Can dual-energy computed tomography improve visualization of hypoenhancing liver lesions in portal venous phase? Assessment of advanced image-based virtual monoenergetic images

Damiano Caruso; Carlo N De Cecco; U Joseph Schoepf; Amanda R Schaefer; Parker W Leland; Dustin Johnson; Andrea Laghi; Andrew D Hardie

doi:10.1016/j.clinimag.2016.10.015

Can dual-energy computed tomography improve visualization of hypoenhancing liver lesions in portal venous phase? Assessment of advanced image-based virtual monoenergetic images

Clin Imaging. 2017 Jan-Feb:41:118-124. doi: 10.1016/j.clinimag.2016.10.015. Epub 2016 Oct 19.

Authors

Damiano Caruso¹, Carlo N De Cecco², U Joseph Schoepf², Amanda R Schaefer³, Parker W Leland³, Dustin Johnson³, Andrea Laghi⁴, Andrew D Hardie⁵

Affiliations

¹ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Department of Radiological Sciences, Oncological and Pathological Sciences University of Rome "Sapienza", via Franco Faggiana 1668, 04100 Latina, Italy.
² Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
³ Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
⁴ Department of Radiological Sciences, Oncological and Pathological Sciences University of Rome "Sapienza", via Franco Faggiana 1668, 04100 Latina, Italy.
⁵ Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: andrewdhardie@gmail.com.

PMID: 27840263
DOI: 10.1016/j.clinimag.2016.10.015

Abstract

Purpose: The purpose was to assess image quality of portal-venous phase dual-energy computed tomography (DECT) for liver lesions.

Methods: We performed 120-kVp-equivalent linear-blended (LB) and monoenergetic reconstructions from 40 to 190 keV by standard (VMI) and advanced virtual monoenergetic (VMI+) methods. Diagnostic performance, and quantitative and qualitative image analyses were assessed and compared.

Results: Liver contrast to noise ratio peaked at 40 keV_VMI+, while image quality and reader preference peaked at 50 keV_VMI+. 50 keV_VMI+ scored overall higher diagnostic performance: lesion sensitivity 95.4% vs. 83.3% for both 75 keV_VMI and LB.

Conclusions: DECT improves assessment of hypoenhancing liver lesions on portal venous phase. 50 keV_VMI+ demonstrated the highest image quality and diagnostic performance over VMI and LB.

Keywords: Dual-energy CT; Liver lesion; Monoenergetic; Portal venous phase.

MeSH terms

Adult
Aged
Female
Humans
Image Processing, Computer-Assisted / methods*
Liver / diagnostic imaging
Liver Neoplasms / diagnostic imaging*
Male
Middle Aged
Portal Vein / diagnostic imaging*
Prospective Studies
Radiography, Dual-Energy Scanned Projection / methods*
Reproducibility of Results
Sensitivity and Specificity
Signal-To-Noise Ratio
Tomography, X-Ray Computed / methods*