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Zhao H, Zhu W, Jin L, Xiong Y, Deng X, Li Y, Zou W. Calcium deblooming in coronary computed tomography angiography via semantic-oriented generative adversarial network. Comput Med Imaging Graph 2025; 122:102515. [PMID: 40020506 DOI: 10.1016/j.compmedimag.2025.102515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 01/09/2025] [Accepted: 02/17/2025] [Indexed: 03/03/2025]
Abstract
Calcium blooming artifact produced by calcified plaque in coronary computed tomography angiography (CCTA) is a significant contributor to false-positive results for radiologists. Most previous research focused on general noise reduction of CT images, while performance was limited when facing the blooming artifact. To address this problem, we designed an automated and robust semantics-oriented adversarial network that fully exploits the calcified plaques as semantic regions in the CCTA. The semantic features were extracted using a feature extraction module and implemented through a global-local fusion module, a generator with a semantic similarity module, and a matrix discriminator. The effectiveness of our network was validated both on a virtual and a clinical dataset. The clinical dataset consists of 372 CCTA and corresponding coronary angiogram (CAG) results, with the assistance of two cardiac radiologists (with 10 and 21 years of experience) for clinical evaluation. The proposed method effectively reduces artifacts for three major coronary arteries and significantly improves the specificity and positive predictive value for the diagnosis of coronary stenosis.
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Affiliation(s)
- Huiyu Zhao
- State Key Laboratory of Advanced Optical Communication Systems and Networks, Intelligent Microwave Lightwave Integration Innovation Center (imLic), Department of Electronic Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Wangshu Zhu
- Institute of Diagnostic and Interventional Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #600 Yishan Rd, Shanghai, China.
| | - Luyuan Jin
- State Key Laboratory of Advanced Optical Communication Systems and Networks, Intelligent Microwave Lightwave Integration Innovation Center (imLic), Department of Electronic Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yijia Xiong
- Institute of Diagnostic and Interventional Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #600 Yishan Rd, Shanghai, China
| | - Xiao Deng
- State Key Laboratory of Advanced Optical Communication Systems and Networks, Intelligent Microwave Lightwave Integration Innovation Center (imLic), Department of Electronic Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yuehua Li
- Institute of Diagnostic and Interventional Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #600 Yishan Rd, Shanghai, China.
| | - Weiwen Zou
- State Key Laboratory of Advanced Optical Communication Systems and Networks, Intelligent Microwave Lightwave Integration Innovation Center (imLic), Department of Electronic Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
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Greffier J, Viry A, Robert A, Khorsi M, Si-Mohamed S. Photon-counting CT systems: A technical review of current clinical possibilities. Diagn Interv Imaging 2025; 106:53-59. [PMID: 39304365 DOI: 10.1016/j.diii.2024.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 09/03/2024] [Indexed: 09/22/2024]
Abstract
In recent years, computed tomography (CT) has undergone a number of developments to improve radiological care. The most recent major innovation has been the development of photon-counting detectors. By comparison with the energy-integrating detectors traditionally used in CT, these detectors offer better dose efficiency, eliminate electronic noise, improve spatial resolution and have intrinsic spectral sensitivity. These detectors also allow the energy of each photon to be counted, thus improving the sampling of the X-ray spectrum in multiple energy bins, to better distinguish between photoelectric and Compton attenuation coefficients, resulting in better spectral images and specific color K-edge images. The purpose of this article was to make the reader more familiar with the basic principles and techniques of new photon-counting CT systems equipped with photon-counting detectors and also to describe the currently available devices that could be used in clinical practice.
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Affiliation(s)
- Joël Greffier
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France.
