung Volume Reduction ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

<b><i>Background:</i></b> Endoscopic lung volume reduction (ELVR) using one-way endobronchial valves is a technique to reduce hyperinflation in patients with severe emphysema by inducing collapse of a severely destroyed pulmonary lobe. Patient selection is mainly based on evaluation of emphysema severity on high-resolution computed tomography and evaluation of lung perfusion with perfusion scintigraphy. Dual-energy contrast-enhanced CT scans may be useful for perfusion assessment in emphysema but has not been compared against perfusion scintigraphy. <b><i>Aims:</i></b> The aim of the study was to compare perfusion distribution assessed with dual-energy contrast-enhanced computed tomography and perfusion scintigraphy. <b><i>Material and Methods:</i></b> Forty consecutive patients with severe emphysema, who were screened for ELVR, were included. Perfusion was assessed with 99mTc perfusion scintigraphy and using the iodine map calculated from the dual-energy contrast-enhanced CT scans. Perfusion distribution was calculated as usually for the upper, middle, and lower thirds of both lungs with the planar technique and the iodine overlay. <b><i>Results:</i></b> Perfusion distribution between the right and left lung showed good correlation (<i>r</i> = 0.8). The limits of agreement of the mean absolute difference in percentage perfusion per region of interest were 0.75–5.6%. The upper lobes showed more severe perfusion reduction than the lower lobes. Mean difference in measured pulmonary perfusion ranged from −2.8% to 2.3%. Lower limit of agreement ranged from −8.9% to 4.6% and upper limit was 3.3–10.0%. <b><i>Conclusion:</i></b> Quantification of perfusion distribution using planar 99mTc perfusion scintigraphy and iodine overlays calculated from dual-energy contrast-enhanced CTs correlates well with acceptable variability.

scholarly journals Incidence and risk of dialysis therapy within 30 days after contrast enhanced computed tomography in patients coded with chronic kidney disease: a nation-wide, population-based study

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7757 ◽  
Author(s):  
Yun-Ju Shih ◽  
Yu-Ting Kuo ◽  
Chung-Han Ho ◽  
Chia-Chun Wu ◽  
Ching-Chung Ko
Keyword(s):  
Computed Tomography ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Administrative Data ◽  
Ct Scans ◽  
Control Group ◽  
Dialysis Therapy ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Background Patients with chronic kidney disease (CKD) are considered at risk of contrast-induced acute kidney injury and possible subsequent need for dialysis therapy. Computed tomography (CT) is the most commonly performed examination requiring intravenous iodinated contrast media (ICM) injection. The actual risk of dialysis in CKD patients undergoing CT with ICM remains controversial. Furthermore, it is also uncertain whether these at-risk patients can be identified by means of administrative data. Our study is conducted in order to determine the incidence and risk of dialysis within 30 days after undergoing contrast enhanced CT in CKD coded patients. Methods This longitudinal, nation-wide, populated-based study is carried out by analyzing the Taiwan National Health Insurance Research Database retrospectively. Patients coded under the diagnosis of CKD who underwent CT are identified within randomly selected one million subjects of the database. From January 2012 to December 2013, 487 patients had undergone CT with ICM. A total of 924 patients who underwent CT without ICM are selected as the control group. Patients with advanced CKD or intensive care unit (ICU) admissions are assigned to the subgroups for analysis. The primary outcome is measured by dialysis events within 30 days after undergoing CT scans. The cumulative incidence is assessed by the Kaplan–Meier method and log-rank test. The risk of 30-day dialysis relative to the control group is analyzed by the Cox proportional hazards model after adjusting for age, sex, and baseline comorbidities. Results The numbers and percentages of dialysis events within 30 days after undergoing CT scans are 20 (4.1%) in the CT with ICM group and 66 (7.1%) in the CT without ICM group (p = 0.03). However, the adjusted hazard ratio (aHR) for 30-day dialysis was 0.84 (95% CI [0.46–1.54], p = 0.57), which is statistically non-significant. In both advanced CKD and ICU admission subgroups, there are also no significant differences in 30-day dialysis risks with the aHR of 1.12 (95% CI [0.38–3.33], p = 0.83) and 0.95 (95% CI [0.44–2.05], p = 0.90), respectively. Conclusions Within 30 days of receiving contrast-enhanced CT scans, 4.1% of CKD coded patients required dialysis, which appear to be lower compared with subjects who received non-contrast CT scans. However, no statistically significant difference is observed after adjustments are made for other baseline conditions. Thereby, the application of administrative data to identify patients with CKD cannot be viewed as a risk factor for the necessity to undergo dialysis within 30 days of receiving contrast-enhanced CT scans.

