Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions

<b<Purpose:</b< To investigate the diagnostic performance of noise-optimized virtual monoenergetic images (VMI+) in dual-energy CT (DECT) of portal vein thrombosis (PVT) compared to standard reconstructions. <b<Method:</b< This retrospective, single-center study included 107 patients (68 men; mean age, 60.1 ± 10.7 years) with malignant or cirrhotic liver disease and suspected PVT who had undergone contrast-enhanced portal-phase DECT of the abdomen. Linearly blended (M_0.6) and virtual monoenergetic images were calculated using both standard VMI and noise-optimized VMI+ algorithms in 20 keV increments from 40 to 100 keV. Quantitative measurements were performed in the portal vein for objective contrast-to-noise ratio (CNR) calculation. The image series showing the greatest CNR were further assessed for subjective image quality and diagnostic accuracy of PVT detection by two blinded radiologists. <b<Results:</b< PVT was present in 38 subjects. VMI+ reconstructions at 40 keV revealed the best objective image quality (CNR, 9.6 ± 4.3) compared to all other image reconstructions (<i<p</i< < 0.01). In the standard VMI series, CNR peaked at 60 keV (CNR, 4.7 ± 2.1). Qualitative image parameters showed the highest image quality rating scores for the 60 keV VMI+ series (median, 4) (<i<p</i< ≤ 0.03). The greatest diagnostic accuracy for the diagnosis of PVT was found for the 40 keV VMI+ series (sensitivity, 96%; specificity, 96%) compared to M_0.6 images (sensitivity, 87%; specificity, 92%), 60 keV VMI (sensitivity, 87%; specificity, 97%), and 60 keV VMI+ reconstructions (sensitivity, 92%; specificity, 97%) (<i<p</i< ≤ 0.01). <b<Conclusions:</b< Low-keV VMI+ reconstructions resulted in significantly improved diagnostic performance for the detection of PVT compared to other DECT reconstruction algorithms..

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:12

Enthalten in:

Diagnostics - 12(2022), 7, p 1682

Sprache:

Englisch

Beteiligte Personen:

Simon S. Martin [VerfasserIn]
Jetlir Kolaneci [VerfasserIn]
Rouben Czwikla [VerfasserIn]
Christian Booz [VerfasserIn]
Leon D. Gruenewald [VerfasserIn]
Moritz H. Albrecht [VerfasserIn]
Zachary M. Thompson [VerfasserIn]
Lukas Lenga [VerfasserIn]
Ibrahim Yel [VerfasserIn]
Thomas J. Vogl [VerfasserIn]
Julian L. Wichmann [VerfasserIn]
Vitali Koch [VerfasserIn]

Links:

doi.org [kostenfrei]
doaj.org [kostenfrei]
www.mdpi.com [kostenfrei]
Journal toc [kostenfrei]

Themen:

Diagnostic imaging
Liver
Medicine (General)
Multidetector computed tomography
Portal vein
Thrombosis

doi:

10.3390/diagnostics12071682

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

DOAJ078978858