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.

Quantification of calcium in solitary pulmonary nodules using single- and dual-energy CT.

Radiology ◽  
1982 ◽  
Vol 145 (2) ◽  
pp. 493-496 ◽  
Author(s):  
C E Cann ◽  
G Gamsu ◽  
F A Birnberg ◽  
W R Webb
Keyword(s):  
Pulmonary Nodules ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Solitary Pulmonary Nodules

scholarly journals Spectral CT Analysis of Solitary Pulmonary Nodules for Differentiating Malignancy from Benignancy: The Value of Iodine Concentration Spatial Distribution Difference

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Linyu Wu ◽  
Guoquan Cao ◽  
Liang Zhao ◽  
Kun Tang ◽  
Jie Lin ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Sensitivity And Specificity ◽  
Pulmonary Nodules ◽  
Iodine Concentration ◽  
Proximal Region ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Solitary Pulmonary Nodules ◽  
Multiple Parameters ◽  
Benign Nodules

Objective. The objective is to assess the value of spatial distribution difference in iodine concentration between malignant and benign solitary pulmonary nodules (SPNs) by analyzing multiple parameters of spectral CT. Methods. Sixty patients with 39 malignant nodules and 21 benign nodules underwent chest contrast CT scans using spectral imaging mode during pulmonary arterial phase (PP), arterial phase (AP), and venous phase (VP). Iodine concentrations of proximal and distal regions in pulmonary nodules on iodine-based material decomposition images were recorded. Normalized iodine concentration (NIC) and the differences in NIC between the proximal and the distal regions (dNIC) were calculated. The two-sample t-test and Mann–Whitney U-test were performed to compare the multiple parameters generated from spectral CT between malignant and benign nodules. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity. Results. NIC in the proximal region (NICpro) and NIC in the distal region (NICdis) between malignant and benign nodules at AP (NICpro, P=0.012; NICdis, P=0.024), and VP (NICpro, P=0.005; NICdis, P =0.004) were significantly different. NICpro at PP (P = 0.037) was also found significantly different between malignant and benign nodules; however, no significant differences were found in NICdis at PP (P = 0.093). In addition, the dNIC of malignant nodules was significantly higher than that of benign ones at PP (median and interquartiles (0.31, 0.11, 0.57 versus -0.26, -0.5, -0.1); p≤0.001), AP (mean dNIC, 0.093 ±0.094 versus -0.075±0.060; p≤0.001), and VP (mean dNIC, 0.171±0.137 versus -0.183±0.127; p≤0.001). The sensitivity and specificity (93%, 95%, respectively) of dNIC during VP were higher than other parameters, with a threshold value of -0.07. Conclusions. Spectral CT imaging with multiple parameters such as NICpro, NICdis, and dNIC may be a new method for differentiating malignant SPNs from benign ones.

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 Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261233
Author(s):  
Jimin Yoon ◽  
Yangsean Choi ◽  
Jinhee Jang ◽  
Na-Young Shin ◽  
Kook-Jin Ahn ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Iodine Concentration ◽  
Diagnostic Value ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes

Purpose To determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC). Methods This was a single-center retrospective cohort study of patients diagnosed with PTC between October 2019 and August 2020. US features of LNs to include hyperechogenicity, round shape, microcalcification, cystic component, and homogeneous/peripheral vascularity were considered suggestive of metastasis. The HU of arterial phase (HUarterial) and DECT-derived CT images [contrast media (CM) and areas under the 100 keV monoenergetic curve (AUC100keV)] were measured. Effective atomic numbers (Zeff), iodine concentration (mg/mL), and slope of the HU curve (λHU) were also obtained. The values for metastatic and benign LNs were compared using Student’s t-test with false-discovery correction. Logistic regression with areas under the receiver operating characteristic curves (AUCs) were performed for predicting metastatic LNs. Results A total of 102 patients were included (49 metastatic and 53 benign LNs; mean age, 46±15 years). Metastatic LNs showed significantly higher values for HUarterial, CM, Zeff, λHU, AUC100keV, and iodine concentration (all, P = 0.001). In logistic regression, the HUarterial demonstrated the highest AUC (0.824; 95% confidence interval [CI], 0.751–0.897), followed by CM HU (0.762; 95% CI, 0.679–0.846). Combination of DECT parameters with US features improved the AUC from 0.890 to 0.941. Conclusion Compared to US features alone, combination with DECT-derived quantitative parameters improved diagnostic performance in predicting metastatic cervical LNs in patients with PTC.

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.

