Quality of Virtual-non-contrast Phases Derived from Arterial and Delayed Phases of Fast-kVp Switching Dual-energy CT in Patients After Endovascular Aortic Repair

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2023 Jun 14

PMID 37314532

Authors

Wojciech Kazimierczak

Natalia Kazimierczak

Zbigniew Serafin

Affiliations

Soon will be listed here.

Abstract

Objective of this study is: to analyze CT numbers in arteries and endoleaks in true non-contrast (TNC) and virtual non-contrast phases derived from arterial (VNCa) and delayed (VNCd) phases of dual-energy CT (DECT) in patients after endovascular aneurysm repair (EVAR); to assess the impact of image noise on subjective image quality parameters and the degree of subtraction of calcifications; to calculate effective dose (ED) reduction following replacement of TNC with VNC. The study included 97 patients after EVAR procedure. An initial single-energy TNC acquisition was followed by two DECT acquisitions. CT numbers of TNC, VNCa, VNCd were analyzed statistically. VNCd images were assessed qualitatively. The mean densities in endoleaks were 46.19 HU in TNC, 51.24 HU in VNCa, 42.24 HU in VNCd. The differences between them were statistically significant (p < 0.05). The mean signal-to-noise ratio (SNR) measured in the aorta and endoleaks was highest in VNCa, lowest in TNC images. No correlation between image noise, the results of qualitative analysis of VNCd, and the degree of subtraction of calcifications was found. Omitting TNC led to mean 6.54 ± 1.63 (SD) mSv (23.28% of total examination) ED reduction. VNC images have a higher SNR compared to TNC images with significant differences in the CT numbers between the TNC and VNC reconstructions. Image noise has no impact on the subjective image quality and the degree of subtraction of calcifications in VNCd images. The findings show a high diagnostic value of VNC images and suggest that VNCd images are optimal in the assessment of endoleaks with possible substantial ED reduction.

Citing Articles

Comparison of virtual and true non-contrast images from dual-layer spectral detector computed tomography (CT) in patients with colorectal cancer.

Wen D, Pu Q, Peng P, Yue X, Ming Y, Yang H Quant Imaging Med Surg. 2024; 14(9):6260-6272.

PMID: 39281124 PMC: 11400675. DOI: 10.21037/qims-24-535.

The impact of deep learning image reconstruction of spectral CTU virtual non contrast images for patients with renal stones.

Zhu H, Kong D, Qian J, Shi X, Fan J Eur J Radiol Open. 2024; 13:100599.

PMID: 39280122 PMC: 11402413. DOI: 10.1016/j.ejro.2024.100599.

Assessing the diagnostic accuracy of artificial intelligence in post-endovascular aneurysm repair endoleak detection using dual-energy computed tomography angiography.

Nowak E, Bialecki M, Bialecka A, Kazimierczak N, Kloska A Pol J Radiol. 2024; 89:e420-e427.

PMID: 39257927 PMC: 11384217. DOI: 10.5114/pjr/192115.

Dual-Energy and Photon-Counting Computed Tomography in Vascular Applications-Technical Background and Post-Processing Techniques.

Stanski M, Michalowska I, Lemanowicz A, Karmelita-Katulska K, Ratajczak P, Slawinska A Diagnostics (Basel). 2024; 14(12).

PMID: 38928639 PMC: 11202784. DOI: 10.3390/diagnostics14121223.

Differentiation of Hamartomas and Malignant Lung Tumors in Single-Phased Dual-Energy Computed Tomography.

Winkelmann M, Gassenmaier S, Walter S, Artzner C, Nikolaou K, Bongers M Tomography. 2024; 10(2):255-265.

PMID: 38393288 PMC: 10892507. DOI: 10.3390/tomography10020020.

References

Kazimierczak W, Kazimierczak N, Lemanowicz A, Nowak E, Migdalski A, Jawien A . Improved Detection of Endoleaks in Virtual Monoenergetic Images in Dual-Energy CT Angiography Following EVAR. Acad Radiol. 2023; 30(12):2813-2824. DOI: 10.1016/j.acra.2023.03.018. View

Flohr T, Petersilka M, Henning A, Ulzheimer S, Ferda J, Schmidt B . Photon-counting CT review. Phys Med. 2020; 79:126-136. DOI: 10.1016/j.ejmp.2020.10.030. View

Sauter A, Muenzel D, Dangelmaier J, Braren R, Pfeiffer F, Rummeny E . Dual-layer spectral computed tomography: Virtual non-contrast in comparison to true non-contrast images. Eur J Radiol. 2018; 104:108-114. DOI: 10.1016/j.ejrad.2018.05.007. View

