First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: a feasibility experiment using joint aspiration as a reference

Diekhoff, Torsten; Ziegeler, Katharina; Feist, Eugen; Kiefer, Tobias; Mews, Jürgen; Hamm, Bernd; Hermann, Kay-Geert A.

doi:10.1007/s00256-015-2204-7

Cited by 20 publications

(12 citation statements)

References 22 publications

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“…Recently, a raw-data-based monochromatic imaging technique was introduced on 320-row CT scanners (12). Previous studies reported that monochromatic high keV images are useful for metal artifact reduction (13,14).…”

Section: Introductionmentioning

confidence: 99%

“…Dual-energy CT-based monochromatic imaging and a dedicated metal artifact reduction algorithm are the principal artifact reduction techniques (10,11). Recently, a raw-data-based monochromatic imaging technique was introduced on 320-row CT scanners (12). Previous studies reported that monochromatic high keV images are useful for metal artifact reduction (13,14).…”

Section: Introductionmentioning

confidence: 99%

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CT venography after knee replacement surgery: comparison of dual-energy CT-based monochromatic imaging and single-energy metal artifact reduction techniques on a 320-row CT scanner

Kidoh

Utsunomiya

Oda

et al. 2017

Acta Radiologica Open

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BackgroundAn optimal metal artifact reduction (MAR) technique is needed for a reliable and accurate image-based diagnosis.PurposeUsing a 320-row scanner, we compared the dual-energy computed tomography (CT)-based monochromatic and the single-energy metal artifact reduction (SEMAR) techniques for CT venography (CTV) to identify the better imaging method for diagnosing deep vein thrombosis (DVT) in patients who had undergone knee replacement surgery.Material and MethodsTwenty-three consecutive patients with suspected DVT after unilateral knee replacement surgery underwent dual-energy CT (135/80 kVp). Monochromatic images of 35–135 keV were generated; the monochromatic image with the best signal-to-noise ratio (SNR) of the popliteal vein near the metal prosthesis were selected. The projection data of 80 kVp were reconstructed using MAR algorithm. The mean SNR ON MAR and the best SNR ON monochromatic images were compared. Two radiologists evaluated visualization of the metal artifacts on a four-point scale where 1 = extensive artifacts, 2 = strong artifacts, 3 = mild artifacts, and 4 = minimal artifacts.ResultsThe mean SNR was significantly higher on the MAR than the monochromatic images (12.8 ± 4.7 versus 7.7 ± 5.1, P < 0.01) and the visual scores were significantly higher for MAR than monochromatic images (2.6 ± 0.8 versus 1.3 ± 0.4, P < 0.01).ConclusionFor CTV after knee replacement surgery, the MAR technique is superior to the monochromatic imaging technique.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CT venography after knee replacement surgery: comparison of dual-energy CT-based monochromatic imaging and single-energy metal artifact reduction techniques on a 320-row CT scanner

Kidoh

Utsunomiya

Oda

et al. 2017

Acta Radiologica Open

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“…The low-and high-energy data model tissue as a function of either two or three basis materials consisting of at least one low-atomic-number material and one highatomic-number material (eg, soft tissue and iodine). There are six commercially available DE CT acquisition schemes (2,7), including dual-source (8), rapid peak kilovoltage switching (9), dual-layered detector (10), split-filter (11), and sequential scanning (12) systems.…”