| | - Anaïs Viry
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, 1007 Lausanne, Switzerland
| | - Antoine Robert
- University of Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Villeurbanne, France
| | - Mouad Khorsi
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, 1007 Lausanne, Switzerland
| | - Salim Si-Mohamed
- University of Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Villeurbanne, France; Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, 69500 Bron, France
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Ventura C, Cacioppa LM, Caldarelli S, Sallei G, Lamponi F, Mascitti M, Carotti M, Floridi C, Valeri G. Toward the Application of Dual-Energy Computed Tomography with Virtual Non-Hydroxyapatite Color-Coded Maps to Identify Traumatic Fractures in Daily Emergency Settings. J Imaging 2024; 10:267. [PMID: 39590731 PMCID: PMC11595750 DOI: 10.3390/jimaging10110267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 10/19/2024] [Accepted: 10/22/2024] [Indexed: 11/28/2024] Open
Abstract
To evaluate the advantages of dual-energy computed tomography (DECT) virtual non-hydroxyapatite color mapping (VNHAP) in combination with standard bone CT (BCT) in the identification of subtle or occult traumatic fractures referred to emergency and acceptance departments (DEAs). Forty patients (22 men; mean age 83 ± 23.7 y) with suspected traumatic fractures referred to our emergency department and examined with a fast kilovoltage-switching single-source spectral CT scan between January and October 2023 were retrospectively reviewed. The BCT and VNHAP images were blindly evaluated by two radiologists with >10 years and <2 years of experience in musculoskeletal imaging. Both techniques were evaluated in terms of sensitivity (SE), specificity (SP), positive and negative predictive values (PPVs and NPVs) and accuracy for fracture detection, as confirmed at a 3-month clinical-instrumental follow-up. Inter-observer agreement and examination times were also analyzed. Fractures were confirmed in 18/40 cases. The highest values of diagnostic performance for VNHAP images were obtained in terms of SP (90.9% and 95%) and PPV (87.5% and 92.8%) and for the less experienced operator. No statistically significant differences were observed between the diagnostic accuracy of the two readers in the evaluation of VNHAP images. Inter-observer agreement was moderate (κ = 0.536) for BCT and substantial (κ = 0.680) for VNHAP. Comparing the two operators, a significantly longer examination time for BCT and no significant difference for VNHAP were registered. Our preliminary experience may encourage the employment of VNHAP maps in combination with BCT images in emergency settings. Their use could be time-saving and valuable in terms of diagnostic performance, especially for less experienced operators.
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Affiliation(s)
- Claudio Ventura
- Diagnostic Radiology Unit, Department of Services, AST Fermo, Via Augusto Murri 21, 63900 Fermo, Italy; (C.V.); (S.C.); (G.V.)
| | - Laura Maria Cacioppa
- Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy;
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
| | - Sonia Caldarelli
- Diagnostic Radiology Unit, Department of Services, AST Fermo, Via Augusto Murri 21, 63900 Fermo, Italy; (C.V.); (S.C.); (G.V.)
| | - Giovanni Sallei
- Ortopedics Unit, Surgical Department, AST Fermo, Via Augusto Murri 21, 63900 Fermo, Italy; (G.S.); (F.L.)
| | - Federico Lamponi
- Ortopedics Unit, Surgical Department, AST Fermo, Via Augusto Murri 21, 63900 Fermo, Italy; (G.S.); (F.L.)
| | - Marco Mascitti
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
| | - Marina Carotti
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
- Division of Radiology, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero Universitaria Delle Marche”, 60126 Ancona, Italy
| | - Chiara Floridi
- Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy;
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
- Division of Radiology, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero Universitaria Delle Marche”, 60126 Ancona, Italy
| | - Gianluca Valeri
- Diagnostic Radiology Unit, Department of Services, AST Fermo, Via Augusto Murri 21, 63900 Fermo, Italy; (C.V.); (S.C.); (G.V.)
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Shrestha B, Stern NB, Zhou A, Dunn A, Porter T. Current trends in the characterization and monitoring of vascular response to cancer therapy. Cancer Imaging 2024; 24:143. [PMID: 39438891 PMCID: PMC11515715 DOI: 10.1186/s40644-024-00767-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 08/26/2024] [Indexed: 10/25/2024] Open
Abstract
Tumor vascular physiology is an important determinant of disease progression as well as the therapeutic outcome of cancer treatment. Angiogenesis or the lack of it provides crucial information about the tumor's blood supply and therefore can be used as an index for cancer growth and progression. While standalone anti-angiogenic therapy demonstrated limited therapeutic benefits, its combination with chemotherapeutic agents improved the overall survival of cancer patients. This could be attributed to the effect of vascular normalization, a dynamic process that temporarily reverts abnormal vasculature to the normal phenotype maximizing the delivery and intratumor distribution of chemotherapeutic agents. Longitudinal monitoring of vascular changes following antiangiogenic therapy can indicate an optimal window for drug administration and estimate the potential outcome of treatment. This review primarily focuses on the status of various imaging modalities used for the longitudinal characterization of vascular changes before and after anti-angiogenic therapies and their clinical prospects.
