Improved Detection of Endoleaks in Virtual Monoenergetic Images in Dual-Energy CT Angiography Following EVAR

Kazimierczak, Wojciech; Kazimierczak, Natalia; Lemanowicz, Adam; Nowak, Ewa; Migdalski, Arkadiusz; Jawień, Arkadiusz; Jankowski, Tomasz; Serafin, Zbigniew

doi:10.1016/j.acra.2023.03.018

Cited by 10 publications

(15 citation statements)

References 48 publications

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“…keV VMI to enhance the endoleak detection e ciency. In a recent study in 2023, Kazimierczak et al 19 showed a high diagnostic value of 40-keV VMIs in endoleak detection, exceeding LB reconstructions. Our results clearly show that despite lower CNR levels, both subjective and overall image quality and endoleak conspicuity ratings were higher for 60 keV compared to 40 keV reconstructions.…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, a series of studies indicate the usefulness of 60 keV reconstructions in angiographic studies, which on one hand show high contrast attenuation, and on the other hand, acceptable image noise levels, resulting in high CNR and SNR values [44][45][46] . Both chosen reconstructions have already proven high image quality parameters in angiographic studies, as well as in endoleak detection [17][18][19][20][21][22] . In a study by Maturen et al 17 , 55 keV VMIs had higher endoleak conspicuity ratings compared to VMI 75 keV.…”

Section: Discussionmentioning

confidence: 99%

“…The objective and subjective image quality parameters were signi cantly higher for ASIR and DLM reconstructions than for standard VMIs. As indicated before, low-energy VMIs have great potential for DECTA endoleak detection [17][18][19][20][21] , and noise-optimized reconstructions allow for either improved endoleak conspicuity 18 or signi cant radiation dose reduction while maintaining image quality 47,48 . Martin et al 18 investigated the image quality parameters and diagnostic accuracy of VMI and noiseoptimized VMI reconstructions for endoleak detection.…”

Section: Discussionmentioning

confidence: 99%

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Enhanced Visualization in Endoleak Detection: A Comparative Analysis of Virtual Monoenergetic Imaging and Advanced Reconstruction Techniques

Kazimierczak,

Wilamowska

et al. 2023

Preprint

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To assess the image quality parameters of dual-energy computed tomography angiography (DECTA) 40-, and 60 keV virtual monoenergetic images (VMIs) combined with deep learning-based image reconstruction model (DLM) and adaptive statistical iterative reconstructions (ASIR). CT scans of 28 post EVAR patients were enrolled. The 60 s delayed phase of DECTA was evaluated. Objective (noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR)) and subjective (overall image quality and endoleak conspicuity – 3 blinded readers assessment) image quality analyses were performed. The following reconstructions were evaluated: VMI 40,60 keV VMI; ASIR VMI 40,60 keV; DLM VMI 40,60 keV. The noise level of the DLM VMI images was approximately 50% lower than that of VMI reconstruction. The highest CNR and SNR values were measured in VMI DLM images. The mean CNR in endoleak in 40 keV was accounted for as 1.83 ± 1.2; 2.07 ± 2.02; 3.6 ± 3.26 in VMI, VMI ASIR, and VMI DLM, respectively. The DLM algorithm significantly reduced noise and increased lesion conspicuity, resulting in higher objective and subjective image quality compared to other reconstruction techniques. The application of DLM algorithms to low-energy VMIs significantly enhances the diagnostic value of DECTA in evaluating endoleaks. DLM reconstructions surpass traditional VMIs and ASIR in terms of image quality.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Enhanced Visualization in Endoleak Detection: A Comparative Analysis of Virtual Monoenergetic Imaging and Advanced Reconstruction Techniques

Kazimierczak,

Wilamowska

et al. 2023

Preprint

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“…This noise represents the denominator of the SNR and CNR equations, and so decreasing noise will increase conspicuity. Conventionally, low-energy monoenergetic reconstructions are thought to have the highest CNR but a low SNR in the context of increased image noise [ 22 , 23 ]. Several research studies have indicated that the optimal SNR is achieved at lower keV, specifically within the range of 40-70 keV, depending on the body region and lower energy bin weighting [ 24 - 27 ].…”

Section: Discussionmentioning

confidence: 99%

Optimisation of virtual monoenergetic reconstructions for the diagnosis of pulmonary embolism using photon-counting detector computed tomography angiography

Chamberlin,

Toth,

Hinen

et al. 2024

Pol J Radiol

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PurposeComputed tomography (CT) pulmonary angiography is considered the gold standard for pulmonary embolism (PE) diagnosis, relying on the discrimination between contrast and embolus. Photon-counting detector CT (PCD-CT) generates monoenergetic reconstructions through energy-resolved detection. Virtual monoenergetic images (VMI) at low keV can be used to improve pulmonary artery opacification. While studies have assessed VMI for PE diagnosis on dual-energy CT (DECT), there is a lack of literature on optimal settings for PCD-CT-PE reconstructions, warranting further investigation.Material and methodsTwenty-five sequential patients who underwent PCD-CT pulmonary angiography for suspicion of acute PE were retrospectively included in this study. Quantitative metrics including signal-to-noise ratio (SNR) and contrast-to-noise (CNR) ratio were calculated for 4 VMI values (40, 60, 80, and 100 keV). Qualitative measures of diagnostic quality were obtained for proximal to distal pulmonary artery branches by 2 cardiothoracic radiologists using a 5-point modified Likert scale.ResultsSNR and CNR were highest for the 40 keV VMI (49.3 ± 22.2 and 48.2 ± 22.1, respectively) and were inversely related to monoenergetic keV. Qualitatively, 40 and 60 keV both exhibited excellent diagnostic quality (mean main pulmonary artery: 5.0 ± 0 and 5.0 ± 0; subsegmental pulmonary arteries 4.9 ± 0.1 and 4.9 ± 0.1, respectively) while distal segments at high (80-100) keVs had worse quality.Conclusions40 keV was the best individual VMI for the detection of pulmonary embolism by quantitative metrics. Qualitatively, 40-60 keV reconstructions may be used without a significant decrease in subjective quality. VMIs at higher keV lead to reduced opacification of the distal pulmonary arteries, resulting in decreased image quality.

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“…DECT allows reconstruction of Virtual Monoenergetic Images (VMIs) to enhance the contrast of intravascular iodine and surrounding tissues, improving the diagnostic value of the examination in terms of, e.g., assessment of vascular stenosis, detection of endoleaks, post-procedural assessment of thoracic aorta [ 9 , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ]. Use of monoenergetic reconstructions with low photon energies (40–60 keV) permits obtaining very high attenuation values associated with the properties of the K absorption curve characteristic of iodine [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

The value of metal artifact reduction and iterative algorithms in dual energy CT angiography in patients after complex endovascular aortic aneurysm repair

Kazimierczak,

Nowak,

Kazimierczak

et al. 2023

Heliyon

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Improved Detection of Endoleaks in Virtual Monoenergetic Images in Dual-Energy CT Angiography Following EVAR

Cited by 10 publications

References 48 publications

Enhanced Visualization in Endoleak Detection: A Comparative Analysis of Virtual Monoenergetic Imaging and Advanced Reconstruction Techniques

Enhanced Visualization in Endoleak Detection: A Comparative Analysis of Virtual Monoenergetic Imaging and Advanced Reconstruction Techniques

Optimisation of virtual monoenergetic reconstructions for the diagnosis of pulmonary embolism using photon-counting detector computed tomography angiography

The value of metal artifact reduction and iterative algorithms in dual energy CT angiography in patients after complex endovascular aortic aneurysm repair

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