Could Spectral CT Have a Potential Benefit in Coronavirus Disease (COVID-19)?

Daoud, B.; Cazejust, J.; Tavolaro, Sebastian; Durand, Sebastien; Pommier, Romain; Hamrouni, Adel; Bornet, Grégoire

doi:10.2214/ajr.20.23546

Cited by 18 publications

(14 citation statements)

References 9 publications

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“…In clinical practice, ED has been used for optimizing the dose distribution in radiotherapy rather than for diagnostic purpose. Recently, Daoud et al [14] have shown the potential benefit of ED in detecting lung lesions. ED images can improve the visualization of lung parenchymal lesions compared to conventional CT in patients with COVID-19 pneumonia [14].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Daoud et al [14] have shown the potential benefit of ED in detecting lung lesions. ED images can improve the visualization of lung parenchymal lesions compared to conventional CT in patients with COVID-19 pneumonia [14]. In the present study, ED images derived from an unenhanced DECT clearly depicted PE, which could not be detected on conventional CT images.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of Pulmonary Embolism in Unenhanced Dual Energy CT Using an Electron Density Image

Bae

Jeon

2021

Diagnostics

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Dual-energy computed tomography (CT) is a promising tool, providing both anatomical information and material properties. Using spectral information such as iodine mapping and virtual monoenergetic reconstruction, dual-energy CT showed added value over pulmonary CT angiography in the diagnosis of pulmonary embolism. However, the role of non-contrast-enhanced dual energy CT in pulmonary embolism has never been reported. Here, we report a case of acute pulmonary embolism detected on an electron density image from an unenhanced dual-energy CT using a dual-layer detector system.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnosis of Pulmonary Embolism in Unenhanced Dual Energy CT Using an Electron Density Image

Bae

Jeon

2021

Diagnostics

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“…ED images showed much better NPV than SC and VNCa images in assessments by readers 1 and 3. Thus, ED maps may have the potential to improve the detection of any structure or disease for visualization of different mass densities in diagnostic radiology [ 8 , 18 ]. In our experience, the costal cartilage as well as the intervertebral discs was well-observed on ED images.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, single-source dual-layer DECT provides a more accurate ED map without conversion to HU as a calibration-free method [ 7 ]. It allows ED imaging by differentiation of Compton scattering and photoelectric effect attenuation through measurement of attenuation at two different energies [ 8 ]. Compton scattering is influenced mainly by the material density, while the ED is dependent on Compton scattering in the high-energy range, such as in radiation therapy [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Compton scattering is influenced mainly by the material density, while the ED is dependent on Compton scattering in the high-energy range, such as in radiation therapy [ 9 , 10 ]. Despite the broad use of ED maps for the calculation of radiation doses in radiation oncology, this technique has not been widely used in diagnostic radiology, with one case series reporting the use of ED images to visualize lung opacity in patients with COVID-19 pneumonia [ 8 ]. We hypothesize that ED maps may show better detectability of cervical disc herniation than SC and even VNCa images of DECT since the material density of the annulus fibrosus and fibrocartilage is higher than those of the other organs [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of electron-density dual-energy CT in detection of cervical disc herniation in comparison with standard gray-scale CT and virtual non-calcium images

et al. 2022

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Objectives To assess the diagnostic performance of dual-energy CT (DECT) with electron-density (ED) image reconstruction compared with standard CT (SC) and virtual non-calcium (VNCa) image CT reconstruction for detecting cervical disc herniation. Methods This cross-sectional study was approved by the IRB. We enrolled 64 patients (336 intervertebral discs from C2/3 to C7/T1; mean age, 55 years; 17 women and 47 men) who underwent DECT with spectral reconstruction and 3-T MRI within 2 weeks between January 2018 and June 2020. Four radiologists independently evaluated the first image set of randomized SC, VNCa, and ED images to detect cervical disc herniation. After 8 weeks, the readers re-evaluated the second and the last image sets with an 8-week interval. MRI evaluations performed by two other experienced served as the reference standard. Comparing diagnostic performance between each images set was evaluated by a generalized estimating equation. Results A total of 233 cervical disc herniations were noted on MRI. For detecting cervical disc herniation, electron-density images showed higher sensitivity (94% [219/233; 95% CI, 90–97] vs. 76% [177/233; 70–81] vs. 69% [160/233; 62–76]) ( p < 0.001) and similar specificity (90% [93/103; 83–95] vs. 89% [92/103; 82–96] vs. 90% [93/103; 83–95]) ( p > 0.05) as SC and VNCa images, respectively. Inter-reader agreement for cervical disc herniation calculated among the four readers was moderate for all image sets ( κ = 0.558 for ED, κ = 0.422 for SC, and κ = 0.449 for VNCa). Conclusion DECT with ED reconstruction can improve cervical disc herniation detection and diagnostic confidence compared with SC and VNCa images. Key Points • Intervertebral discs with high material density are well visualized on electron-density images obtained from dual-energy CT. • Electron-density images showed much higher sensitivity and diagnostic accuracy than standard CT and virtual non-calcium images for the detection of cervical disc herniation. • Electron-density images can have false-negative results, especially for disc herniation with high signal intensity on T2W images and can show pseudo-disc extrusion at the lower cervical spine. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08374-y.

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