Utility of dual energy computed tomography in the evaluation of infiltrative skeletal lesions and metastasis: a literature review

Tan, Martin; Lloyd, Thomas B.

doi:10.1007/s00256-022-04032-6

Cited by 11 publications

(5 citation statements)

References 48 publications

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“…The researchers found that spectral CT imaging, in this case, iodine-based and waterbased material decomposition images, provided improved lesion conspicuity and better visualization of small vessels [44]. Therefore, in the literature, we can find few studies describing the importance of spectral CT in various fields and anatomical regions, including the study of brain gliomas [45], liver fibrosis [46], urological [47] and gynecological tumors [48], spinal tophaceous gout [49,50], and many others [33,34,51].…”

Section: Discussionmentioning

confidence: 99%

Dual-Layer Spectral CT as Innovative Imaging Guidance in Lung Biopsies: Could Color-Coded Z-Effective Images Allow More Diagnostic Samplings and Biomarkers Information?

Piacentino,

Fontana,

Zorzetto

et al. 2023

JCM

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The aim of the study was to try to obtain more information on diagnostic samplings and biomarkers using dual-layer spectral CT in lung biopsies. Lung biopsies were performed by merging images obtained with CBCT with those from spectral CT to use them as functional guidance, experimenting with double sampling to determine the difference between the area with a higher Z-effective number and that with a lower Z-effective number. Ten patients with large lung lesions on spectral CT were selected and underwent percutaneous transthoracic lung mass biopsy. Technical success was calculated. The percentage of neoplastic, inflammatory, fibrotic, necrotic cells, or non-neoplastic lung parenchyma was reported. The possibility of carrying out immunohistochemical or molecular biology investigations was analyzed. All lesions were results malignant in 10/10 samples in the Zmax areas; in the Zmin areas, malignant cells were found in 7/10 samples. Technical success was achieved in 100% of cases for Zmax sampling and in 70% for Zmin sampling (p-value: 0.2105). The biomolecular profile was detected in 9/10 (90%) cases in Zmax areas, while in 4/10 (40%) cases in Zmin areas (p-value: 0.0573). The advantage of Z-effective imaging would be to identify a region of the lesion that is highly vascularized and probably richer in neoplastic cells, thus decreasing the risk of obtaining a non-diagnostic biopsy sample.

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Section: Discussionmentioning

confidence: 99%

Dual-Layer Spectral CT as Innovative Imaging Guidance in Lung Biopsies: Could Color-Coded Z-Effective Images Allow More Diagnostic Samplings and Biomarkers Information?

Piacentino,

Fontana,

Zorzetto

et al. 2023

JCM

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“…The distinction between marrow infiltration and reconversion to hematopoietic bone marrow cannot be made with DECT [ 25 ]. Since the amount of hematopoietic bone marrow varies with age and other factors, the optimal cutoff values to detect diffuse infiltration could be variable [ 24 ].…”

Section: Wbldctmentioning

confidence: 99%

Imaging of Multiple Myeloma: Present and Future

Rodríguez-Laval,

Lumbreras-Fernández,

Aguado-Bueno

et al. 2024

JCM

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Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start treatment. Low-dose whole-body computed tomography (CT) is the modality of choice for the initial assessment, and dual-energy CT is a developing technique with the potential for detecting non-lytic marrow infiltration and evaluating the response to treatment. Magnetic resonance imaging (MRI) is more sensitive and specific than 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of small focal lesions and diffuse marrow infiltration. However, FDG-PET/CT is recommended as the modality of choice for follow-up. Recently, diffusion-weighted MRI has become a new technique for the quantitative assessment of disease burden and therapy response. Although not widespread, we address current proposals for structured reporting to promote standardization and diminish variations. This review provides an up-to-date overview of MM imaging, indications, advantages, limitations, and recommended reporting of each technique. We also cover the main differential diagnosis and pitfalls and discuss the ongoing controversies and future directions, such as PET-MRI and artificial intelligence.

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“…Then, VNC imaging and iodine mapping can be helpful tool for the identification of iodine containing lesions by iodine subtraction. The better iodine enhancement observed by iodine density maps in high density structures like bones is indeed an advantage of DECT for the identification of enhancing tumors [ 83 ]. Hence, VNC imaging may improve the sensitivity of CT in depicting bone metastases [ 84 ].…”

Section: Musculoskeletal Applicationsmentioning

confidence: 99%

“…Another interesting point is the opportunity to differentiate peri-skeletal tissues extension from reactive edema by highlighting the different iodine concentration and slope curve [ 86 ]. Qualitative analysis of DECT images on VNCa images has shown to increase the diagnostic performance of DECT if compared to monoenergetic CT [ 83 ]. Bone metastases and myeloma present as hyperattenuating lesions on VNCa.…”

Section: Musculoskeletal Applicationsmentioning

confidence: 99%

Dual-energy CT in musculoskeletal imaging: technical considerations and clinical applications

Albano,

Di Luca,

D’Angelo

et al. 2024

Radiol med

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Dual-energy CT stands out as a robust and innovative imaging modality, which has shown impressive advancements and increasing applications in musculoskeletal imaging. It allows to obtain detailed images with novel insights that were once the exclusive prerogative of magnetic resonance imaging. Attenuation data obtained by using different energy spectra enable to provide unique information about tissue characterization in addition to the well-established strengths of CT in the evaluation of bony structures. To understand clearly the potential of this imaging modality, radiologists must be aware of the technical complexity of this imaging tool, the different ways to acquire images and the several algorithms that can be applied in daily clinical practice and for research. Concerning musculoskeletal imaging, dual-energy CT has gained more and more space for evaluating crystal arthropathy, bone marrow edema, and soft tissue structures, including tendons and ligaments. This article aims to analyze and discuss the role of dual-energy CT in musculoskeletal imaging, exploring technical aspects, applications and clinical implications and possible perspectives of this technique.

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Utility of dual energy computed tomography in the evaluation of infiltrative skeletal lesions and metastasis: a literature review

Cited by 11 publications

References 48 publications

Dual-Layer Spectral CT as Innovative Imaging Guidance in Lung Biopsies: Could Color-Coded Z-Effective Images Allow More Diagnostic Samplings and Biomarkers Information?

Dual-Layer Spectral CT as Innovative Imaging Guidance in Lung Biopsies: Could Color-Coded Z-Effective Images Allow More Diagnostic Samplings and Biomarkers Information?

Imaging of Multiple Myeloma: Present and Future

Dual-energy CT in musculoskeletal imaging: technical considerations and clinical applications

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