A noise-optimized virtual monoenergetic reconstruction algorithm improves the diagnostic accuracy of late hepatic arterial phase dual-energy CT for the detection of hypervascular liver lesions

Cecco, Carlo N. De; Caruso, Damiano; Schoepf, U. Joseph; Santis, Domenico De; Muscogiuri, Giuseppe; Albrecht, Moritz H.; Meinel, Felix G.; Wichmann, Julian L.; Burchett, Philip; Varga-Szemes, Ákos; Sheafor, Douglas H.; Hardie, Andrew D.

doi:10.1007/s00330-018-5313-6

Cited by 59 publications

(39 citation statements)

References 27 publications

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“…The objective image noise characteristics of MEI(+) reconstructions observed in this study are comparable with recent investigations that show increased noise for lower energy levels [ 5 , 10 , 17 ]. Interestingly, while subjective image parameters were best for MEI(+) reconstructions at 55 keV in the study by Frellesen, in our study, both readers favored the 40-keV and 50-keV MEI(+).…”

Section: Discussionsupporting

confidence: 90%

“…Several studies in the field of oncological and vascular imaging have shown that MEI(+) reconstructions are superior to MEI and PEI, providing excellent image quality due to significantly lower image noise at similar attenuation levels [ 5 , 8 – 10 , 15 – 18 ]. Only two of these studies investigated image quality in patients with PDAC [ 10 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Monoenergetic image (MEI) reconstructions derived from different types of dual-energy CT (DECT) encompassing dual-source [ 5 ], split-filter [ 6 ], rapid kilovoltage peak (kVp) switching [ 7 ], and dual-layer [ 8 ] are valuable techniques that improve tissue contrast [ 9 ]. DECT has been shown to improve image quality and tissue contrast in diseases of the liver and pancreas [ 5 , 10 , 11 ] and, thus, can increase tumor delineation [ 12 ]. However, one drawback of MEI is the increased image noise at low keV levels [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…This technique performs a spatial frequency-based recombination that reduces the image noise of lower energy levels and improves image contrast at higher energies to obtain the best possible image contrast. These novel reconstruction algorithms have been shown to improve signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in oncological and vascular imaging [ 5 , 10 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Objective and subjective comparison of virtual monoenergetic vs. polychromatic images in patients with pancreatic ductal adenocarcinoma

et al. 2019

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Objectives The aim of this study was to assess the objective and subjective image characteristics of monoenergetic images (MEI[+]), using a noise-optimized algorithm at different kiloelectron volts (keV) compared to polyenergetic images (PEI), in patients with pancreatic ductal adenocarcinoma (PDAC). Methods This retrospective, institutional review board-approved study included 45 patients (18 male, 27 female; mean age 66 years; range, 42–96 years) with PDAC who had undergone a dual-energy CT (DECT) of the abdomen for staging. One standard polyenergetic image (PEI) and five MEI(+) images in 10-keV intervals, ranging from 40 to 80 keV, were reconstructed. Line-density profile analysis, as well as the contrast-to-noise ratio (CNR) of the tumor, the signal-to-noise ratio (SNR) of the regular pancreas parenchyma and the tumor, and the CNR of the three main peripancreatic vessels, was calculated. For subjective quality assessment, two readers independently assessed the images using a 5-point Likert scale. Reader reliability was evaluated using an intraclass correlation coefficient. Results Line-density profile analysis revealed the largest gradient in attenuation between PDAC and regular tissue in MEI(+) at 40 keV. Low-keV MEI(+)reconstructions at 40 and 50 keV increased CNR and SNR compared to PEI (40 keV: CNR 46.8 vs. 7.5; SNR Pankreas 32.5 vs. 15.7; SNR Lesion 13.5 vs. 8.6; p < 0.001). MEI(+) at 40 keV and 50 keV were consistently preferred by the observers ( p < 0.05), showing a high intra-observer 0.937 (0.92–0.95) and inter-observer 0.911 (0.89–0.93) agreement. Conclusion MEI(+) reconstructions at 40 keV and 50 keV provide better objective and subjective image quality compared to conventional PEI of DECT in patients with PDAC. Key Points • Low-keV MEI(+) reconstructions at 40 and 50 keV increase tumor-to-pancreas contrast compared to PEI. • Low-keV MEI(+) reconstructions improve objective and subjective image quality parameters compared to PEI. • Dual-energy post-processing might be a valuable tool in the diagnostic workup of patients with PDAC. Electronic supplementary material The online version of this article (10.1007/s00330-019-06116-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Objective and subjective comparison of virtual monoenergetic vs. polychromatic images in patients with pancreatic ductal adenocarcinoma

