Preliminary study on the differentiation between parapelvic cyst and hydronephrosis with non-calculous using only pre-contrast dual-energy spectral CT scans

Han, Dong; Ma, Genshan; Wei, Lequn; Ren, Chao; Zhou, Jieli; Shen, Chen; He, Tao

doi:10.1259/bjr.20160632

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Unlike conventional CT imaging, spectral CT acquisition is a novel imaging technique which generates monochromatic and material decomposition images[ 19 ]. On the other hand, using fast kilovoltage switching between high and low tube voltages (140 kVp and 80 kVp) in a single X-ray tube in less than 0.5ms coupled with a high-performance gemstone detector and powerful image post-processing [ 10 , 20 ], spectral CT generates both material decomposition images and a set of monochromatic images with energy levels from 40-140keV. The creation of monochromatic image sets not only improves the low contrast resolution in comparison with the polychromatic images[ 10 ], but also provides the ability to select energy levels where the two types of effusions exhibit the greatest difference in CT values.…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT

et al. 2018

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PurposeTo investigate the value of spectral CT in the differential diagnosis of benign from malignant pleural effusion.Method and materials14 patients with benign pleural effusion and 15 patients with malignant pleural effusion underwent non-contrast spectral CT imaging. These patients were later verified by the combination of disease history, clinical signs and other information with the consensus of surgeons and radiologists. Various Spectral CT image parameters measured for the effusion were as follows: CT numbers of the polychromatic 140kVp images, monochromatic images at 40keV and 100keV, the material density contents from the water, fat and blood-based material decomposition images, the effective atomic number and the spectral curve slope. These values were statistically compared with t test and logistic regression analysis between benign and malignant pleural effusion.ResultsThe CT value of benign and malignant pleural effusion in the polychromatic 140kVp images showed no differences (12.61±3.39HU vs. 14.71±5.03HU) (P>0.05), however, they were statistically different on the monochromatic images at 40keV (43.15±3.79 vs. 39.42±2.60, p = 0.005) and 100keV (9.11±1.38 vs. 6.52±2.04, p<0.001). There was difference in the effective atomic number value between the benign (7.87±0.08) and malignant pleural effusion (7.90±0.02) (P = 0.02). Using 6.32HU as the threshold for CT value measurement at 100keV, one could obtain sensitivity of 100% and specificity of 66.7% with area-under-curve of 0.843 for differentiating benign from malignant effusion. In addition, age and disease history were potential confounding factors for differentiating malignant pleural effusion from benign, since the older age (61.13±12.51 year-old vs48.57±12.33 year-old) as well as longer disease history (70.00±49.28 day vs.28.36±21.64 day) were more easily to be found in the malignant pleural effusion group than those in the benign pleural effusion group. By combining above five factors, one could obtain sensitivity of 100% and specificity of 71.4% with area-under-curve of 0.933 for differentiating benign from malignant effusion.ConclusionThe CT value measurement at both high and low energy levels and the effective atomic number obtained in a single spectral CT scan can assist the differential diagnosis of benign from malignant pleural effusion.Combining them with patient age and disease history can further improve diagnostic performance.Clinical relevance/ApplicationClinical findings and Spectral CT imaging can provide significant evidences about the nature of pleural effusion.

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confidence: 99%

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT

et al. 2018

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“…CT Scan Urography is an examination used to detect various diseases in the area of the urinary system including tumors, hematuria, renal calculi, cysts to hydronephrosis [1]- [6]. The procedure for CT urography examination is quite varied depending on the standard of the equipment, the setting of the instrument parameters, the protocol or standard of the examination procedure and the policies of the institution [7].…”

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confidence: 99%

An Innovation of Black Tea as a Substitute for the Use of Positive Contrast Media in CT Urography in Hydronephrosis Cases: Case Study

Wati¹,

Istiqomah²,

Salsabila³

et al. 2023

AMM

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The use of contrast media on CT scans needs to be done to see the urinary tract clearly. Contrast media itself has side effects that can harm patients if they have allergies. The purpose of this study was to determine if black tea can be used as a natural contrast medium to replace iodine contrast media in CT urography. This study used a case study method by observing a patient diagnosed with hydronephrosis who underwent CT urography. Prior to the examination, the patient had drunk 600 ml of black tea. Examination using CT Scan GE Revolution ACT 32 slices with axial, coronal and sagittal images. The results of the image are then taken to a radiologist and a radiographer to assess the image quality and anatomical clarity in the form of an interview. The results showed that the patient drank 600 ml of plain black tea on a CT-Scan urography examination in cases of Hydronephrosis could open or clarify the ureteral tract, making it easier for doctors to read out radiographs. The use of tea was able to reveal the ureteral groove and facilitate tracking. Black tea with natural ingredients has the opportunity to be a substitute for iodine contrast media which uses chemicals in CT Urography so as to reduce the potential for allergies and side effects to patients and is inexpensive. Studies related to the ratio of black tea and water can be carried out to obtain an optimal density value.

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“…The dual energy spectral CT can differentiate between material densities by two different energies; low and high-energy images [6]. Dual energy spectral imaging can produce virtual monoenergetic images (40-140 keV) that reduce the beam hardening artifact that affects the CT number and provides a more accurate CT attenuation value than the conventional polychromatic X-ray [7,8]. Many thousands of dual-energy spectral chest CT scans have been performed each year in our hospital.…”

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Dual-energy spectral CT in assessment of pleural effusion

Muang-im,

Euathrongchit,

Tantraworasin

et al. 2022

ASEAN J Radiol

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Background: Pleural effusion is a common clinical problem. The ability to differentiate between benign and malignant pleural effusions has many clinical benefits. However, few studies have investigated the diagnostic value of dual-energy spectral computed tomography (DECT) in pleural effusion. Objective: To evaluate the diagnostic values of DECT for assessment of pleural effusion. Materials and Methods: We retrospectively analyzed data from 87 patients presenting with pleural effusion who underwent chest DECT from October 2019 to November 2020. Two reviewers blindly reviewed the CT images of pleural effusion in consensus. The pleural fluid attenuation in standard conventional CT images and monoenergetic images, at 40 keV, 100 keV and 140 keV, were recorded. Data pertaining to the effective atomic number, the iodine concentration (IC)and associated CT findings including pleural thickening, pleural nodules and extrapleural fat clouding was analyzed. Results: Of 87 patients, 44 were presented with benign effusions and the remaining 43 were presented with malignancy.There were no statistically significant differences in differentiating between benign and malignant pleural effusions by using the attenuation values, the effective atomic number or the IC. Irregular pleural thickening and pleural nodules were detected statistically significant in the patients with malignant pleural effusions with moderate accuracy, (48.83%; p < 0.01; AuROC 0.7103 and 34.88%; p < 0.01; AuROC 0.654 respectively). Conclusion: DECT attenuation values did not show any reliable clinical value in the differentiation between benign and malignant pleural effusions. The presence of pleural nodules or irregular pleural thickening would suggest malignant pleural effusion with moderate accuracy.

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Preliminary study on the differentiation between parapelvic cyst and hydronephrosis with non-calculous using only pre-contrast dual-energy spectral CT scans

Cited by 5 publications

References 22 publications

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT

An Innovation of Black Tea as a Substitute for the Use of Positive Contrast Media in CT Urography in Hydronephrosis Cases: Case Study

Dual-energy spectral CT in assessment of pleural effusion

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