scholarly journals Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils

Respiration ◽  
2016 ◽  
Vol 92 (6) ◽  
pp. 404-413
Author(s):  
Frédéric Lador ◽  
Anne-Lise Hachulla ◽  
Olivia Hohn ◽  
Jérôme Plojoux ◽  
Maxime Ronot ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Volume ◽  
Dual Energy ◽  
Volume Reduction ◽  
Pulmonary Perfusion ◽  
Lung Volume Reduction ◽  
Dual Energy Computed Tomography ◽  
Contrast Enhanced

scholarly journals Automated detection and segmentation of thoracic lymph nodes from CT using 3D foveal fully convolutional neural networks

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andra-Iza Iuga ◽  
Heike Carolus ◽  
Anna J. Höink ◽  
Tom Brosch ◽  
Tobias Klinder ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Detection Rate ◽  
Cross Validation ◽  
Bronchial Carcinoma ◽  
Ct Scans ◽  
Training Dataset ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background In oncology, the correct determination of nodal metastatic disease is essential for patient management, as patient treatment and prognosis are closely linked to the stage of the disease. The aim of the study was to develop a tool for automatic 3D detection and segmentation of lymph nodes (LNs) in computed tomography (CT) scans of the thorax using a fully convolutional neural network based on 3D foveal patches. Methods The training dataset was collected from the Computed Tomography Lymph Nodes Collection of the Cancer Imaging Archive, containing 89 contrast-enhanced CT scans of the thorax. A total number of 4275 LNs was segmented semi-automatically by a radiologist, assessing the entire 3D volume of the LNs. Using this data, a fully convolutional neuronal network based on 3D foveal patches was trained with fourfold cross-validation. Testing was performed on an unseen dataset containing 15 contrast-enhanced CT scans of patients who were referred upon suspicion or for staging of bronchial carcinoma. Results The algorithm achieved a good overall performance with a total detection rate of 76.9% for enlarged LNs during fourfold cross-validation in the training dataset with 10.3 false-positives per volume and of 69.9% in the unseen testing dataset. In the training dataset a better detection rate was observed for enlarged LNs compared to smaller LNs, the detection rate for LNs with a short-axis diameter (SAD) ≥ 20 mm and SAD 5–10 mm being 91.6% and 62.2% (p < 0.001), respectively. Best detection rates were obtained for LNs located in Level 4R (83.6%) and Level 7 (80.4%). Conclusions The proposed 3D deep learning approach achieves an overall good performance in the automatic detection and segmentation of thoracic LNs and shows reasonable generalizability, yielding the potential to facilitate detection during routine clinical work and to enable radiomics research without observer-bias.

scholarly journals CT diagnosis of ilioinguinal lymph node metastases in melanoma using radiological characteristics beyond size and asymmetry

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
M J Wilkinson ◽  
H Snow ◽  
K Downey ◽  
K Thomas ◽  
A Riddell ◽  
...  
Keyword(s):  
Lymph Node ◽  
Diagnostic Accuracy ◽  
Multivariable Analysis ◽  
Ct Scans ◽  
Non Invasive ◽  
Poor Predictor ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Node Metastases

