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Advanced image-based virtual monoenergetic dual-energy CT angiography of the abdomen: optimization of kiloelectron volt settings to improve image contrast

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare quantitative image quality parameters in abdominal dual-energy computed tomography angiography (DE-CTA) using an advanced image-based (Mono+) reconstruction algorithm for virtual monoenergetic imaging and standard DE-CTA.

Methods

Fifty-five patients (36 men; mean age, 64.2 ± 12.7 years) who underwent abdominal DE-CTA were retrospectively included. Mono + images were reconstructed at 40, 50, 60, 70, 80, 90 and 100 keV levels and as standard linearly blended M_0.6 images (60 % 100 kV, 40 % 140 kV). The contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) of the common hepatic (CHA), splenic (SA), superior mesenteric (SMA) and left renal arteries (LRA) were objectively measured.

Results

Mono+ DE-CTA series showed a statistically superior CNR for 40, 50, 60, 70 and 80 keV (P < 0.031) compared to M_0.6 images for all investigated arteries except SMA at 80 keV (P = 0.08). CNR at 40 keV revealed a mean relative increase of 287.7 % compared to linearly blended images among all assessed arteries (P < 0.001). SNR of Mono+ images was consistently significantly higher at 40, 50, 60 and 70 keV compared to M_0.6 for CHA and SA (P < 0.009).

Conclusions

Compared to linearly blended images, Mono+ reconstructions at low keV levels of abdominal DE-CTA datasets significantly improve quantitative image quality.

Key Points

• Mono+ combines increased attenuation with reduced image noise compared to standard DE-CTA.

• Mono+ shows superior contrast-to-noise ratios at low keV compared to linearly-blended images.

• Contrast-to-noise ratio in monoenergetic DE-CTA peaks at 40 keV.

• Mono+ reconstructions significantly improve quantitative image quality at low keV levels.

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References

  1. Vlahos I, Chung R, Nair A, Morgan R (2012) Dual-energy CT: vascular applications. AJR 199:87–97

    Article  Google Scholar 

  2. Brockmann C, Jochum S, Sadick M et al (2009) Dual-energy CT angiography in peripheral arterial occlusive disease. Cardiovasc Intervent Radiol 32:630–637

    Article  PubMed  Google Scholar 

  3. Huang SY, Nelson RC, Miller MJ et al (2012) Assessment of vascular contrast and depiction of stenoses in abdominopelvic and lower extremity vasculature: comparison of dual-energy MDCT with digital subtraction angiography. Acad Radiol 19:1149–1157

    Article  PubMed  Google Scholar 

  4. Sommer WH, Johnson TR, Becker CR et al (2009) The value of dual-energy bone removal in maximum intensity projections of lower extremity computed tomography angiography. Invest Radiol 44:285–292

    Article  PubMed  Google Scholar 

  5. Stolzmann P, Frauenfelder T, Pfammatter T et al (2008) Endoleaks after endovascular abdominal aortic aneurysm repair: detection with dual-energy dual-source CT. Radiology 249:682–691

    Article  PubMed  Google Scholar 

  6. Yu L, Leng S, McCollough CH (2012) Dual-energy CT-based monochromatic imaging. AJR 199:9–15

    Article  Google Scholar 

  7. Apfaltrer P, Sudarski S, Schneider D et al (2014) Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CT pulmonary angiography. Eur J Radiol 83:322–328

    Article  PubMed  Google Scholar 

  8. Schneider D, Apfaltrer P, Sudarski S et al (2014) Optimization of kiloelectron volt settings in cerebral and cervical dual-energy CT angiography determined with virtual monoenergetic imaging. Acad Radiol 21:431–436

    Article  PubMed  Google Scholar 

  9. Sudarski S, Apfaltrer PW, Nance J et al (2013) Optimization of keV-settings in abdominal and lower extremity dual-source dual-energy CT angiography determined with virtual monoenergetic imaging. Eur J Radiol 82:574–581

    Article  Google Scholar 

  10. Maturen KE, Kaza RK, Liu PS, Quint LE, Khalatbari SH, Platt JF (2012) “Sweet spot” for endoleak detection: optimizing contrast to noise using low keV reconstructions from fast-switch kVp dual-energy CT. J Comput Assist Tomogr 36:83–87

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bamberg F, Dierks A, Nikolaou K, Reiser MF, Becker CR, Johnson TRC (2011) Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation. Eur Radiol 21:1424–1429

    Article  PubMed  Google Scholar 

  12. Zhou C, Zhao YE, Luo S et al (2011) Monoenergetic imaging of dual-energy CT reduces artifacts from implanted metal orthopedic devices in patients with factures. Acad Radiol 18:1252–1257

    Article  PubMed  Google Scholar 

  13. Grant KL, Flohr TG, Krauss B, Sedlmair M, Thomas C, Schmidt B (2014) Assessment of an advanced image-based technique to calculate virtual monoenergetic computed tomographic images from a dual-energy examination to improve contrast-to-noise ratio in examinations using iodinated contrast media. Invest Radiol 49:586–592

