Dual-Energy and Dual-Source CT: Is There a Role in the Abdomen and Pelvis?

Fletcher, Joel G.; Takahashi, Naoki; Hartman, Robert P.; Guimarães, Luís; Huprich, James E.; Hough, David M.; Yu, Lifeng; McCollough, Cynthia H.

doi:10.1016/j.rcl.2008.10.003

Cited by 154 publications

(103 citation statements)

References 12 publications

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“…The recent introduction of dual-source CT (DSCT) systems has re-enlivened DECT for various clinical indications [9][10][11][12][13][14][15][16][17], owing to the simultaneous data acquisition of two X-ray tube-detector systems at two different X-ray spectra.…”

Section: Discussionmentioning

confidence: 99%

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

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PURPOSE: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). MATERIALS AND METHODS: 70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140 kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140 kV ratio was calculated. RESULTS: All intra-and interobserver agreements were excellent (r = 0.93-0.97; p < 0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p < 0.05; average increase, 12.5 +/-3.6HU), while the ratios remained similar (each, p > 0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p < 0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p < 0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p < 0.05). CONCLUSION: DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80 kV and 140 kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.Dual-Energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study 1 Abstract Purpose: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). Materials and Methods:70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140kV ratio was calculated.Results: All intra-and interobserver agreements were excellent (r=0.93-0.97; p<0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p<0.05; average increase, 12.5±3.6HU), while the ratios remained similar (each, p>0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p<0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p<0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p<0.05). Conclusion:DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80kV and 140kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.

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Section: Discussionmentioning

confidence: 99%

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

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“…The use of dual-energy has revealed that 80-kVp images demonstrate a better image contrast than do 140-kVp images (15,20,(86)(87)(88). This phenomenon appears to be useful for the evaluation of enhanced liver lesions in the arterial phase in hepatocellular carcinoma and in hypervascular liver metastases.…”

Section: Gastrointestinal and Abdominal Applicationsmentioning

confidence: 99%

“…2) (19,20). Using 64-MDCT with fast kVp switching, the GSI dataset is loaded on the workstation, and water (virtual non-contrast), iodine, and monochromatic images in addition to spectral data can be obtained using the desired kiloelectron voltage (from 40 to 140 keV) (Fig.…”

mentioning

confidence: 99%

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

146

127

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A lthough dual-energy CT (DECT) was first conceived in 1976, it has not been used widely for clinical indications (1-11). Recently, the simultaneous acquisition of dual-energy data has been introduced using multidetector CT (MDCT) with two X-ray tubes and rapid peak kilovoltage (kVp) switching (gemstone spectral imaging, GSI) (12-16). Two major advantages of DECT are material decomposition by the almost simultaneous acquisition of two image series with different kVp (80 and 140 kVp) and the elimination of misregistration artifacts. In general, noncontrast (unenhanced) images can be avoided by using the dual-energy mode for body and neurological applications; iodine can be removed from the image, and a virtual non-contrast (water) image can be acquired. The major advantage of 80-kVp compared to 140-kVp images is a higher image contrast (Fig. 1). Hounsfield unit measurements on DECT are not absolute and can change depending on the kVp used for the acquisition (at different keV). Typically, a combination of 80/140 kVp is used for DECT, but for some applications, 100/140 kVp is preferred. In this study, we summarized the clinical applications of DECT in the brain, chest and abdomen and in the cardiovascular and musculoskeletal systems (Table 1). Technique and principlesThe basic principle of dual-energy is the acquisition of 2 datasets from the same anatomic location with different kVp (usually 80 and 140 kVp) (1,2,17,18). In the early days of CT, consecutive single-slice acquisitions with different kVp were performed as a dual-energy technique, but this method suffered from breathing and partial volume artifacts (1, 2). At present, an entire body can be scanned within seconds using the DECT technique, and thus, misregistration artifacts due to breathing are eliminated.Currently, three systems are capable of the nearly simultaneous acquisition of dual-energy data during a single breath hold (12, 14, 15): 64-slice dual-source CT (Definition, Siemens Medical Systems; Erlangen, Germany), 128-slice dual-source CT (Definition Flash, Siemens Medical Systems) and high-definition 64-MDCT (Discovery 750 HD, GE Healthcare; Milwaukee, Wisconsin, USA). In the two systems available from Siemens, the two tubes (tubes A and B) use different kVp (80 and 140 kVp), and in 64-MDCT, the kVp switches from 80 to 140 kVp in less than 0.5 ms. In dual systems, there is concern regarding the susceptibility of the system to cardiac motion due to the time difference (75 or 83 ms) between the tube A and tube B acquisitions of the dual-energy data, but the dual-source CT and 64-MDCT have not been compared to evaluate this issue. The technical specifications of the DECT systems are summarized in Table 2.The images presented in this article were acquired using a 64-slice dual source CT (Definition, Siemens Medical Systems) and a 64-MDCT (Discovery 750HD, GE Healthcare). The DECT data acquired by both systems can be evaluated with a dedicated workstation using dual-energy software that ABSTRACT Although dual-energy CT (DECT) was first conceived in ...

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“…Such evaluation strategies have dominated tumor detection and characterization, including assessment of solid and cystic liver, pancreatic and renal tumors. Evolving data also suggests improved quantitation of lesion behavior and response to therapy based on the ability to better visualize contrast enhancement and tissue characteristics, and also measure iodine dynamics and concentration [5][6][7].…”

Section: Overview Of Abdominal Usementioning

confidence: 99%

Dual Energy CT Application in the Abdomen

Bolus

2013

Curr Radiol Rep

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The evolution of dual energy computed tomography (DECT) and associated clinical advances continue to permeate the landscape of abdominal imaging. This article reviews general topics and recent contributions pertinent to progressive clinical implementation of this technology. Recent studies underscore the recognition of the dependence of the Hounsfield unit (HU) on keV and the resultant need for the translation of traditional diagnostic criteria. Similarly, critical assessment of virtual unenhanced imaging and its potential to replace true non-contrast imaging has been reflected in a number of studies that explore this critical radiation dose control function. The introduction of novel protocols includes the use of biphasic contrast technique, which, coupled with material discrimination, highlight capabilities unique to the DECT technique.

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Dual-Energy and Dual-Source CT: Is There a Role in the Abdomen and Pelvis?

Cited by 154 publications

References 12 publications

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Dual Energy CT Application in the Abdomen

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