Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Thaiss, Wolfgang M.; Sauter, Alexander; Bongers, Malte; Horger, Marius; Nikolaou, Konstantin

doi:10.1016/j.ejrad.2015.06.001

Cited by 17 publications

(9 citation statements)

References 118 publications

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“…Moreover, Thaiss et al [20] reported that DE-CT and perfusion CT showed good agreement in terms of diagnosis and evaluation of therapy response. Although multiple studies have shown that there was a good agreement between DE-CT and contrast enhanced or perfusion CT scanning, [21] only a few of studies on the correlation between parameters from DE-CT and DI-PCT in lung cancer patients have been reported.…”

Section: Discussionmentioning

confidence: 99%

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Chen

Duan

et al. 2017

Medicine

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To investigate the potential relationship between perfusion parameters from first-pass dual-input perfusion computed tomography (DI-PCT) and iodine uptake levels estimated from dual-energy CT (DE-CT).The pre-experimental part of this study included a dynamic DE-CT protocol in 15 patients to evaluate peak arterial enhancement of lung cancer based on time-attenuation curves, and the scan time of DE-CT was determined. In the prospective part of the study, 28 lung cancer patients underwent whole-volume perfusion CT and single-source DE-CT using 320-row CT. Pulmonary flow (PF, mL/min/100 mL), aortic flow (AF, mL/min/100 mL), and a perfusion index (PI = PF/[PF + AF]) were automatically generated by in-house commercial software using the dual-input maximum slope method for DI-PCT. For the dual-energy CT data, iodine uptake was estimated by the difference (λ) and the slope (λHU). λ was defined as the difference of CT values between 40 and 70 KeV monochromatic images in lung lesions. λHU was calculated by the following equation: λHU = |λ/(70 − 40)|. The DI-PCT and DE-CT parameters were analyzed by Pearson/Spearman correlation analysis, respectively.All subjects were pathologically proved as lung cancer patients (including 16 squamous cell carcinoma, 8 adenocarcinoma, and 4 small cell lung cancer) by surgery or CT-guided biopsy. Interobserver reproducibility in DI-PCT (PF, AF, PI) and DE-CT (λ, λHU) were relatively good to excellent (intraclass correlation coefficient [ICC]Inter = 0.8726–0.9255, ICCInter = 0.8179–0.8842; ICCInter = 0.8881–0.9177, ICCInter = 0.9820–0.9970, ICCInter = 0.9780–0.9971, respectively). Correlation coefficient between λ and AF, and PF were as follows: 0.589 (P < .01) and 0.383 (P < .05). Correlation coefficient between λHU and AF, and PF were as follows: 0.564 (P < .01) and 0.388 (P < .05).Both the single-source DE-CT and dual-input CT perfusion analysis method can be applied to assess blood supply of lung cancer patients. Preliminary results demonstrated that the iodine uptake relevant parameters derived from DE-CT significantly correlated with perfusion parameters derived from DI-PCT.

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Section: Discussionmentioning

confidence: 99%

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Chen

Duan

et al. 2017

Medicine

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“…This is because VMI with low energy provides increased contrast enhancement of the pulmonary vessels even if the scan is not performed during the early enhancement phase (Fig. 2) (11,12). A recent study proved that VMI at 40 keV performed at a delayed phase (60 seconds after contrast media administration) was useful for the evaluation of hilar LNs, showing the greatest contrast differences between the pulmonary vessels and LNs (13).…”

Section: Contrast Enhancementmentioning

confidence: 99%

Application of Dual-Energy Spectral Computed Tomography to Thoracic Oncology Imaging

Kim

Park

et al. 2020

Korean J Radiol

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Computed tomography (CT) is an important imaging modality in evaluating thoracic malignancies. The clinical utility of dual-energy spectral computed tomography (DESCT) has recently been realized. DESCT allows for virtual monoenergetic or monochromatic imaging, virtual non-contrast or unenhanced imaging, iodine concentration measurement, and effective atomic number (Zeff map). The application of information gained using this technique in the field of thoracic oncology is important, and therefore many studies have been conducted to explore the use of DESCT in the evaluation and management of thoracic malignancies. Here we summarize and review recent DESCT studies on clinical applications related to thoracic oncology.

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“…For example, if there is a density difference between a tumor and an atelectasis area but there is a fuzzy transition area between them, the tumor that cannot be clearly delineated is defined as undifferentiable. nodes and osteoblastic metastases (9,10) because MonoE with low keV provides an increased contrast-to-noise ratio (11) and contrast enhancement of vessels, even if the scan is not performed during the early enhancement phase (12). However, in other DESCTs, MonoE with too low keVs exhibits a high noise level and, consequently, an impaired image quality (13).…”

Section: Discussionmentioning

confidence: 99%

Application value of double-layer spectral detector CT in differentiating central lung cancer from atelectasis

Wen¹,

Zhao²,

Yin³

et al. 2022

Ann Palliat Med

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Background: Central lung cancer with obstructive atelectasis is very common in clinical practice.Determination of the tumor borderline is important. Conventional computed tomography (CT) alone may not be sufficiently accurate to distinguish central lung cancer from obstructive atelectasis. Spectral CT can improve the soft-tissue resolution greatly. In this study, we evaluated the application value of double-layer spectral detector CT in differentiating central lung cancer from atelectasis.Methods: A total of 51 patients (37 males) with pathologically confirmed central lung cancer accompanied by atelectasis were enrolled. The rates of differentiation between tumors and atelectasis were retrospectively analyzed using conventional CT and three types of spectral images (40 keV virtual monoenergetic imaging, iodine density map, and their fusion image) of unenhanced scans as well as arterial and venous phases.Cochran's Q test and Friedman test were used to compare the differentiation rates and the maximal diameters of the tumors in each image.Results: Among the 51 cases, conventional CT, 40 keV monoenergetic, iodine density, and their fusion images of the venous phase were successful in differentiating tumors from atelectasis in 17 (33.33%), 35 (68.63%), 39 (76.47%), and 38 (74.51%) cases, respectively. The differentiation rates of the 40 keV monoenergetic, iodine density, and fusion images were significantly higher than those of conventional images (χ 2 =−0.35, −0.43, and −0.41, respectively, all P<0.001). There were no significant differences in the differentiation rates among the 40 keV monoenergetic, iodine density, and fusion images (χ 2 =−0.06, −0.08, 0.02, respectively, all P=1.00). The maximal tumor diameters in the four images did not significantly differ (χ 2 =3.61, P=0.31). Conventional and spectral images of unenhanced and arterial phases could not/barely identify the tumor borderlines.Conclusions: Venous-phase spectral images of double-layer spectral detector CT can differentiate most central lung cancers from atelectasis, and the maximal diameter measurement of the tumor is reliable. Double-layer spectral detector CT can accurately identify the borderlines of most central lung cancers through spectral images during routine CT examinations without requiring other imaging modalities.Therefore, this method has considerable clinical value for applications in tumor staging, efficacy evaluation, and radiotherapy.

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Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Cited by 17 publications

References 118 publications

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Application of Dual-Energy Spectral Computed Tomography to Thoracic Oncology Imaging

Application value of double-layer spectral detector CT in differentiating central lung cancer from atelectasis

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