Albrecht M, Vogl T, Martin S, Nance J, Duguay T, Wichmann J . Review of Clinical Applications for Virtual Monoenergetic Dual-Energy CT. Radiology. 2019; 293(2):260-271. DOI: 10.1148/radiol.2019182297. View

Sartoretti T, Mergen V, Higashigaito K, Eberhard M, Alkadhi H, Euler A . Virtual Noncontrast Imaging of the Liver Using Photon-Counting Detector Computed Tomography: A Systematic Phantom and Patient Study. Invest Radiol. 2022; 57(7):488-493. DOI: 10.1097/RLI.0000000000000860. View

Buffa V, Solazzo A, DAuria V, Del Prete A, Vallone A, Luzietti M . Dual-source dual-energy CT: dose reduction after endovascular abdominal aortic aneurysm repair. Radiol Med. 2014; 119(12):934-941. DOI: 10.1007/s11547-014-0420-1. View

Niehoff J, Woeltjen M, Saeed S, Michael A, Boriesosdick J, Borggrefe J . Assessment of hepatic steatosis based on virtual non-contrast computed tomography: Initial experiences with a photon counting scanner approved for clinical use. Eur J Radiol. 2022; 149:110185. DOI: 10.1016/j.ejrad.2022.110185. View

Mergen V, Racine D, Jungblut L, Sartoretti T, Bickel S, Monnin P . Virtual Noncontrast Abdominal Imaging with Photon-counting Detector CT. Radiology. 2022; 305(1):107-115. DOI: 10.1148/radiol.213260. View

Siegel M, Ramirez-Giraldo J . Dual-Energy CT in Children: Imaging Algorithms and Clinical Applications. Radiology. 2019; 291(2):286-297. DOI: 10.1148/radiol.2019182289. View

10.

Chandarana H, Godoy M, Vlahos I, Graser A, Babb J, Leidecker C . Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms--initial observations. Radiology. 2008; 249(2):692-700. DOI: 10.1148/radiol.2492080359. View

11.

Stolzmann P, Frauenfelder T, Pfammatter T, Peter N, Scheffel H, Lachat M . Endoleaks after endovascular abdominal aortic aneurysm repair: detection with dual-energy dual-source CT. Radiology. 2008; 249(2):682-91. DOI: 10.1148/radiol.2483080193. View

12.

Scott R, Bridgewater S, Ashton H . Randomized clinical trial of screening for abdominal aortic aneurysm in women. Br J Surg. 2002; 89(3):283-5. DOI: 10.1046/j.0007-1323.2001.02014.x. View

13.

Boning G, Rotzinger R, Kahn J, Freyhardt P, Renz D, Maurer M . Tailored CT angiography in follow-up after endovascular aneurysm repair (EVAR): combined dose reduction techniques. Acta Radiol. 2018; 59(11):1316-1325. DOI: 10.1177/0284185118756952. View

14.

Huda W, Ogden K, Khorasani M . Converting dose-length product to effective dose at CT. Radiology. 2008; 248(3):995-1003. PMC: 2657852. DOI: 10.1148/radiol.2483071964. View

15.

Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T . Editor's Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2018; 57(1):8-93. DOI: 10.1016/j.ejvs.2018.09.020. View

16.

Decker J, Bette S, Scheurig-Muenkler C, Jehs B, Risch F, Woznicki P . Virtual Non-Contrast Reconstructions of Photon-Counting Detector CT Angiography Datasets as Substitutes for True Non-Contrast Acquisitions in Patients after EVAR-Performance of a Novel Calcium-Preserving Reconstruction Algorithm. Diagnostics (Basel). 2022; 12(3). PMC: 8946873. DOI: 10.3390/diagnostics12030558. View

17.

Ascenti G, Mazziotti S, Lamberto S, Bottari A, Caloggero S, Racchiusa S . Dual-energy CT for detection of endoleaks after endovascular abdominal aneurysm repair: usefulness of colored iodine overlay. AJR Am J Roentgenol. 2011; 196(6):1408-14. DOI: 10.2214/AJR.10.4505. View

18.

Chaikof E, Dalman R, Eskandari M, Jackson B, Lee W, Mansour M . The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2017; 67(1):2-77.e2. DOI: 10.1016/j.jvs.2017.10.044. View

19.

McCollough C, Leng S, Yu L, Fletcher J . Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications. Radiology. 2015; 276(3):637-53. PMC: 4557396. DOI: 10.1148/radiol.2015142631. View

20.

Toepker M, Moritz T, Krauss B, Weber M, Euller G, Mang T . Virtual non-contrast in second-generation, dual-energy computed tomography: reliability of attenuation values. Eur J Radiol. 2012; 81(3):e398-405. DOI: 10.1016/j.ejrad.2011.12.011. View