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Affiliation(s)
- Binita Shrestha
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA.
| | - Noah B Stern
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Annie Zhou
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Andrew Dunn
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Tyrone Porter
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
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Algin O, Tokgoz N, Cademartiri F. Photon-counting computed tomography in radiology. Pol J Radiol 2024; 89:e433-e442. [PMID: 39444656 PMCID: PMC11497591 DOI: 10.5114/pjr/191743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/28/2024] [Indexed: 10/25/2024] Open
Abstract
Photon-counting detector computed tomography (PCD-CT) devices have recently been introduced into practice, despite photon-counting detector technology having been studied for many years. PCD-CT devices are expected to provide advantages in dose reduction, tissue specificity, artifact-free imaging, and multi-contrast demonstration capacity. Noise reduction and increased spatial resolution are expected using PCD-CT, even under challenging scanning conditions. Some experimental or preliminary studies support this hypothesis. This pictorial review illustrates the features of PCD-CT systems, particularly in the interventional field. PCD-CT offers superior image quality and better lesion discrimination than conventional CT techniques for various conditions. PCD-CT shows significant improvements in many aspects of vascular imaging. It is still in its early stages, and several challenges have been identified. Also, PCD-CT devices have some important caveats. The average cost of these devices is 3 to 4 times higher than conventional CT units. This additional cost must be justified by improved clinical benefits or reduced clinical harms. Further investigations will be needed to resolve these issues.
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Affiliation(s)
- Oktay Algin
- Interventional MR Clinical R&D Institute, Ankara University, Ankara, Türkiye
- Department of Radiology, Medical Faculty, Ankara University, Ankara, Türkiye
- National MR Research Center (UMRAM), Bilkent University, Ankara, Türkiye
| | | | - Filippo Cademartiri
- Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica, Pisa, Toscana, Italy
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Madjidyar J, Pravdivtseva M, Hensler J, Jansen O, Larsen N, Wodarg F. Non-invasive follow-up for intracranial aneurysms treated with contour neurovascular system-comparison of digital subtraction angiography (DSA) to magnetic resonance imaging (MRI) and spectral computed tomography angiography (CTA) in vitro. Interv Neuroradiol 2024:15910199241277907. [PMID: 39219551 PMCID: PMC11569776 DOI: 10.1177/15910199241277907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE The contour neurovascular system (CNS) is an intrasaccular flow-disrupting device designed for the treatment of intracranial wide-necked bifurcation aneurysms. Metal artifacts limit magnetic resonance imaging (MRI) accessibility after implantation. The purpose of this in vitro study was to evaluate non-invasive imaging alternatives to digital subtraction angiography (DSA). MATERIAL AND METHODS Three aneurysms of patients originally treated with CNS were three-dimensional (3D)-printed (one at the basilar tip and two at the middle cerebral artery bifurcation). CNS devices were implanted under fluoroscopic control into the 3D models. Post-implantation two-dimensional-DSA, flat panel computed tomography angiography (CTA), MRI, and spectral CTA were performed. RESULTS Time of flight angiography and T1 weighted sequences showed large susceptibility artifacts at the detachment zone of the devices. A thin-sliced T2 weighted sequence in cross-sectional orientation to the aneurysm allowed visualization of the aneurysm dome, but the aneurysm neck and parent vessel could not be assessed. Focused spectral CTA, especially a 40 keV reconstruction with a metal artifact reduction algorithm (orthopedic metal artifact reduction (OMAR)), showed only minor artifacts at the detachment zone. This approach achieved a very similar result to DSA and flat panel computed tomography, enabling the assessment of the device structure, aneurysm perfusion, and parent vessel perfusion. DISCUSSION AND CONCLUSION For non-invasive follow-up of CNS, focused 40 keV CTA with OMAR seems to be a valuable option. MRI can be valuable for larger aneurysms to assess the aneurysm dome, but was not suitable for evaluating the parent vessels and aneurysm neck after CNS implantation in this study.
