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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....

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Autores principales: Martin, Simon S., Kolaneci, Jetlir, Czwikla, Rouben, Booz, Christian, Gruenewald, Leon D., Albrecht, Moritz H., Thompson, Zachary M., Lenga, Lukas, Yel, Ibrahim, Vogl, Thomas J., Wichmann, Julian L., Koch, Vitali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317258/
https://www.ncbi.nlm.nih.gov/pubmed/35885585
http://dx.doi.org/10.3390/diagnostics12071682
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author Martin, Simon S.
Kolaneci, Jetlir
Czwikla, Rouben
Booz, Christian
Gruenewald, Leon D.
Albrecht, Moritz H.
Thompson, Zachary M.
Lenga, Lukas
Yel, Ibrahim
Vogl, Thomas J.
Wichmann, Julian L.
Koch, Vitali
author_facet Martin, Simon S.
Kolaneci, Jetlir
Czwikla, Rouben
Booz, Christian
Gruenewald, Leon D.
Albrecht, Moritz H.
Thompson, Zachary M.
Lenga, Lukas
Yel, Ibrahim
Vogl, Thomas J.
Wichmann, Julian L.
Koch, Vitali
author_sort Martin, Simon S.
collection PubMed
description 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.
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spelling pubmed-93172582022-07-27 Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions Martin, Simon S. Kolaneci, Jetlir Czwikla, Rouben Booz, Christian Gruenewald, Leon D. Albrecht, Moritz H. Thompson, Zachary M. Lenga, Lukas Yel, Ibrahim Vogl, Thomas J. Wichmann, Julian L. Koch, Vitali Diagnostics (Basel) Article 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. MDPI 2022-07-10 /pmc/articles/PMC9317258/ /pubmed/35885585 http://dx.doi.org/10.3390/diagnostics12071682 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martin, Simon S.
Kolaneci, Jetlir
Czwikla, Rouben
Booz, Christian
Gruenewald, Leon D.
Albrecht, Moritz H.
Thompson, Zachary M.
Lenga, Lukas
Yel, Ibrahim
Vogl, Thomas J.
Wichmann, Julian L.
Koch, Vitali
Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
title Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
title_full Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
title_fullStr Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
title_full_unstemmed Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
title_short Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions
title_sort dual-energy ct for the detection of portal vein thrombosis: improved diagnostic performance using virtual monoenergetic reconstructions
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317258/
https://www.ncbi.nlm.nih.gov/pubmed/35885585
http://dx.doi.org/10.3390/diagnostics12071682
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