The assessment of intracranial bleeding with virtual unenhanced imaging by means of dual-energy CT angiography

Ferda, Jiří; Novák, Milan; Mírka, Hynek; Baxa, Jan; Ferdová, Eva; Bednářová, Alena; Flohr, Thomas; Schmidt, Bernhard; Klotz, Ernst; Kreuzberg, Boris

doi:10.1007/s00330-009-1495-2

Cited by 74 publications

(47 citation statements)

References 9 publications

(14 reference statements)

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“…4), and Gupta et al (23) have reported sensitivity, specificity and accuracy values of >90% for the detection of a hemorrhage on contrast-enhanced CT images that were acquired from 18 patients using dual-energy. Ferda et al (24) have used the same technique and reported similar findings in 25 patients, but the contrast-to-noise ratio of the virtual non-contrast images was lower than that of conventional noncontrast images. In addition, the use of virtual non-contrast images has been reported for the diagnosis of a lipiodol embolism after hepatocellular carcinoma chemoembolization (25).…”

Section: Neuroradiological Applicationsmentioning

confidence: 82%

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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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Section: Neuroradiological Applicationsmentioning

confidence: 82%

“…They also allow the removal of bone and calcium from the carotid and brain CTA (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Section: Neuroradiological Applicationsmentioning

confidence: 99%

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

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

146

127

View full text Add to dashboard Cite

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“…Very few studies were performed on the detection of intracranial bleeding. 8 Our study focused on evaluating the value of VNC images in diagnosing SAH. Compared with the previous studies, the present study had the following advantages: First, only SAH was studied and discussed in this study, while the previous studies discussed SAH, combining intracerebral and subdural bleeding, which was easier to detect on VNC images.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, few studies have compared VNC and TNC images in SAH. 8 The purpose of our study was to assess the utility of VNC images obtained from dual-energy CTA for diagnosing SAH compared with TNC images.…”

mentioning

confidence: 99%

Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage

Jiang¹,

Zhang

Xie

et al. 2015

AJNR Am J Neuroradiol

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“…[3][4][5] This discrimination is based on the differences between the photoelectric and Compton scattering components underlying the x-ray attenuation of hemorrhage and iodine. Because both phenomena are dependent on the x-ray photon energy, one can discriminate the pixel attenuation arising from these 2 effects by scanning at 2 different energy levels, such as 80kV and 140kV.…”

mentioning

confidence: 99%

Differentiation of Hemorrhage from Iodinated Contrast in Different Intracranial Compartments Using Dual-Energy Head CT

Phan

Yoo²,

Hirsch³

et al. 2012

AJNR Am J Neuroradiol

175

114

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BACKGROUND AND PURPOSE:Identification of ICH, particularly after ischemic stroke therapy, is important for guiding subsequent antithrombotic management and is often confounded by contrast staining or extravasations within intracerebral or extra-axial compartments. This study evaluates the accuracy of DECT in distinguishing ICH from iodinated contrast in patients who received contrast via IA or IV delivery.

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The assessment of intracranial bleeding with virtual unenhanced imaging by means of dual-energy CT angiography

Cited by 74 publications

References 9 publications

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

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

Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage

Differentiation of Hemorrhage from Iodinated Contrast in Different Intracranial Compartments Using Dual-Energy Head CT

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