    Article  PubMed  Google Scholar 

  14. Schabel C, Bongers M, Sedlmair M et al (2014) Assessment of the hepatic veins in poor contrast conditions using dual energy CT: evaluation of a novel monoenergetic extrapolation software algorithm. Rofo 186:591–597

    Article  CAS  PubMed  Google Scholar 

  15. Wichmann JL, Majenka P, Beeres M et al (2014) Single-portal-phase low-tube-voltage dual-energy CT for short-term follow-up of acute pancreatitis: evaluation of CT severity index, interobserver agreement and radiation dose. Eur Radiol 24:2927–2935

    Article  PubMed  Google Scholar 

  16. Guimarães LS, Fletcher JG, Harmsen WS et al (2010) Appropriate patient selection at abdominal dual-energy CT using 80 kV: relationship between patient size, image noise, and image quality. Radiology 257:732–742

    Article  PubMed  Google Scholar 

  17. Sigal-Cinqualbre AB, Hennequin R, Abada HT, Chen X, Paul J-F (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174

    Article  PubMed  Google Scholar 

  18. Szucs-Farkas Z, Kurmann L, Strautz T, Patak MA, Vock P, Schindera ST (2008) Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100- and 80-kVp protocols. Invest Radiol 43:871–876

    Article  PubMed  Google Scholar 

  19. Szucs-Farkas Z, Verdun FR, von Allmen G, Mini RL, Vock P (2008) Effect of X-ray tube parameters, iodine concentration, and patient size on image quality in pulmonary computed tomography angiography: a chest-phantom-study. Invest Radiol 43:374–381

    Article  PubMed  Google Scholar 

  20. Wichmann JL, Nöske E-M, Kraft J et al (2014) Virtual monoenergetic dual-energy computed tomography: optimization of kiloelectron volt settings in head and neck cancer. Invest Radiol 49:735–741

    Article  PubMed  Google Scholar 

  21. Leschka S, Stolzmann P, Schmid FT et al (2008) Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur Radiol 18:1809–1817

    Article  PubMed  Google Scholar 

  22. Schueller-Weidekamm C, Schaefer-Prokop CM, Weber M, Herold CJ, Prokop M (2006) CT angiography of pulmonary arteries to detect pulmonary embolism: improvement of vascular enhancement with low kilovoltage settings. Radiology 241:899–907

    Article  PubMed  Google Scholar 

  23. Delesalle M-A, Pontana F, Duhamel A et al (2013) Spectral optimization of chest CT angiography with reduced iodine load: experience in 80 patients evaluated with dual-source, dual-energy CT. Radiology 267:256–266

    Article  PubMed  Google Scholar 

  24. Carrascosa P, Capunay C, Rodriguez-Granillo GA, Deviggiano A, Vallejos J, Leipsic JA (2014) Substantial iodine volume load reduction in CT angiography with dual-energy imaging: insights from a pilot randomized study. Int J Cardiovasc Imaging 8:1613–1620

    Article  Google Scholar 

  25. Raju R, Thompson AG, Lee K et al (2014) Reduced iodine load with CT coronary angiography using dual-energy imaging: a prospective randomized trial compared with standard coronary CT angiography. J Cardiovasc Comput Tomogr 8:282–288

    Article  PubMed  PubMed Central  Google Scholar 

  26. Meinel FG, Canstein C, Schoepf UJ et al (2014) Image quality and radiation dose of low tube voltage 3rd generation dual-source coronary CT angiography in obese patients: a phantom study. Eur Radiol 24:1643–1650

    Article  PubMed  Google Scholar 

  27. Gordic S, Husarik DB, Desbiolles L, Leschka S, Frauenfelder T, Alkadhi H (2014) High-pitch coronary CT angiography with third generation dual-source CT: limits of heart rate. Int J Cardiovasc Imaging 30:1173–11

    Article  PubMed  Google Scholar 

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Acknowledgments

The scientific guarantor of this publication is Dr. Julian L. Wichmann. The authors of this manuscript declare relationships with the following companies: Ralf W. Bauer is on the speakers' bureau of Siemens Healthcare, Computed Tomography division. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Approval from the institutional animal care committee was not required because animal subjects were not included in this study. No study subjects or cohorts have been previously reported. Methodology: retrospective, case–control study, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Moritz H. Albrecht, Jan-Erik Scholtz, Kristina Hüsers, Martin Beeres, Andreas M. Bucher, Moritz Kaup, Simon S. Martin, Sebastian Fischer, Boris Bodelle, Ralf W. Bauer, Thomas Lehnert, Thomas J. Vogl & Julian L. Wichmann

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  1. Moritz H. Albrecht
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  2. Jan-Erik Scholtz
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  3. Kristina Hüsers
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Correspondence to Moritz H. Albrecht.

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Albrecht, M.H., Scholtz, JE., Hüsers, K. et al. Advanced image-based virtual monoenergetic dual-energy CT angiography of the abdomen: optimization of kiloelectron volt settings to improve image contrast. Eur Radiol 26, 1863–1870 (2016). https://doi.org/10.1007/s00330-015-3970-2

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  • DOI: https://doi.org/10.1007/s00330-015-3970-2

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