scholarly journals Dual-Source Dual-Energy Thin-Section CT Combined with Small Field of View Technique for Diagnosing Small Lymph Node in Thyroid Cancer

2020 ◽  
Author(s):  
Shuiqing Zhuo ◽  
Jiayuan Sun ◽  
Jinyong Chang ◽  
Longzhong Liu ◽  
Sheng Li
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
Dual Source ◽  
Small Lymph Node ◽  
Short Diameter

Abstract Background To evaluate the diagnostic performance of quantitative special CT parameters derived from dual-source dual-energy CT at small field of view (FOV) for small lymph node metastasis in thyroid cancer. Methods This was a retrospective study. From 2016 to 2019, 280 patients with thyroid disease underwent thin-section dual-source dual-energy thyroid CT and thyroid surgery. The data of patients with lymph nodes having a short diameter of 2-6 mm were analyzed. The targeted lymph nodes were sketched, their quantitative dual-energy CT parameters were measured, and all parameters between metastatic and nonmetastatic lymph nodes were compared. These parameters were then fitted to univariable and multivariable binary logistic regression models. The diagnostic role of spectral parameters was analyzed by receiver operating characteristic curves and compared with the McNemar test. Small FOV CT images and a mathematical model were used to judge the lymph nodes status respectively and then compared with pathological results.Results Of the 216 lymph nodes investigated in this study, 52.3% and 23.6% had a short diameter of 2-3 mm and 4 mm, respectively. Multiple quantitative CT parameters were found to be significantly different between benign and malignant lymph nodes and binary regression analysis was performed. The mathematical model was: p=ey/(1+ ey), y= = -23.119+0.033×precontrast electron cloud density+0.076×arterial phase normalized iodine concentration+2.156×arterial phase normalized effective atomic number -0.540×venous phase slope of the spectral Hounsfield unit curve +1.676×venous phase iodine concentration. This parameter model has an AUC of 92%, with good discrimination and consistency, and the diagnostic accuracy was 90.3%. The diagnostic accuracy of CT image model was 43.1%, and for lymph nodes with short-diameter 2-3 mm, the diagnostic accuracy was 22.1%.Conclusions Parameter model show higher diagnostic accuracy than CT image model for diagnosing small lymph node metastasis in thyroid cancer, and quantitative dual-energy CT parameters were very useful for small lymph nodes that were difficult to be diagnosed only on conventional CT images.Trial registration This study is retrospectively registered, and we have registered a prospective study (Registration number: ChiCTR2000035195;http://www.chictr.org.cn)

scholarly journals Diagnostic accuracy of color-coded virtual noncalcium reconstructions derived from portal venous phase dual-energy CT in the assessment of lumbar disk herniation

2021 ◽  
Author(s):  
Vitali Koch ◽  
Moritz H. Albrecht ◽  
Leon D. Gruenewald ◽  
Ibrahim Yel ◽  
Katrin Eichler ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Portal Venous Phase ◽  
Lumbar Disk ◽  
Contrast Enhanced ◽  
Dual Source ◽  
Venous Phase

