Dual-Energy CT for the Detection of Portal Vein Thrombosis : Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
Purpose: 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. Method: 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. Results: 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 (p < 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) (p ≤ 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%) (p ≤ 0.01). Conclusions: Low-keV VMI+ reconstructions resulted in significantly improved diagnostic performance for the detection of PVT compared to other DECT reconstruction algorithms.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Diagnostics (Basel, Switzerland) - 12(2022), 7 vom: 10. Juli |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Martin, Simon S [VerfasserIn] |
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| Links: |
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| Themen: |
Diagnostic imaging |
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| Anmerkungen: |
Date Revised 08.03.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/diagnostics12071682 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344053768 |
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| 100 | 1 | |a Martin, Simon S |e verfasserin |4 aut | |
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| 520 | |a Purpose: 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. Method: 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. Results: 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 (p < 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) (p ≤ 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%) (p ≤ 0.01). Conclusions: Low-keV VMI+ reconstructions resulted in significantly improved diagnostic performance for the detection of PVT compared to other DECT reconstruction algorithms | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a diagnostic imaging | |
| 650 | 4 | |a liver | |
| 650 | 4 | |a multidetector computed tomography | |
| 650 | 4 | |a portal vein | |
| 650 | 4 | |a thrombosis | |
| 700 | 1 | |a Kolaneci, Jetlir |e verfasserin |4 aut | |
| 700 | 1 | |a Czwikla, Rouben |e verfasserin |4 aut | |
| 700 | 1 | |a Booz, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Gruenewald, Leon D |e verfasserin |4 aut | |
| 700 | 1 | |a Albrecht, Moritz H |e verfasserin |4 aut | |
| 700 | 1 | |a Thompson, Zachary M |e verfasserin |4 aut | |
| 700 | 1 | |a Lenga, Lukas |e verfasserin |4 aut | |
| 700 | 1 | |a Yel, Ibrahim |e verfasserin |4 aut | |
| 700 | 1 | |a Vogl, Thomas J |e verfasserin |4 aut | |
| 700 | 1 | |a Wichmann, Julian L |e verfasserin |4 aut | |
| 700 | 1 | |a Koch, Vitali |e verfasserin |4 aut | |
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