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Affiliation(s)
- Jawid Madjidyar
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Mariya Pravdivtseva
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Johannes Hensler
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Naomi Larsen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Fritz Wodarg
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany
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Chen Y, Wu T, Zhu Y, Chen J, Gao C, Wu L. Trends and hotspots of energy-based imaging in thoracic disease: a bibliometric analysis. Insights Imaging 2024; 15:209. [PMID: 39143273 PMCID: PMC11324624 DOI: 10.1186/s13244-024-01788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/25/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVE To conduct a bibliometric analysis of the prospects and obstacles associated with dual- and multi-energy CT in thoracic disease, emphasizing its current standing, advantages, and areas requiring attention. METHODS The Web of Science Core Collection was queried for relevant publications in dual- and multi-energy CT and thoracic applications without a limit on publication date or language. The Bibliometrix packages, VOSviewer, and CiteSpace were used for data analysis. Bibliometric techniques utilized were co-authorship analyses, trend topics, thematic map analyses, thematic evolution analyses, source's production over time, corresponding author's countries, and a treemap of authors' keywords. RESULTS A total of 1992 publications and 7200 authors from 313 different sources were examined in this study. The first available document was published in November 1982, and the most cited article was cited 1200 times. Siemens AG in Germany emerged as the most prominent author affiliation, with a total of 221 published articles. The most represented scientific journals were the "European Radiology" (181 articles, h-index = 46), followed by the "European Journal of Radiology" (148 articles, h-index = 34). Most of the papers were from Germany, the USA, or China. Both the keyword and topic analyses showed the history of dual- and multi-energy CT and the evolution of its application hotspots in the chest. CONCLUSION Our study illustrates the latest advances in dual- and multi-energy CT and its increasingly prominent applications in the chest, especially in lung parenchymal diseases and coronary artery diseases. Photon-counting CT and artificial intelligence will be the emerging hot technologies that continue to develop in the future. CRITICAL RELEVANCE STATEMENT This study aims to provide valuable insights into energy-based imaging in chest disease, validating the clinical application of multi-energy CT together with photon-counting CT and effectively increasing utilization in clinical practice. KEY POINTS Bibliometric analysis is fundamental to understanding the current and future state of dual- and multi-energy CT. Research trends and leading topics included coronary artery disease, pulmonary embolism, and radiation dose. All analyses indicate a growing interest in the use of energy-based imaging techniques for thoracic applications.
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Affiliation(s)
- Yufan Chen
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ting Wu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yangtong Zhu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiawei Chen
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Linyu Wu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
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Monfregola A, De Angelis L, Comune R, Arienzo F, Barbato G, Di Stasio M, Pourmolkara D, Rosano N, Picchi SG, Galluzzo M, Granata V, Tamburrini S. Interlobar pulmonary sequestration with celiac aberrant artery in an elderly patient treated with combined endovascular and video-assisted thoracoscopic approach. Radiol Case Rep 2024; 19:3418-3424. [PMID: 38854910 PMCID: PMC11157120 DOI: 10.1016/j.radcr.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 06/11/2024] Open
Abstract
Pulmonary sequestration is a rare congenital pulmonary anomaly where a portion of the lung parenchyma is supplied by an anomalous systemic artery, usually originating from the thoracic or abdominal aorta. Traditionally surgical resection and ligation of the aberrant feeding vessel are the gold standard treatments of this disease. Hybrid operations consisting in endovascular arterial embolization and surgical resection is a promising treatment option. We report a case of a 69-years-old man with symptomatic intralobular sequestration successfully treated by hybrid approach.