Abstract Objectives To investigate the diagnostic accuracy of color-coded contrast-enhanced dual-energy CT virtual noncalcium (VNCa) reconstructions for the assessment of lumbar disk herniation compared to unenhanced VNCa imaging. Methods A total of 91 patients were retrospectively evaluated (65 years ± 16; 43 women) who had undergone third-generation dual-source dual-energy CT and 3.0-T MRI within an examination interval up to 3 weeks between November 2019 and December 2020. Eight weeks after assessing unenhanced color-coded VNCa reconstructions for the presence and degree of lumbar disk herniation, corresponding contrast-enhanced portal venous phase color-coded VNCa reconstructions were independently analyzed by the same five radiologists. MRI series were additionally analyzed by one highly experienced musculoskeletal radiologist and served as reference standard. Results MRI depicted 210 herniated lumbar disks in 91 patients. VNCa reconstructions derived from contrast-enhanced CT scans showed similar high overall sensitivity (93% vs 95%), specificity (94% vs 95%), and accuracy (94% vs 95%) for the assessment of lumbar disk herniation compared to unenhanced VNCa images (all p > .05). Interrater agreement in VNCa imaging was excellent for both, unenhanced and contrast-enhanced CT (κ = 0.84 vs κ = 0.86; p > .05). Moreover, ratings for diagnostic confidence, image quality, and noise differed not significantly between unenhanced and contrast-enhanced VNCa series (all p > .05). Conclusions Color-coded VNCa reconstructions derived from contrast-enhanced dual-energy CT yield similar diagnostic accuracy for the depiction of lumbar disk herniation compared to unenhanced VNCa imaging and therefore may improve opportunistic retrospective lumbar disk herniation assessment, particularly in case of staging CT examinations. Key Points • Color-coded dual-source dual-energy CT virtual noncalcium (VNCa) reconstructions derived from portal venous phase yield similar high diagnostic accuracy for the assessment of lumbar disk herniation compared to unenhanced VNCa CT series (94% vs 95%) with MRI serving as a standard of reference. • Diagnostic confidence, image quality, and noise levels differ not significantly between unenhanced and contrast-enhanced portal venous phase VNCa dual-energy CT series. • Dual-source dual-energy CT might have the potential to improve opportunistic retrospective lumbar disk herniation assessment in CT examinations performed for other indications through reconstruction of VNCa images.

scholarly journals Comparison between Conventional Unenhanced and Virtual Unenhanced Imaging of Hepatopancreaticobiliary System with Third-Generation Dual-Source Dual-Energy CT—An Observational Study

2021 ◽  
Author(s):  
Swathigha Selvaraj ◽  
Niyas N. P. ◽  
Rupa Renganathan ◽  
Rajkumar Ramasamy ◽  
Rinoy Ram Anandan ◽  
...  
Keyword(s):  
Image Quality ◽  
Statistical Significance ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
P Value ◽  
Diagnostic Image Quality ◽  
Third Generation ◽  
Dual Source ◽  
Virtual Unenhanced

Abstract Objectives The aims of our study were to assess the comparability of conventional unenhanced images (CUIs) of hepatopancreaticobiliary system with virtual unenhanced images (VUIs) derived from arterial and portal venous phases acquired in a third-generation, dual-source, dual-energy CT (DECT), and also to assess the best dataset among these VUIs. We also calculated the radiation effective dose (ED) reduction by eliminating noncontrast acquisition. Materials and Methods 60 patients were included in our study. Unenhanced images in single energy and contrast-enhanced images in dual-energy mode were acquired. Arterial virtual unenhanced (AVU) and portal virtual unenhanced (PVU) images were generated and compared with CUI, using both objective and subjective methods. The ED was calculated separately for each phase. Statistical significance between difference in mean attenuation values were analyzed using ANOVA and unpaired student t-test. Results In our study, the difference in mean attenuation of liver, spleen, and pancreas between the three phases—CU, AVU, and PVU—were insignificant with p-value > 0.05. This indicates that the values were comparable. Among the VUI, AVU images were statistically superior in image quality. Elimination of noncontrast CT from triple phase abdominal imaging can achieve an average ED reduction of 39%. Conclusions We conclude that VUI generated in third-generation, dual-source DECT has diagnostic image quality and can replace the CUI in triple-phase studies, with a mean ED reduction by 39%. The VUI obtained from arterial phase is superior to those obtained from portal venous phase.

Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer

2018 ◽  
Vol 28 (12) ◽  
pp. 5241-5249 ◽  
Author(s):  
Jing Li ◽  
Mengjie Fang ◽  
Rui Wang ◽  
Di Dong ◽  
Jie Tian ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Diagnostic Accuracy ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Node Metastasis

Diagnostic accuracy of third-generation dual-source dual-energy CT: a prospective trial and protocol for clinical implementation

2018 ◽  
Vol 37 (4) ◽  
pp. 735-741 ◽  
Author(s):  
Tim Nestler ◽  
Kai Nestler ◽  
Andreas Neisius ◽  
Hendrik Isbarn ◽  
Christopher Netsch ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Prospective Trial ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Third Generation ◽  
Clinical Implementation ◽  
Dual Source
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