Dual-energy Spectral CT Quantitative Parameters for the Differentiation of Glioma Recurrence from Treatment-Related Changes: A Preliminary Study

Abstract Background: Differentiating glioma recurrence from treatment-related changes can be challenging on conventional imaging. We evaluated the use of dual-energy spectral computed tomographic (CT) quantitative parameters for this differentiation. Methods: Twenty-eight patients were examined by dual-energy spectral imaging CT. The slope of the spectral Hounsfield unit curve (λ HU ), effective atomic number (Z eff ), normalized effective atomic number (Z eff-N ), iodine concentration (IC), and normalized iodine concentration (IC N ) in the post-treatment enhanced areas were calculated. Pathological results or clinicoradiologic follow-up of ≥2 months were used for final diagnosis. Nonparametric and t -tests were used to compare quantitative parameters between glioma recurrence and treatment-related changes. Positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated; sensitivity and specificity were calculated using receiver operating characteristic (ROC) curves. ROC curves were generated using predictive probabilities to evaluate the diagnostic value. Results: There were no significant differences in quantitative parameters based on examination of pre-contrast λ HU , Z eff , Z eff-N , IC, IC N and venous phase IC N ( P >0.05). Venous phase λ HU , Z eff , Z eff-N , and IC in glioma recurrence were higher than in treatment-related changes ( P <0.001). The optimal venous phase threshold was 1.03, 7.75, 1.04, and 2.85 mg/cm 3 , achieving 66.7%, 91.7%, 83.3%, and 91.7% sensitivity; 100.0%, 77.8%, 88.9%, and 77.8% specificity; 100.0%, 73.3%, 83.3%, and 73.3% PPV; 81.8%, 93.3%, 88.9%, and 93.3% NPV; and 86.7%, 83.3%, 86.7%, and 83.3% accuracy, respectively. The areas under the curve (AUC) were 0.912, 0.912, 0.931, and 0.910 in glioma recurrence and treatment-related changes, respectively. Conclusions: Dual-energy spectral CT imaging may provide quantitative values to aid in differentiation of glioma recurrence from treatment-related changes.

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Dual-energy Spectral CT Quantitative Parameters for the Differentiation of Glioma Recurrence from Treatment-Related Changes: A Preliminary Study

10.21203/rs.2.15990/v2 ◽

2019 ◽

Author(s):

Yanchun Lv ◽

Jian Zhou ◽

Xiaofei Lv ◽

Li Tian ◽

Haoqiang He ◽

...

Keyword(s):

Atomic Number ◽

Predictive Value ◽

Effective Atomic Number ◽

Roc Curves ◽

Iodine Concentration ◽

Dual Energy ◽

Spectral Ct ◽

Quantitative Parameters ◽

Glioma Recurrence ◽

Venous Phase

Abstract Background: Differentiating glioma recurrence from treatment-related changes can be challenging on conventional imaging. We evaluated the use of dual-energy spectral computed tomographic (CT) quantitative parameters for this differentiation. Methods: Twenty-eight patients were examined by dual-energy spectral imaging CT. The slope of the spectral Hounsfield unit curve (λHU), effective atomic number (Zeff), normalized effective atomic number (Zeff-N), iodine concentration (IC), and normalized iodine concentration (ICN) in the post-treatment enhanced areas were calculated. Pathological results or clinicoradiologic follow-up of ≥2 months were used for final diagnosis. Nonparametric and t-tests were used to compare quantitative parameters between glioma recurrence and treatment-related changes. Positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated; sensitivity and specificity were calculated using receiver operating characteristic (ROC) curves. ROC curves were generated using predictive probabilities to evaluate the diagnostic value. Results: There were no significant differences in quantitative parameters based on examination of pre-contrast λHU, Zeff, Zeff-N, IC, ICN and venous phase ICN (P>0.05). Venous phase λHU, Zeff, Zeff-N, and IC in glioma recurrence were higher than in treatment-related changes (P<0.001). The optimal venous phase threshold was 1.03, 7.75, 1.04, and 2.85 mg/cm3, achieving 66.7%, 91.7%, 83.3%, and 91.7% sensitivity; 100.0%, 77.8%, 88.9%, and 77.8% specificity; 100.0%, 73.3%, 83.3%, and 73.3% PPV; 81.8%, 93.3%, 88.9%, and 93.3% NPV; and 86.7%, 83.3%, 86.7%, and 83.3% accuracy, respectively. The areas under the curve (AUC) were 0.912, 0.912, 0.931, and 0.910 in glioma recurrence and treatment-related changes, respectively. Conclusions: Dual-energy spectral CT imaging may provide quantitative values to aid in differentiation of glioma recurrence from treatment-related changes.

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Dual-energy Spectral CT Quantitative Parameters for the Differentiation of Glioma Recurrence from Treatment-Related Changes: A Preliminary Study

10.21203/rs.2.15990/v3 ◽

2019 ◽

Author(s):

Yanchun Lv ◽

Jian Zhou ◽

Xiaofei Lv ◽

Li Tian ◽

Haoqiang He ◽

...