Abstract Background Diagnosis of lymph node (LN) metastasis in melanoma with non-invasive methods is challenging. The aim of this study was to evaluate the diagnostic accuracy of six LN characteristics on CT in detecting melanoma-positive ilioinguinal LN metastases, and to determine whether inguinal LN characteristics can predict pelvic LN involvement. Methods This was a single-centre retrospective study of patients with melanoma LN metastases at a tertiary cancer centre between 2008 and 2016. Patients who had preoperative contrast-enhanced CT assessment and ilioinguinal LN dissection were included. CT scans containing significant artefacts obscuring the pelvis were excluded. CT scans were reanalysed for six LN characteristics (extracapsular spread (ECS), minimum axis (MA), absence of fatty hilum (FH), asymmetrical cortical nodule (CAN), abnormal contrast enhancement (ACE) and rounded morphology (RM)) and compared with postoperative histopathological findings. Results A total of 90 patients were included. Median age was 58 (range 23–85) years. Eighty-eight patients (98 per cent) had pathology-positive inguinal disease and, of these, 45 (51 per cent) had concurrent pelvic disease. The most common CT characteristics found in pathology-positive inguinal LNs were MA greater than 10 mm (97 per cent), ACE (80 per cent), ECS (38 per cent) and absence of RM (38 per cent). In multivariable analysis, inguinal LN characteristics on CT indicative of pelvic disease were RM (odds ratio (OR) 3.3, 95 per cent c.i. 1.2 to 8.7) and ECS (OR 4.2, 1.6 to 11.3). Cloquet’s node is known to be a poor predictor of pelvic spread. Pelvic LN disease was present in 50 per cent patients, but only 7 per cent had a pathology-positive Cloquet’s node. Conclusion Additional CT radiological characteristics, especially ECS and RM, may improve diagnostic accuracy and aid clinical decisions regarding the need for inguinal or ilioinguinal dissection.

scholarly journals Dual-Energy Computed Tomography of the Lung in COVID-19 Patients: Mismatch of Perfusion Defects and Pulmonary Opacities

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 870
Author(s):  
Saif Afat ◽  
Ahmed E. Othman ◽  
Konstantin Nikolaou ◽  
Sebastian Gassenmaier
Keyword(s):  
Computed Tomography ◽  
Dual Energy ◽  
Lung Damage ◽  
Rating System ◽  
Pulmonary Perfusion ◽  
Imaging Studies ◽  
Dual Energy Computed Tomography ◽  
Contrast Enhanced ◽  
Perfusion Defects

To evaluate contrast-enhanced dual-energy computed tomography (DECT) chest examinations regarding pulmonary perfusion patterns and pulmonary opacities in patients with confirmed COVID-19 disease. Fourteen patients with 24 DECT examinations performed between April and May 2020 were included in this retrospective study. DECT studies were assessed independently by two radiologists regarding pulmonary perfusion defects, using a Likert scale ranging from 1 to 4. Furthermore, in all imaging studies the extent of pulmonary opacities was quantified using the same rating system as for perfusion defects. The main pulmonary findings were ground glass opacities (GGO) in all 24 examinations and pulmonary consolidations in 22 examinations. The total lung scores after the addition of the scores of the single lobes showed significantly higher values of opacities compared to perfusion defects, with a median of 12 (9–18) for perfusion defects and a median of 17 (15–19) for pulmonary opacities (p = 0.002). Furthermore, mosaic perfusion patterns were found in 19 examinations in areas with and without GGO. Further studies will be necessary to investigate the pathophysiological background of GGO with maintained perfusion compared to GGO with reduced perfusion, especially regarding long-term lung damage and prognosis.

scholarly journals The Effect of Contrast-enhanced Computed Tomography (CT) Scans on the Calculated Dose of Radiotherapy in a Thorax Phantom

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Athar Ehtiati ◽  
Payman Hejazi ◽  
Mohsen Bakhshandeh ◽  
Ali Jabbary Arfaee ◽  
Eftekhar Rajab Bolookat ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Media ◽  
Ct Scan ◽  
Treatment Planning ◽  
Tumor Volume ◽  
Ct Scans ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Despite the benefits of contrast-enhanced computed tomography (CT) scans in better tumor volume delineation, it can affect the accuracy of dose calculation in radiation therapy. This study examined this effect on a thorax phantom. Objectives: The influence of different variables including the concentrations of the Visipaque contrast media, tumor sizes, and CT scan energies on the dose measurement was examined. Methods: Transparent cylinders containing the contrast media were inserted in the lung area of the phantom and the CT scans were made. Non-enhanced CT scans were also acquired. Treatment planning using 2 opposite fields was performed on the CT scans and the doses were calculated in the treatment planning system. The results of the 2 sets of enhanced and non-enhanced CT scans were compared. Results: The correlation between concentration and the percentage of mean dose of the tumor volume was significant in 2 of the tumor sizes. The differences in the mean doses of the 2 plans were examined and more than 3% increase was observed in higher concentrations of the contrast media. Conclusions: According to this study, the suitable concentration of the contrast media administered and the CT scan energy should be considered. This would help to decrease the discrepancies between the calculated and delivered dose in radiotherapy treatments to a clinically acceptable level. The importance of time delays for CT scans after administration of the contrast media is emphasized.