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Affiliation(s)
| | - Leda De Angelis
- Division of Radiology, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Rosita Comune
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Arienzo
- Department of Interventional Radiology, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Giovanni Barbato
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Di Stasio
- Department of Thoracic Surgery, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Domenico Pourmolkara
- Department of Thoracic Surgery, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Nicola Rosano
- Department of Radiology, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | | | - Michele Galluzzo
- Department of Emergency Radiology, San Camillo Forlanini Hospital, Rome, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, Naples, Italy
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Zhang Y, Liu L, Yu H, Wang T, Zhang Y, Liu Y. ReMAR: a preoperative CT angiography guided metal artifact reduction framework designed for follow-up CTA of endovascular coiling. Phys Med Biol 2024; 69:145015. [PMID: 38959913 DOI: 10.1088/1361-6560/ad5ef4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/03/2024] [Indexed: 07/05/2024]
Abstract
Objective. Follow-up computed tomography angiography (CTA) is necessary for ensuring occlusion effect of endovascular coiling. However, the implanted metal coil will introduce artifacts that have a negative spillover into radiologic assessment.Method. A framework named ReMAR is proposed in this paper for metal artifacts reduction (MARs) from follow-up CTA of patients with coiled aneurysms. It employs preoperative CTA to provide the prior knowledge of the aneurysm and the expected position of the coil as a guidance thus balances the metal artifacts removal performance and clinical feasibility. The ReMAR is composed of three modules: segmentation, registration and MAR module. The segmentation and registration modules obtain the metal coil knowledge via implementing aneurysms delineation on preoperative CTA and alignment of follow-up CTA. The MAR module consisting of hybrid convolutional neural network- and transformer- architectures is utilized to restore sinogram and remove the artifact from reconstructed image. Both image quality and vessel rendering effect after metal artifacts removal are assessed in order to responding clinical concerns.Main results. A total of 137 patients undergone endovascular coiling have been enrolled in the study: 13 of them have complete diagnosis/follow-up records for end-to-end validation, while the rest lacked of follow-up records are used for model training. Quantitative metrics show ReMAR significantly reduced the metal-artifact burden in follow-up CTA. Qualitative ranks show ReMAR could preserve the morphology of blood vessels during artifact removal as desired by doctors.Significance. The ReMAR could significantly remove the artifacts caused by implanted metal coil in the follow-up CTA. It can be used to enhance the overall image quality and convince CTA an alternative to invasive follow-up in treated intracranial aneurysm.
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Affiliation(s)
- Yaoyu Zhang
- College of Electrical Engineering, Sichuan University, Chengdu 610065, People's Republic of China
| | - Lunxin Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610044, People's Republic of China
| | - Hui Yu
- College of Computer Science, Sichuan University, Chengdu 610065, People's Republic of China
| | - Tao Wang
- College of Computer Science, Sichuan University, Chengdu 610065, People's Republic of China
| | - Yi Zhang
- College of Computer Science, Sichuan University, Chengdu 610065, People's Republic of China
| | - Yan Liu
- College of Electrical Engineering, Sichuan University, Chengdu 610065, People's Republic of China
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Tarchi SM, Salvatore M, Lichtenstein P, Sekar T, Capaccione K, Luk L, Shaish H, Makkar J, Desperito E, Leb J, Navot B, Goldstein J, Laifer S, Beylergil V, Ma H, Jambawalikar S, Aberle D, D'Souza B, Bentley-Hibbert S, Marin MP. Radiology of fibrosis. Part I: Thoracic organs. J Transl Med 2024; 22:609. [PMID: 38956586 PMCID: PMC11218337 DOI: 10.1186/s12967-024-05244-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/27/2024] [Indexed: 07/04/2024] Open
Abstract
Sustained injury from factors such as hypoxia, infection, or physical damage may provoke improper tissue repair and the anomalous deposition of connective tissue that causes fibrosis. This phenomenon may take place in any organ, ultimately leading to their dysfunction and eventual failure. Tissue fibrosis has also been found to be central in both the process of carcinogenesis and cancer progression. Thus, its prompt diagnosis and regular monitoring is necessary for implementing effective disease-modifying interventions aiming to reduce mortality and improve overall quality of life. While significant research has been conducted on these subjects, a comprehensive understanding of how their relationship manifests through modern imaging techniques remains to be established. This work intends to provide a comprehensive overview of imaging technologies relevant to the detection of fibrosis affecting thoracic organs as well as to explore potential future advancements in this field.
