Purpose: Detecting bladder cancer (BC) in routine CT images is important but is sometimes difficult when cancer is small. We evaluated the ability of 40-keV advanced monoenergetic images to depict BC.
Materials and methods: Fifty-two patients with a median age of 74 years (range 45-92) who were diagnosed as BC with transurethral resection or cystectomy, were included. They were examined with contrast-enhanced dual-energy CT (DE-CT) and advanced virtual monoenergetic images (40 keV) were reconstructed. For evaluating depictability of BC on 40-keV or virtual-120-kVp images, the difference in CT number between the cancer and bladder wall (BC-BW value) were calculated. We also subjectively assessed depictability of BC in virtual-120-kVp and 40-keV images using a 4-grade Likert scale (3: clear, 0: not visualized).
Results: In 42 of 52 patients, BC-BW values could be calculated because BC was detected on CT images. The mean BC-BW value at 40 keV was significantly higher than that of virtual 120 kVp [80.5 ± 54 (SD) vs. 11.4 ± 12.5 HU, P < 0.01]. Average scores of subjective evaluations in the virtual-120-kVp and 40-keV images were 1.7 ± 1.2 and 2.1 ± 1.2, respectively (P < 0.001).
Conclusion: The advanced monoenergetic reconstruction technique reconstructed using DE-CT image is useful to depict BC.
Keywords: Advanced virtual monoenergetic image; Bladder cancer; Dual energy CT.
© 2021. The Author(s).