scholarly journals Prospective Study on the Performance of 18F-DOPA Positron Emission Tomography/Computed Tomography in Patients with Medullary Thyroid Carcinoma

2022 ◽  
Author(s):  
Inés Califano ◽  
Fabian Pitoia ◽  
Roxana Chirico ◽  
Alejandra de Salazar ◽  
Maria Bastianello
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Distant Metastases ◽  
Emission Tomography ◽  
Medullary Thyroid ◽  
Contrast Enhanced Ct ◽  
Positron Emission ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Enhanced Ct

Abstract Purpose 18F-DOPA Positron Emission Tomography/Computed Tomography (18F-DOPA PET/CT) is a sensitive functional imaging method (65-75%) for detecting disease localization in medullary thyroid cancer (MTC). We aimed: i) to assess the clinical usefulness of 18F-DOPA PET/CT in patients with MTC and elevated calcitonin (Ctn) and CEA levels and, ii) to evaluate changes in disease management secondary to the findings encountered with this methodology. Methods thirty-six patients with MTC and Ctn levels ≥150 pg/ml were prospectively included. Neck ultrasound, chest contrast-enhanced CT, liver magnetic resonance imaging/ abdominal 3-phase contrast-enhanced CT and bone scintigraphy were carried out up to 6 months before the 18F DOPA PET/CT. Results 77.7% were female and 27% had hereditary MTC. Median Ctn level was 1450 pg/ml [150-56620], median CEA level 413 ng/ml [2.9-7436]. Median Ctn DT was 37.5 months [5.7-240]; median CEA DT was 31.8 [4.9-180]. 18F-DOPA PET/CT was positive in 33 patients (91.6%); in 18 (56%) uptake was observed in lymph nodes in the neck or mediastinum, in 7 cases (22%) distant metastases were diagnosed, and in 8 additional patients (24%) both locoregional and distant sites of disease were found. Ctn and CEA levels were higher in patients with ≥ 3 foci of distant metastases. In 14 patients (38.8%), findings on 18F-DOPA PET/CT led to changes in management; surgery for locoregional lymph nodes was the most frequent procedure in 8 patients (22%). Conclusion 18F-DOPA PET/CT was useful for the detection of recurrent disease in MTC and provided helpful information for patient management.

scholarly journals Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital

2020 ◽  
Vol 42 (3) ◽  
pp. 82-86
Author(s):  
Umesh P Khanal ◽  
Keshav Sah ◽  
Ram B Chand
Keyword(s):  
Computed Tomography ◽  
Third Ventricle ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Upper Limits ◽  
Gender And Age ◽  
Enhanced Ct

Introduction Measurement of ventricles of the brain is important for evaluating changes due to growth, ageing, intrinsic and extrinsic pathologies. The aim of this study was to determine the various parameters of the third ventricle and to assess their association with gender and age using computed tomography (CT) scans of head. MethodsThis retrospective, quantitative, cross sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to October 2019 (4 months) on images of 100 patients (50 males and 50 females) whose age group were 18-87 years, who underwent non-contrast and contrast enhanced CT scan of head. ResultsThe total mean of width of third ventricle was found to be 0.33±0.09 cm, 0.35±0.10 cm in male and 0.31±0.06 cm in female. Third ventricle width (TVW) showed statistically significant correlation with male and also with Age. Mean of third ventricle sylvian fissure distance index was 0.41±0.67 cm, 0.42±0.65 cm in male and 0.39±0.06 cm in female respectively. Mean of third ventricle ratio was 0.03±0.09 cm, 0.03±0.09 cm in male and 0.02±0.09 in female respectively. The value were slightly higher in male. ConclusionThe third ventricle width in CT in this study was 0.33±0.09 cm. CT was very useful to determine the upper limits of normal value and its variation with age.

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