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

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.

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

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 (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.

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

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.

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

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.

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

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

scholarly journals Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoxia Wang ◽  
Daihong Liu ◽  
Xiangfei Zeng ◽  
Shixi Jiang ◽  
Lan Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
Negative Group ◽  
Positive Group ◽  
Quantitative Parameters ◽  
Venous Phase ◽  
Expression Status

Abstract Background Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki67 are the most useful immunohistochemical biomarkers of invasive breast cancer. The purpose of this study is to investigate the possibility of quantitative parameters derived from dual-energy CT (DECT) to discriminate immunohistochemical biomarkers of invasive breast cancer. Methods This prospective study enrolled 120 patients with invasive breast cancer who underwent preoperative contrast-enhanced DECT for staging purposes from June 2019 to January 2020. DECT quantitative parameters, including normalized iodine concentration (NIC), the slope of the spectral Hounsfield unit curve (λHu), and the normalized effective atomic number (nZeff), were obtained from reconstructed images. DECT quantitative parameters were compared with the expression status, and the correlations with the value of immunohistochemical biomarkers were evaluated. Inter-observer reproducibility analysis was performed to assess the measurement reproducibility of quantitative parameters. The diagnostic performance of the quantitative parameters was analyzed by receiver operating characteristic curve. Results The ER-negative group tended to display higher venous phase NIC and nZeff compared with the ER-positive group (individually, p = 0.003, 0.011; area under the curve [AUC] of 0.65, 0.60). The PR-negative group demonstrated higher arterial and venous phase NIC compared with the PR-positive group (individually, p = 0.022, 0.005; AUC of 0.63, 0.65). NIC was correlated negatively with the value of ER and PR expression (r = − 0.175 ~ − 0.265, p = 0.002 ~ 0.042). The HER2-positive group tended to display higher venous phase nZeff than the HER2-negative group (p = 0.022; AUC of 0.59). The Ki67 high-proliferation group demonstrated higher arterial phase, venous phase NIC and nZeff than the Ki67 low-proliferation group (p < 0.001 ~ 0.005; AUC of 0.67 ~ 0.75). Both the NIC and nZeff were correlated positively with the value of Ki67 (r = 0.240 ~ 0.490, p < 0.001 ~ 0.014). Conclusions NIC and nZeff derived from DECT could be used to discriminate expression status and may associate with the value of immunohistochemical biomarkers of invasive breast cancer.

scholarly journals Assessment of Solitary Pulmonary Nodules Based on Virtual Monochrome Images and Iodine-Dependent Images Using a Single-Source Dual-Energy CT with Fast kVp Switching

2020 ◽  
Vol 9 (8) ◽  
pp. 2514
Author(s):  
Arkadiusz Zegadło ◽  
Magdalena Żabicka ◽  
Marta Kania-Pudło ◽  
Artur Maliborski ◽  
Aleksandra Różyk ◽  
...  
Keyword(s):  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Iodine Concentration ◽  
Modern Medicine ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
Solitary Pulmonary Nodules ◽  
Phase Images ◽  
Venous Phase

With lung cancer being the most common malignancy diagnosed worldwide, lung nodule assessment has proved to be one of big challenges of modern medicine. The aim of this study was to examine the usefulness of Dual Energy Computed Tomography (DECT) in solitary pulmonary nodule (SPN) assessment. Between January 2017 and June 2018; 65 patients (42 males and 23 females) underwent DECT scans in the late arterial phase (AP) and venous phase (VP). We concluded that imaging at an energy level of 65 keV was the most accurate in detecting malignancy in solitary pulmonary nodules (SPNs) measuring ≤30 mm in diameter on virtual monochromatic maps. Both virtual monochromatic images and iodine concentration maps prove to be highly useful in differentiating benign and malignant pulmonary nodules. As for iodine concentration maps, the analysis of venous phase images resulted in the highest clinical usefulness. To summarize, DECT may be a useful tool in the differentiation of benign and malignant SPNs. A single-phase DECT examination with scans acquired 90 s after contrast media injection is recommended.

scholarly journals Dual energy spectral CT imaging of pulmonary embolism with Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
Lixin Yang ◽  
Jihang Sun ◽  
Jiangying Li ◽  
Tong Yu ◽  
Bei Wang ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Mycoplasma Pneumoniae ◽  
Iodine Concentration ◽  
Pulmonary Angiography ◽  
Dual Energy ◽  
Normal Lung ◽  
Spectral Ct ◽  
Significant Difference ◽  
Perfusion Defects ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background: Pulmonary embolism (PE) associated with Mycoplasma pneumoniae pneumonia (MPP) in children has already attracted more attention. We aimed to evaluate the application of dual-energy spectral CT in diagnosing PE in children with MPP.Methods: Eight-three children with MPP and highly suspected PE, underwent CT pulmonary angiography (CTPA) with spectral imaging mode. Noise, clot-to-artery contrast-to-noise ratio, image quality and diagnosis confidence were calculated and assessed on nine monochromatic image sets (40 to 80keV). CTPA images were observed for the presence, localization, and embolic degrees of PE. Emboli were divided between intra and extra-consolidation. For extra-consolidation clots, iodine concentration (IC) of perfusion defects and normal lung, perfusion defects of 4 children before and after the treatment were measured and compared. For intra-consolidation clots, IC of consolidation areas with clots and consolidation areas without clot were measured and compared.Results: The optimal energy level for detecting PE in children was 55 keV. 116 clots (29 extra consolidations) were found in 25 children, IC of defect regions associated with PE was 0.69±0.28mg/mL (extra-consolidations) and 0.90±0.23mg/mL (intra-consolidations), both significantly lower than the 2.76±0.45mg/mL in normal lungs and 10.25±1.76mg/mL in consolidations without clots (P<0.001). Significant difference was found in the presence or absence of perfusion defects between occlusive clots and nonocclusive clots(P<0.001). IC of the perfusion defects significantly increased after treatment (P<0.001).Conclusions: In spectral CTPA 55 keV images optimize PE detection for children. and MD images quantify pulmonary blood flow of PE, and may help to detect small clots and quantify embolic degrees.

