Dual-energy-CT of hypervascular liver lesions in patients with HCC: investigation of image quality and sensitivity

Altenbernd, Jens; Heusner, Till A.; Ringelstein, Adrian; Ladd, Susanne C.; Forsting, Michael; Antoch, Gerald

doi:10.1007/s00330-010-1964-7

Cited by 102 publications

(58 citation statements)

References 30 publications

(40 reference statements)

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“…This approach has been widely used in the literature. Altenbernd et al [17] showed that low-kVp images of DECT datasets are more sensitive in detecting hypervascular liver lesions, than the weighted average 120 kVp image series, but with a decrease in subjective image quality. With the advent of iterative reconstructions, Marin et al [18,19] showed the advantage of using iterative reconstruction when low kV is used.…”

Section: Discussionmentioning

confidence: 99%

Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction

Botsikas

Barnaure

Terraz

et al. 2016

WJR

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Author contributions: Botsikas D designed and performed the research and wrote the paper; Barnaure I contributed to the analysis, provided clinical advice and supervised the report; Terraz S, Becker CD, Kalovidouri A and Montet X provided clinical advice and supervised the report.Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Geneva University Hospital.Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. ) and reconstructed with filtered back projection. The second group of 25 patients underwent a dual-energy CT at 80-140 kVp with iodixanol 270. The 80 kVp component of the second group was reconstructed iteratively (SAFIRE ® -Siemens). All hyperdense and hypodense hepatic lesions ≥ 5 mm were identified with both protocols. Aorta and portal vessels/liver parenchyma contrast to noise ratio (CNR) in arterial phase, hypervascular lesion/liver parenchyma CNR in arterial phase, hypodense lesion/ liver parenchyma CNR in portal and late phase were calculated in both groups. RESULTS: Aorta/liver and focal lesions altogether/liver CNR were higher for the second protocol (P = 0.0078 and 0.0346). Hypervascular lesions/liver CNR was not statistically different (P = 0.86). Hypodense lesion/liver CNR in the portal phase was significantly higher for the second group (P = 0.0107). Hypodense lesion/liver CNR in the late phase was the same for both groups (P = 0.9926). Core tip: The purpose of this retrospective study was to evaluate the efficiency of hepatic multidetector computed tomography (MDCT) with dynamic contrast enhancement using iodixanol 270 mg/mL and 80 kVp acquisitions reconstructed with sinogram affirmed iterative reconstruction in comparison with a standard protocol using Iohexol 350 mg/mL and 120 kVp acquisitions. MDCT imaging with 80 kVp with iterative reconstruction and iodixanol 270 yields equal or even better image quality. The proposed MDCT protocol with less iodine load and lower radiation dose may thus be applied for liver imaging in patients with impaired renal or cardiac function but also in the general population. CONCLUSION

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Section: Discussionmentioning

confidence: 99%

Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction

Botsikas

Barnaure

Terraz

et al. 2016

WJR

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“…17.1). In recent years, dual-energy and spectral CT technique has emerged, where the utilization of dual-source or polychromatic X-ray beams and the differential attenuation of such beams of different energies in tissues are applied to improve the detection of hypervascular hepatocellular carcinomas [14] or for the quantification of hepatic iron content [15]. However, dual-energy CT technology is still not widely employed in clinical practice despite potential merits, in part because of the post-processing time required to generate the appropriate images.…”

Section: Learning Objectivesmentioning

confidence: 99%

Focal Liver Lesions

Schima

Koh

Baron

2018

IDKD Springer Series

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“…By virtue of the nature of radiation attenuation, the contrast-to-noise ratio of HCCs in late arterial-phase images taken at 80-kVp can be better than those at 120-kVp, even though the overall noise level is higher in 80-kVp images than in 120-kVp images [28,29] (figs. 2, 3).…”

Section: ) Low-tube-voltage Ct Imagingmentioning

confidence: 99%

“…According to a previous study, these postprocessed image sets may improve evaluation of the therapeutic response of HCC to radiofrequency ablation and may also lead to lower radiation doses if precontrast CT scans can be replaced by virtual noncontrast images [36]. Given that iodinated contrast material provides greater X-ray attenuation at low tube voltage settings through an increased photoelectric effect, it is expected that low-kVp images of dual-energy datasets will be more sensitive than high-kVp images in detecting hypervascular liver lesions such as HCC, despite the higher noise levels [28]. As an alternative approach for improving detection of hypervascular HCC on CT, fused images can be created by blending the CT datasets obtained at different tube energies [37].…”

Section: ) Low-tube-voltage Ct Imagingmentioning

confidence: 99%

Recent Advances in CT and MR Imaging for Evaluation of Hepatocellular Carcinoma

et al. 2012

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Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Accurate diagnosis and assessment of disease extent are crucial for proper management of patients with HCC. Imaging plays a crucial role in early detection, accurate staging, and the planning of management strategies. A variety of imaging modalities are currently used in evaluating patients with suspected HCC; these include ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and angiography. Among these modalities, dynamic MRI and CT are regarded as the best imaging techniques available for the noninvasive diagnosis of HCC. Recent improvements in CT and MRI technology have made noninvasive and reliable diagnostic assessment of hepatocellular nodules possible in the cirrhotic liver, and biopsy is frequently not required prior to treatment. Until now, the major challenge for radiologists in imaging cirrhosis has been the characterization of small cirrhotic nodules smaller than 2 cm in diameter. Further technological advancement will undoubtedly have a major impact on liver tumor imaging. The increased speed of data acquisition in CT and MRI has allowed improvements in both spatial and temporal resolution, which have made possible a more precise evaluation of the hemodynamics of liver nodules. Furthermore, the development of new, tissue-specific contrast agents such as gadoxetic acid has improved HCC detection on MRI. In this review, we discuss the role of CT and MRI in the diagnosis and staging of HCC, recent technological advances, and the strengths and limitations of these imaging modalities.

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Dual-energy-CT of hypervascular liver lesions in patients with HCC: investigation of image quality and sensitivity

Abstract: Low-kVp images of dual-energy datasets are more sensitive in detecting hypervascular liver lesions. However, this increase in sensitivity goes along with a decrease in the subjective image quality of low-kVp images.

Cited by 102 publications

References 30 publications

Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction

Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction

Focal Liver Lesions

Recent Advances in CT and MR Imaging for Evaluation of Hepatocellular Carcinoma

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