Keyword(s):

Hounsfield Unit ◽

Roc Curves ◽

Iodine Concentration ◽

Final Diagnosis ◽

Dual Energy ◽

Spectral Ct ◽

Predictive Values ◽

Quantitative Parameters ◽

Glioma Recurrence ◽

Venous Phase

Abstract Background: Differentiating glioma recurrence from treatment-related changes can be challenging on conventional imaging. We evaluated the efficacy of quantitative parameters measured by dual-energy spectral computed tomographic (CT) for this differentiation. Methods: Twenty-eight patients were examined by dual-energy spectral CT. The effective and normalized atomic number (Zeff and Zeff-N, respectively); spectral Hounsfield unit curve (λHU) slope; and iodine and normalized iodine concentration (IC and ICN, respectively) in the post-treatment enhanced areas were calculated. Pathological results or clinicoradiologic follow-up of ≥2 months were used for final diagnosis. Nonparametric and t-tests were used to compare quantitative parameters between glioma recurrence and treatment-related changes. Sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), and accuracy were calculated using receiver operating characteristic (ROC) curves. Predictive probabilities were used to generate ROC curves to determine the diagnostic value. Results: Examination of pre-contrast λHU, Zeff, Zeff-N, IC, ICN, and venous phase ICN showed no significant differences in quantitative parameters (P>0.05). Venous phase λHU, Zeff, Zeff-N, and IC in glioma recurrence were higher than in treatment-related changes (P<0.001). The optimal venous phase threshold was 1.03, 7.75, 1.04, and 2.85 mg/cm3, achieving 66.7%, 91.7%, 83.3%, and 91.7% sensitivity; 100.0%, 77.8%, 88.9%, and 77.8% specificity; 100.0%, 73.3%, 83.3%, and 73.3% PPV; 81.8%, 93.3%, 88.9%, and 93.3% NPV; and 86.7%, 83.3%, 86.7%, and 83.3% accuracy, respectively. The respective areas under the curve (AUCs) were 0.912, 0.912, 0.931, and 0.910 in glioma recurrence and treatment-related changes. Conclusions: Glioma recurrence could be potentially differentiated from treatment-related changes based on quantitative values measured by dual-energy spectral CT imaging.

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Accuracy of electron density, effective atomic number, and iodine concentration determination with a dual-layer dual-energy computed tomography system

Medical Physics ◽

10.1002/mp.12903 ◽

2018 ◽

Vol 45 (6) ◽

pp. 2486-2497 ◽

Cited By ~ 23

Author(s):

Chia-ho Hua ◽

Nadav Shapira ◽

Thomas E. Merchant ◽

Paul Klahr ◽

Yoad Yagil

Keyword(s):

Computed Tomography ◽

Electron Density ◽

Atomic Number ◽

Effective Atomic Number ◽

Iodine Concentration ◽

Dual Energy ◽

Dual Energy Computed Tomography ◽

Concentration Determination ◽

Tomography System

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Therapy response assessment of non-small cell lung cancer using dual-energy computed tomography iodine map

Journal of X-Ray Science and Technology ◽

10.3233/xst-210989 ◽

2021 ◽

pp. 1-12

Author(s):

Lei Zhao ◽

Lijuan Liu ◽

Haiyan Zhao ◽

Jiaqi Bao ◽

Yana Dou ◽

...

Keyword(s):

Advanced Nsclc ◽

Therapy Response ◽

Roc Curves ◽

Iodine Concentration ◽

Dual Energy ◽

Small Cell ◽

Small Cell Lung ◽

Quantitative Parameters ◽

Iodine Map ◽

Post Therapy

OBJECTIVE: To investigate feasibility of the quantitative parameters of dual-energy computed tomography (DECT) to assess therapy response in advanced non-small cell lung cancer (NSCLC) compared with the traditional enhanced CT parameters based on the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. METHODS: Forty-five patients with unresectable locally advanced NSCLC who underwent DECT before and after chemotherapy or concurrent chemoradiotherapy (cCRT) were prospectively enrolled. By comparing baseline studies with follow-up, patients were divided into two groups according to RECIST guidelines as follows: disease control (DC, including partial response and stable disease) and progressive disease (PD). The diameter (D), attenuation, iodine concentration and normalized iodine concentration of arterial and venous phases (ICA, ICv, NICA, NICv) and the percentage of these changes pre- and post-therapy were measured and calculated. The Pearson correlation was used to analyze correlation between various quantitative parameters. The receiver operating characteristic (ROC) curves were used to evaluate accuracy of therapy response prediction. RESULTS: The change percentages of Attenuation (Δ-Attenuation-A and Δ-Attenuation-V), IC (ΔICA and ΔICV) and NIC (ΔNICA and ΔNICV) pre- and post-therapy correlate with the change percentage of D (ΔD). Among these, ΔICA strongly correlates with Δ D (r = 0.793, P < 0.001). The areas under ROC curves generated using Δ-Attenuation-A, ΔICA, and ΔNICA are 0.796, 0.900, and 0.880 with the corresponding cutoff value of 9.096, −15.692, and −4.7569, respectively, which are significantly different (P < 0.001). CONCLUSIONS: The quantitative parameters of DECT iodine map, especially iodine concentration, in arterial phase provides a new quantitative image marker to predict therapy response of patients diagnosed with advanced NSCLC.