Clinical Utility of Dual-Energy CT in the Evaluation of Solitary Pulmonary Nodules: Initial Experience

Radiology ◽  
2008 ◽  
Vol 249 (2) ◽  
pp. 671-681 ◽  
Author(s):  
Eun Jin Chae ◽  
Jae-Woo Song ◽  
Joon Beom Seo ◽  
Bernhard Krauss ◽  
Yu Mi Jang ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Pulmonary Nodules ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Initial Experience ◽  
Solitary Pulmonary Nodules

scholarly journals The utility of a dual-phase, dual-energy CT protocol in patients presenting with overt gastrointestinal bleeding

2021 ◽  
Vol 10 (7) ◽  
pp. 205846012110306
Author(s):  
Payam Mohammadinejad ◽  
Lukasz Kwapisz ◽  
Jeff L Fidler ◽  
Shannon P Sheedy ◽  
Jay P Heiken ◽  
...  
Keyword(s):  
Dual Energy ◽  
Arterial Phase ◽  
Gi Bleeding ◽  
Two Phase ◽  
Portal Venous Phase ◽  
Portal Phase ◽  
Ct Protocol ◽  
Phase Images ◽  
Venous Phase ◽  
Gi Bleed

Background Due to their easy accessibility, CT scans have been increasingly used for investigation of gastrointestinal (GI) bleeding. Purpose To estimate the performance of a dual-phase, dual-energy (DE) GI bleed CT protocol in patients with overt GI bleeding in clinical practice and examine the added value of portal phase and DE images. Materials and Methods Consecutive patients with GI bleeding underwent a two-phase DE GI bleed CT protocol. Two gastroenterologists established the reference standard. Performance was estimated using clinical CT reports. Three GI radiologists rated confidence in GI bleeding in a subset of 62 examinations, evaluating first mixed kV arterial images, then after examining additional portal venous phase images, and finally after additional DE images (virtual non-contrast and virtual monoenergetic 50 keV images). Results 52 of 176 patients (29.5%) had GI bleeding by the reference standard. The overall sensitivity, specificity, and positive and negative predictive values of the CT GI bleed protocol for detecting GI bleeding were 65.4%, 89.5%, 72.3%, and 86.0%, respectively. In patients with GI bleeding, diagnostic confidence of readers increased after adding portal phase images to arterial phase images ( p = 0.002), without additional benefit from dual energy images. In patients without GI bleeding, confidence in luminal extravasation appropriately decreased after adding portal phase, and subsequently DE images ( p = 0.006, p = 0.018). Conclusion A two-phase DE GI bleed CT protocol had high specificity and negative predictive value in clinical practice. Portal venous phase images improved diagnostic confidence in comparison to arterial phase images alone. Dual-energy images further improved radiologist confidence in the absence of bleeding.

Feasibility study of using virtual non-contrast images derived from dual-energy CT to replace true non-contrast images in patients diagnosed with papillary thyroid carcinoma

2021 ◽  
pp. 1-10
Author(s):  
Jiang Zhou ◽  
Yan Zhou ◽  
Hao Hu ◽  
Mei-Ping Shen ◽  
Ying-Qian Ge ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Radiation Dose ◽  
Thyroid Carcinoma ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
Papillary Thyroid ◽  
Subjective Score ◽  
Venous Phase ◽  
Noise Ratio

OBJECTIVE: To assess the feasibility of using virtual non-contrast (VNC) images derived from dual-energy computed tomography (DECT) to replace true non-contrast (TNC) images of papillary thyroid carcinoma (PTC) patients. METHODS: Images of 96 PTC patients were retrospectively analyzed. TNC images were acquired under the single-energy mode of DECT after the plain scanning. The arterial and venous phase VNC (VNC-a and VNC-v) images were generated by the post-processing algorithm from the arterial phase and venous phase of contrast-enhanced CT images, respectively. Mean attenuation values, image noise, number and length of calcification were measured. Radiation dose was also calculated. Last, subjective score of image quality was evaluated by a 5-point scale. RESULTS: Signal-to-noise ratio (SNR) of each tissue in TNC images is significantly higher than that of VNC images (p<0.050). Contrast-to-noise ratio (CNR) of fat, muscle, thyroid nodules and internal carotid artery in TNC images is significantly higher than that of VNC images, while CNR in TNC images is lower for cervical vertebra (p<0.001). Calcification is detected on TNC images of 44 patients, while it is omitted on VNC images of 14 patients (31.8%). The subjective score of TNC images is higher than VNC images (p<0.001). The effective dose reduction is 47.6% by avoiding plain scanning. CONCLUSIONS: Considering the different attenuation value, SNR, CNR and especially reduced detection rate of calcification, we deem that VNC images cannot be directly used to replace TNC images in PTC patients, despite the reduced radiation dose.

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