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confidence: 99%

Dual-Energy CT: Lower Limits of Iodine Detection and Quantification

et al. 2019

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Background: Assessments of the quantitative limitations among the six commercially available dual-energy (DE) CT acquisition schemes used by major CT manufacturers could aid researchers looking to use iodine quantification as an imaging biomarker.Purpose: To determine the limits of detection and quantification of DE CT in phantoms by comparing rapid peak kilovoltage switching, dual-source, split-filter, and dual-layer detector systems in six different scanners. Materials and Methods:Seven 50-mL iohexol solutions were used, with concentrations of 0.03-2.0 mg iodine per milliliter. The solutions and water sample were scanned five times each in two phantoms (small, 20-cm diameter; large, 30 3 40-cm diameter) with six DE CT systems and a total of 10 peak kilovoltage settings or combinations. Iodine maps were created, and the mean iodine signal in each sample was recorded. The limit of blank (LOB) was defined as the upper limit of the 95% confidence interval of the water sample. The limit of detection (LOD) was defined as the concentration with a 95% chance of having a signal above the LOB. The limit of quantification (LOQ) was defined as the lowest concentration where the coefficient of variation was less than 20%. Results:The LOD range was 0.021-0.26 mg/mL in the small phantom and 0.026-0.55 mg/mL in the large phantom. The LOQ range was 0.07-0.50 mg/mL in the small phantom and 0.20-1.0 mg/mL in the large phantom. The dual-source and rapid peak kilovoltage switching systems had the lowest LODs, and the dual-layer detector systems had the highest LODs. Conclusion:The iodine limit of detection using dual-energy CT systems varied with scanner and phantom size, but all systems depicted iodine in the small and large phantoms at or below 0.3 and 0.5 mg/mL, respectively, and enabled quantification at concentrations of 0.5 and 1.0 mg/mL, respectively.

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“…Besides the study design, this false-positive result may be due to the quantity of the CPPD crystals that could be below the detection limit of DECT. A previous phantom study showed that single source DECT allowed reliable detection of CPPD crystals at concentrations of 6.25% or higher [ 17 ]. In the current study DECT detected CPPD crystals in a patient with severe osteoarthritis, although microscopic analysis did not found CPPD crystals in her joint fluid.…”

Section: Discussionmentioning

confidence: 99%

“…In general, x-rays having a different energy of the emitted photons are absorbed differently and therefore differ in attenuation in CT scans acquired with high or low tube voltage. Thus, a dual-energy gradient can be calculated, which characterizes this differing x-ray interaction and is relatively specific for a given material [ 14 – 17 ]. Recent studies reported that DECT was able to distinguish CPPD crystals from uric acid crystals and was useful to diagnose CPPD deposition disease, especially when crystal examination was not available or radiography was not easily interpretable [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography

Tanikawa¹,

Ogawa

Okuma

et al. 2018

J Orthop Surg Res

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BackgroundCalcium pyrophosphate dihydrate (CPPD) crystals are commonly observed in osteoarthritic joints. The aim of our study was to investigate the efficacy of a dual-energy computed tomography (DECT) for detecting CPPD crystals in knee meniscus.MethodsTwenty-six patients undergoing primary total knee arthroplasty were included in the study. Radiographs of knee joint and synovial fluid specimens were analyzed for the presence of CPPD crystals. Meniscus extracted during surgery was scanned using DECT. Sensitivity and specificity of DECT and radiograph for detecting CPPD crystals were calculated against a reference standard (polarizing light microscopy of synovial fluid aspirate). Meniscus in which CPPD crystals were suspected with DECT was further examined to confirm the crystals using a polarized microscopy.ResultsCPPD crystals in synovial fluid were observed in 9 (36%) patients. The sensitivity and specificity of DECT in the detection of CPPD crystals, against microscopic identification, were 77.8 and 93.8%, respectively. The sensitivity and specificity of conventional radiography in the detection of CPPD crystals were 44.4 and 100%, respectively. DECT was able to detect the area where CPPD crystals were deposited in the meniscus.ConclusionDECT provides good diagnostic sensitivity and specificity for detection of CPPD crystals in knee meniscus as well as spatial information about CPPD crystals. DECT is currently a research tool, but we believe that DECT can be a useful instrument to diagnose CPPD deposition disease, especially for the regions where aspiration is difficult to be performed such as pubic symphysis, atlantoaxial joint, interphalangeal joint.

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First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: a feasibility experiment using joint aspiration as a reference

Abstract: This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future.

Cited by 20 publications

References 22 publications

CT venography after knee replacement surgery: comparison of dual-energy CT-based monochromatic imaging and single-energy metal artifact reduction techniques on a 320-row CT scanner

CT venography after knee replacement surgery: comparison of dual-energy CT-based monochromatic imaging and single-energy metal artifact reduction techniques on a 320-row CT scanner

Dual-Energy CT: Lower Limits of Iodine Detection and Quantification

Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography

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