학술논문
Material density iodine images in dual-energy CT: Detection and characterization of hypervascular liver lesions compared to magnetic resonance imaging.
Document Type
Academic Journal
Author
Muenzel D; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA; Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675 Munich, Germany. Electronic address: muenzel@tum.de.; Lo GC; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA.; Yu HS; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA.; Parakh A; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA.; Patino M; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA.; Kambadakone A; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA.; Rummeny EJ; Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675 Munich, Germany.; Sahani DV; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA.
Source
Publisher: Elsevier Science Ireland Ltd Country of Publication: Ireland NLM ID: 8106411 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7727 (Electronic) Linking ISSN: 0720048X NLM ISO Abbreviation: Eur J Radiol Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: To determine the diagnostic potential of Material Density (MD) iodine images in dual-energy CT (DECT) for the detection and characterization of hypervascular liver lesions compared to monenergetic 65keV images, using MRI as the standard.
Materials and Methods: The study complied with HIPAA guidelines and was approved by the institutional review board. Fifty-two patients (36 men, 16 women; age range, 29-87 years) with 236 hypervascular liver lesions (benign, n=31; malignant, n=205; mean diameter, 29.4mm; range: 6-90.6mm) were included. All of them underwent both contrast-enhanced single-source DECT and contrast-enhanced abdominal MRI within three months. Late arterial phase CT imaging was performed with dual energies of 140 and 80kVp. Protocol A showed monoenergetic 65keV images, and protocol B presented MD-iodine images. Three radiologists qualitatively evaluated randomized images, and lesion detection, characterization, and reader confidence were recorded. Liver-to-lesion ratio (LLR) and contrast-to-noise ratio (CNR) were assessed on protocol A, protocol B, and MRI. Paired t-tests were used to compare LLR, CNR, and the number of detected lesions.
Results: LLR was significantly increased in protocol B (2.8±2.33) compared to protocol A (0.77±0.55) and MRI (0.61±0.66). CNR was significantly higher in protocol B (0.08±0.04) compared to protocol A (0.01±0.01) and MRI (0.01±0.01). All three observers correctly identified more liver lesions using protocol B vs protocol A: 83.13% vs 63.64%, 84.57% vs 68.09%, and 79.37% vs 65.52%. There was no significant difference between the three observers in classification of a lesion as benign or malignant. However, higher diagnostic confidence was reported more frequently by the experienced radiologist when using protocol B vs protocol A (84.6% vs 75%).
Conclusion: MD-iodine images in DECT help to increase the conspicuity and detection of hypervascular liver lesions.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Materials and Methods: The study complied with HIPAA guidelines and was approved by the institutional review board. Fifty-two patients (36 men, 16 women; age range, 29-87 years) with 236 hypervascular liver lesions (benign, n=31; malignant, n=205; mean diameter, 29.4mm; range: 6-90.6mm) were included. All of them underwent both contrast-enhanced single-source DECT and contrast-enhanced abdominal MRI within three months. Late arterial phase CT imaging was performed with dual energies of 140 and 80kVp. Protocol A showed monoenergetic 65keV images, and protocol B presented MD-iodine images. Three radiologists qualitatively evaluated randomized images, and lesion detection, characterization, and reader confidence were recorded. Liver-to-lesion ratio (LLR) and contrast-to-noise ratio (CNR) were assessed on protocol A, protocol B, and MRI. Paired t-tests were used to compare LLR, CNR, and the number of detected lesions.
Results: LLR was significantly increased in protocol B (2.8±2.33) compared to protocol A (0.77±0.55) and MRI (0.61±0.66). CNR was significantly higher in protocol B (0.08±0.04) compared to protocol A (0.01±0.01) and MRI (0.01±0.01). All three observers correctly identified more liver lesions using protocol B vs protocol A: 83.13% vs 63.64%, 84.57% vs 68.09%, and 79.37% vs 65.52%. There was no significant difference between the three observers in classification of a lesion as benign or malignant. However, higher diagnostic confidence was reported more frequently by the experienced radiologist when using protocol B vs protocol A (84.6% vs 75%).
Conclusion: MD-iodine images in DECT help to increase the conspicuity and detection of hypervascular liver lesions.
(Copyright © 2017 Elsevier B.V. All rights reserved.)