Comparison of image quality and radiation dose between split-filter dual-energy images and single-energy images in single-source abdominal CT

Euler, André; Obmann, Markus M; Szücs-Farkas, Zsolt; Mileto, Achille; Zaehringer, Caroline; Falkowski, Anna L.; Winkel, David; Marin, Daniele; Stieltjes, Bram; Krauß, Bernhard; Schindera, Sebastian T.

doi:10.1007/s00330-018-5338-x

Cited by 46 publications

(22 citation statements)

References 25 publications

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“…A prior study by May et al, comparing dual-vs. single-source DECT in head and neck imaging (using the same scanner types as in our study), showed similar results to our study in terms of superior image quality of 3 rd generation dual-source CT [22]. Other prior split-filter investigations often use a study setting of "single-source split-filter vs. single-source standard protocol" and therefore only offer limited comparability to our study results [17,21]. To the best of our knowledge, this is the first study to compare the image quality of dual-energy CTPA from a single-source single-layer split-filter scanner vs. a state-ofthe-art (3 rd generation) dual-source CT-scanner.…”

Section: Discussionsupporting

confidence: 85%

“…In this study, we compared this technique with well-established dual-source DECT to assess the impact of a split-filter on both CTPA image quality and dual-energyderived pulmonary iodine distribution at the time point of imaging by means of iodine distribution maps. To date, only data regarding image quality and associated radiation exposure of split-filter protocols in abdominal as well as in head and neck imaging is available [17,[21][22][23]. A prior study by May et al, comparing dual-vs. single-source DECT in head and neck imaging (using the same scanner types as in our study), showed similar results to our study in terms of superior image quality of 3 rd generation dual-source CT [22].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism

Petritsch

Pannenbecker

Weng

et al. 2020

Rofo

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Purpose Comparison of dual-source dual-energy CT (DS-DECT) and split-filter dual-energy CT (SF-DECT) regarding image quality and radiation dose in patients with suspected pulmonary embolism. Materials and Methods We retrospectively analyzed pulmonary dual-energy CT angiography (CTPA) scans performed on two different CT scanners in 135 patients with suspected pulmonary embolism (PE). Scan parameters for DS-DECT were 90/Sn150 kV (n = 68 patients), and Au/Sn120 kV for SF-DECT (n = 67 patients). The iodine delivery rate was 1400 mg/s in the DS-DECT group vs. 1750 mg/s in the SF-DECT group. Color-coded iodine distribution maps were generated for both protocols. Objective (CT attenuation of pulmonary trunk [HU], signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR]) and subjective image quality parameters (two readers [R], five-point Likert scale), as well as radiation dose parameters (effective radiation dose, size-specific dose estimations [SSDE]) were compared. Results All CTPA scans in both groups were of diagnostic image quality. Subjective CTPA image quality was rated as good or excellent in 80.9 %/82.4 % (R1 / R2) of DS-DECT scans, and in 77.6 %/76.1 % of SF-DECT scans. For both readers, the image quality of split-filter iodine distribution maps was significantly lower (p < 0.05) with good or excellent ratings in only 43.3 %/46.3 % (R1 / R2) vs. 83.8 %/88.2 % for maps from DS-DECT. The HU values of the pulmonary trunk did not differ between the two techniques (p = n. s.), while both the SNR and CNR were significantly higher in the split-filter group (p < 0.001; p = 0.003). Both effective radiation dose (2.70 ± 1.32 mSv vs. 2.89 ± 0.94 mSv) and SSDE (4.71 ± 1.63 mGy vs. 5.84 ± 1.11 mGy) were significantly higher in the split-filter group (p < 0.05). Conclusion The split-filter allows for dual-energy imaging of suspected pulmonary embolism but is associated with lower iodine distribution map quality and higher radiation dose. Key points: Citation Format

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism

Petritsch

Pannenbecker

Weng

et al. 2020

Rofo

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“…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 ].…”

Section: Introductionmentioning

confidence: 99%

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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“…A potential disadvantage, as with other single-source approaches, is limited spectral separation that decreases the contrast-to-noise ratio. This problem can be minimized by the addition of monoenergetic images, which result in image quality similar to that of single-energy CT (9).…”

Section: Dual-energy Technologiesmentioning

confidence: 99%

Dual-Energy CT in Children: Imaging Algorithms and Clinical Applications

Siegel

Ramírez-Giraldo

2019

Radiology

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Dual-energy CT enables the simultaneous acquisition of CT images at two different x-ray energy spectra. By acquiring high-and low-energy spectral data, dual-energy CT can provide unique qualitative and quantitative information about tissue composition, allowing differentiation of multiple materials including iodinated contrast agents. The two dual-energy CT postprocessing techniques that best exploit the advantages of dual-energy CT in children are the material-decomposition images (which include virtual nonenhanced, iodine, perfused lung blood volume, lung vessel, automated bone removal, and renal stone characterization images) and virtual monoenergetic images. Clinical applications include assessment of the arterial system, lung perfusion, neoplasm, bowel diseases, renal calculi, tumor response to treatment, and metal implants. Of importance, the radiation exposure level of dual-energy CT is equivalent to or less than that of conventional single-energy CT. In this review, the authors discuss the basic principles of the dual-energy CT technologies and postprocessing techniques and review current clinical applications in the pediatric chest and abdomen.

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Comparison of image quality and radiation dose between split-filter dual-energy images and single-energy images in single-source abdominal CT

Cited by 46 publications

References 25 publications

Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism

Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism

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

Dual-Energy CT in Children: Imaging Algorithms and Clinical Applications

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