et al. 2019

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“…First, VM images provide reconstructions of specific kiloelectron volt (KeV). This allows for iodine contrast enhancement and artifact reduction reconstructions, which have been used in cardiac, pulmonary and abdominal vascular imaging [ 15 , 16 , 17 , 18 ], oncological imaging [ 19 , 20 , 21 ] and metal artifact reduction [ 22 , 23 ]. The second type of reconstructions are linked to material decomposition, i.e., differentiation of tissues based on atomic composition, which enables the separation of iodine contrast for VNC reconstructions [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

Taudorf

Ulriksen

et al. 2020

Diagnostics

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Dual-energy computed tomography (DECT) can estimate tissue vascularity and perfusion via iodine quantification. The aim of this systematic review was to outline current and emerging clinical applications of iodine quantification within the gastrointestinal tract using DECT. The search was conducted with three databases: EMBASE, Pubmed and The Cochrane Library. This identified 449 studies after duplicate removal. From a total of 570 selected studies, 30 studies were enrolled for the systematic review. The studies were categorized into four main topics: gastric tumors (12 studies), colorectal tumors (8 studies), Crohn’s disease (4 studies) and miscellaneous applications (6 studies). Findings included a significant difference in iodine concentration (IC) measurements in perigastric fat between T1–3 vs. T4 stage gastric cancer, poorly and well differentiated gastric and colorectal cancer, responders vs. non-responders following chemo- or chemoradiotherapy treatment among cancer patients, and a positive correlation between IC and Crohn’s disease activity. In conclusion, iodine quantification with DECT may be used preoperatively in cancer imaging as well as for monitoring treatment response. Future studies are warranted to evaluate the capabilities and limitations of DECT in splanchnic flow.

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Improvement of image quality of laryngeal squamous cell carcinoma using noise‐optimized virtual monoenergetic image and nonlinear blending image algorithms in dual‐energy computed tomography

Liu

et al. 2021

Head & Neck

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Background Dual‐energy computed tomography (DECT) has been used to improve image quality of head and neck squamous cell carcinoma (SCC). This study aimed to assess image quality of laryngeal SCC using linear blending image (LBI), nonlinear blending image (NBI), and noise‐optimized virtual monoenergetic image (VMI+) algorithms. Methods Thirty‐four patients with laryngeal SCC were retrospectively enrolled between June 2019 and December 2020. DECT images were reconstructed using LBI (80 kV and M_0.6), NBI, and VMI+ (40 and 55 keV) algorithms. Contrast‐to‐noise ratio (CNR), tumor delineation, and overall image quality were assessed and compared. Results VMI+ (40 keV) had the highest CNR and provided better tumor delineation than VMI+ (55 keV), LBI, and NBI, while NBI provided better overall image quality than VMI+ and LBI (all corrected p < 0.05). Conclusions VMI+ (40 keV) and NBI improve image quality of laryngeal SCC and may be preferable in DECT examination.

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A noise-optimized virtual monoenergetic reconstruction algorithm improves the diagnostic accuracy of late hepatic arterial phase dual-energy CT for the detection of hypervascular liver lesions

Abstract: • Low-keV VMI+ are characterized by higher contrast resulting from maximum iodine attenuation. • VMI+ provides superior image quality compared with VMI or M_0.6. • 50-keV_VMI+ provides higher accuracy for the detection of hypervascular liver lesions < 1cm.

Cited by 59 publications

References 27 publications

Objective and subjective comparison of virtual monoenergetic vs. polychromatic images in patients with pancreatic ductal adenocarcinoma

Objective and subjective comparison of virtual monoenergetic vs. polychromatic images in patients with pancreatic ductal adenocarcinoma

Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

Improvement of image quality of laryngeal squamous cell carcinoma using noise‐optimized virtual monoenergetic image and nonlinear blending image algorithms in dual‐energy computed tomography

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