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Dual-energy spectral CT quantitative parameters for the differentiation of Glioma recurrence from treatment-related changes: a preliminary study

BMC Medical Imaging ◽

10.1186/s12880-019-0406-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yanchun Lv ◽

Jian Zhou ◽

Xiaofei Lv ◽

Li Tian ◽

Haoqiang He ◽

...

Keyword(s):

Dual Energy ◽

Spectral Ct ◽

Quantitative Parameters ◽

Glioma Recurrence ◽

Preliminary Study

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Fast kVp-switching dual energy contrast-enhanced thorax and cardiac CT: A phantom study on the accuracy of iodine concentration and effective atomic number measurement

Medical Physics ◽

10.1002/mp.12437 ◽

2017 ◽

Vol 44 (9) ◽

pp. 4724-4735 ◽

Cited By ~ 9

Author(s):

Antonios E. Papadakis ◽

John Damilakis

Keyword(s):

Atomic Number ◽

Cardiac Ct ◽

Effective Atomic Number ◽

Iodine Concentration ◽

Dual Energy ◽

Phantom Study ◽

Contrast Enhanced

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Material Identification in Presence of Metal for Baggage Screening

Electronic Imaging ◽

10.2352/issn.2470-1173.2020.14.coimg-294 ◽

2020 ◽

Vol 2020 (14) ◽

pp. 294-1-294-8

Author(s):

Sandamali Devadithya ◽

David Castañón

Keyword(s):

Atomic Number ◽

Effective Atomic Number ◽

Simulated Data ◽

Dual Energy ◽

Basis Functions ◽

Total Variation Regularization ◽

Ct Scanner ◽

Edge Preserving ◽

Baggage Screening ◽

Dual Energy Imaging

Dual-energy imaging has emerged as a superior way to recognize materials in X-ray computed tomography. To estimate material properties such as effective atomic number and density, one often generates images in terms of basis functions. This requires decomposition of the dual-energy sinograms into basis sinograms, and subsequently reconstructing the basis images. However, the presence of metal can distort the reconstructed images. In this paper we investigate how photoelectric and Compton basis functions, and synthesized monochromatic basis (SMB) functions behave in the presence of metal and its effect on estimation of effective atomic number and density. Our results indicate that SMB functions, along with edge-preserving total variation regularization, show promise for improved material estimation in the presence of metal. The results are demonstrated using both simulated data as well as data collected from a dualenergy medical CT scanner.

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A Spectrum-Adaptive Decomposition Method for Effective Atomic Number Estimation Using Dual Energy CT

Electronic Imaging ◽

10.2352/issn.2470-1173.2020.14.coimg-293 ◽

2020 ◽

Vol 2020 (14) ◽

pp. 293-1-293-7

Author(s):

Ankit Manerikar ◽

Fangda Li ◽

Avinash C. Kak

Keyword(s):

Atomic Number ◽

Decomposition Method ◽

Traditional Approach ◽

Effective Atomic Number ◽

Dual Energy ◽

Performance Comparison ◽

Estimation Methods ◽

Dual Energy Ct ◽

Projection Data ◽

X Ray

Dual Energy Computed Tomography (DECT) is expected to become a significant tool for voxel-based detection of hazardous materials in airport baggage screening. The traditional approach to DECT imaging involves collecting the projection data using two different X-ray spectra and then decomposing the data thus collected into line integrals of two independent characterizations of the material properties. Typically, one of these characterizations involves the effective atomic number (Zeff) of the materials. However, with the X-ray spectral energies typically used for DECT imaging, the current best-practice approaches for dualenergy decomposition yield Zeff values whose accuracy range is limited to only a subset of the periodic-table elements, more specifically to (Z < 30). Although this estimation can be improved by using a system-independent ρe — Ze (SIRZ) space, the SIRZ transformation does not efficiently model the polychromatic nature of the X-ray spectra typically used in physical CT scanners. In this paper, we present a new decomposition method, AdaSIRZ, that corrects this shortcoming by adapting the SIRZ decomposition to the entire spectrum of an X-ray source. The method reformulates the X-ray attenuation equations as direct functions of (ρe, Ze) and solves for the coefficients using bounded nonlinear least-squares optimization. Performance comparison of AdaSIRZ with other Zeff estimation methods on different sets of real DECT images shows that AdaSIRZ provides a higher output accuracy for Zeff image reconstructions for a wider range of object materials.

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