scholarly journals Quantitative Analysis of Hypervascular Hepatic Metastases and Hepatocellular Carcinoma using Spectral CT Imaging

2019 ◽  
Author(s):  
Zhiqiang Yang ◽  
Xinyi Wang ◽  
Hao Shi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Quantitative Analysis ◽  
Spectral Curve ◽  
Iodine Concentration ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Portal Venous Phase ◽  
Significant Difference ◽  
Venous Phase

Abstract Objective The goal of this study is to evaluate the performance of spectral CT-based quantitative analysis in differential diagnosis of hypervascular hepatic metastasis (HVHM) and hepatocellular carcinoma (HCC). Methods Spectral CT scans were performed for 47 patients with hepatic malignant tumors, including 20 patients with HVHM and 27 patients with HCC, which generated the following sets of data: single energy images in the arterial phase; iodine and water maps; marginal areas of lesions that manifested apparent signal intensification; and energy spectral parameters of normal liver tissues and abdominal aorta. Subsequently, we calculated the normalized iodine concentrations (NIC), lesion-normal parenchyma iodine concentration ratio (LNR), iodine concentration difference (ICD) between the arterial phase and the venous phase, and the spectral curve slope. An independent samples t test and receiver operating characteristic (ROC) curve analysis were applied to examine these quantitative parameters. Results In the arterial phase, the HVHM and HCC groups displayed no differences in NIC, LNR, or spectral curve slope (P > 0.05). In the venous phase, the two groups displayed significant differences in NIC, LNR, and spectral curve slope; the NIC was 0.59 ± 0.08 for the HVHM group and 0.4 5 ± 0.10 for the HCC group; the LNR was 1.17 ± 0.22 and 0.92 ± 0.16, respectively; the spectral curve slope was 1.85 ± 0.49 and 1.18 ± 0.34, respectively. In addition, there was no significant difference in ICD between the HVHM group (0.54 ± 0.39 g/L) and HCC group (0.45 ± 0.39 g/L) (P > 0.05). Finally, there were no significant differences of water or iodine concentration between the arterial phase and venous phase (P > 0.05). Taken together, the spectral curve slope in the portal venous phase had the best performance in differentiating HVHM from HCC. Conclusions HVHM and HCC have apparent differences in spectral curve and concentrations of radiocontrast agents in the portal venous phase. Hence, spectral CT imaging provides a new multiparameter quantitative approach for differentiating HVHM and HCC.

Differentiation of liver abscess from liver metastasis using dual-energy spectral CT quantitative parameters

2019 ◽  
Vol 113 ◽  
pp. 204-208 ◽  
Author(s):  
Nan Wang ◽  
Ye Ju ◽  
Jingjun Wu ◽  
Ailian Liu ◽  
Anliang Chen ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Liver Abscess ◽  
Dual Energy ◽  
Spectral Ct ◽  
Quantitative Parameters

scholarly journals Dual-Energy Computed Tomography Imaging in Early-Stage Hepatocellular Carcinoma: A Preliminary Study

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Author(s):  
Jinping Li ◽  
Sheng Zhao ◽  
Zaisheng Ling ◽  
Daqing Li ◽  
Guangsheng Jia ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Early Stage ◽  
Energy Levels ◽  
Water Concentration ◽  
Iodine Concentration ◽  
Dual Energy ◽  
Arterial Phase ◽  
Attenuation Curve ◽  
Spectral Attenuation ◽  
Venous Phase

Background. This study aims to evaluate the application of dual-energy computed tomography (DECT) for multiparameter quantitative measurement in early-stage hepatocellular carcinoma (HCC). Methods. The study retrospectively enrolled 30 patients with early-stage HCC and 43 patients with early-stage HCC who received radiofrequency ablation (RFA) and underwent abdomen enhanced CT scans in GSI mode. The GSI viewer was used for image display and data analysis. The regions of interest (ROIs) were delineated in the arterial phase and the venous phase. The optimal single energy value, CT values on different energy levels (40 keV, 70 keV, 100 keV, and 140 keV), the optimal energy level, the slope of the spectral attenuation curve, the effective atomic number (Zeff), iodine concentration (IC), water concentration (WC), normalized iodine concentration (NIC), and normalized water concentration (NWC) are measured and quantitatively analyzed. Results. The CT values of early-stage HCC at different single energy levels in dual phases were significantly different, and the single energy values were negatively correlated with the CT values. In the arterial phase and the venous phase, the optimal energy values for the best contrast-to-noise ratio were (68.34 ± 3.20) keV and (70.14 ± 2.01) keV, respectively. The slope of the spectral attenuation curve showed a downward trend at 40 keV, 70 keV, 100 keV, and 140 keV, but there was no statistically significant difference P > 0.05 . Zeff was positively correlated with IC and standardized IC, but has no significant correlation with WC and NWC in dual phases. Conclusion. DECT imaging contains multiparameter information and has different application values for early-stage HCC, and it is necessary to select the parameters reasonably for personalized and comprehensive evaluation.

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