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Affiliation(s)
- Sofia Maria Tarchi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA.
| | - Mary Salvatore
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Philip Lichtenstein
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Thillai Sekar
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Kathleen Capaccione
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Lyndon Luk
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Hiram Shaish
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Jasnit Makkar
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Elise Desperito
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Jay Leb
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Benjamin Navot
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Jonathan Goldstein
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Sherelle Laifer
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Volkan Beylergil
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Hong Ma
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Dwight Aberle
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Belinda D'Souza
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Stuart Bentley-Hibbert
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
| | - Monica Pernia Marin
- Department of Radiology, Columbia University Irving Medical Center, 630 W 168th Street, New York, NY, 10032, USA
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11
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Bodard S, Kharroubi-Lakouas D, Guinebert S, Dariane C, Gillard P, Sakhi H, Ferriere E, Delaye M, Timsit MO, Correas JM, Hélénon O, Boudhabhay I. [Cancer imaging and prevention of renal failure]. Bull Cancer 2024; 111:663-674. [PMID: 36371283 DOI: 10.1016/j.bulcan.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/11/2022]
Abstract
The risk of acute renal failure (ARF) following iodinated contrast media injection has long been overestimated because of the previous use of more toxic ICPs and uncontrolled studies. Nowadays, this concept is being questioned. Patients with severe renal failure and/or ARF are the only group still considered at risk. In these patients, it is necessary to discuss an alternative without an iodinated contrast agent. Contrast-enhanced ultrasound, MRI, spectral CT or PET-CT scan can be used instead of contrast-enhanced CT. Preventive measures should be applied when appropriate substitute to CT is not available or not diagnosed (minimum necessary dose of ICP, interruption of some treatments and prior hydration). These recommendations formalized by the European Society of Urogenital Radiology (ESUR) in 2018 address most situations faced by clinicians. In complex situations, an opinion from a nephrologist remains necessary after asking the radiologist about the availability of acceptable substitutes.
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Affiliation(s)
- Sylvain Bodard
- AP-HP, Hôpital Necker Enfants malades, service d'imagerie adulte, 75015 Paris, France; Université de Paris Cité, 75006 Paris, France; Sorbonne université, CNRS, Inserm, laboratoire d'imagerie biomédicale, Paris, France.
| | | | - Sylvain Guinebert
- AP-HP, Hôpital Necker Enfants malades, service d'imagerie adulte, 75015 Paris, France; Université de Paris Cité, 75006 Paris, France
| | - Charles Dariane
- Université de Paris Cité, 75006 Paris, France; AP-HP, hôpital européen Georges Pompidou, service d'urologie, 75015 Paris, France
| | - Paul Gillard
- AP-HP, Hôpital Necker Enfants malades, service d'imagerie adulte, 75015 Paris, France
| | - Hamza Sakhi
- Université de Paris Cité, 75006 Paris, France; AP-HP, hôpital Necker Enfants malades, service de néphrologie et transplantation rénale adulte, 75015 Paris, France
| | - Elsa Ferriere
- Université de Paris Cité, 75006 Paris, France; AP-HP, hôpital Necker Enfants malades, service de néphrologie et transplantation rénale adulte, 75015 Paris, France
| | - Matthieu Delaye
- Institut curie, université Versailles Saint-Quentin, département d'oncologie médicale, Saint-Cloud, France; Groupe de Recherche Interdisciplinaire Francophone en Onco-Néphrologie (GRIFON), Paris, France
| | - Marc-Olivier Timsit
- Université de Paris Cité, 75006 Paris, France; AP-HP, hôpital européen Georges Pompidou, service d'urologie, 75015 Paris, France
| | - Jean-Michel Correas
- AP-HP, Hôpital Necker Enfants malades, service d'imagerie adulte, 75015 Paris, France; Université de Paris Cité, 75006 Paris, France
| | - Olivier Hélénon
- AP-HP, Hôpital Necker Enfants malades, service d'imagerie adulte, 75015 Paris, France; Université de Paris Cité, 75006 Paris, France
| | - Idris Boudhabhay
- Université de Paris Cité, 75006 Paris, France; AP-HP, hôpital Necker Enfants malades, service de néphrologie et transplantation rénale adulte, 75015 Paris, France
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12
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Sokiranski R, Faltings D, Sokiranski S, Pirsig W, Mudry A. Probable fatal mastoiditis by the around 2300 year old Heidelberg's Egyptian mummy Djed-Hor. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:107-112. [PMID: 37002005 DOI: 10.1016/j.anorl.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 03/31/2023]
Abstract
The universal use of computed tomography (CT) has opened up new possibilities in the noninvasive examination of human mummies, and particularly the detailed study of the fine structures of the temporal bone. The aim of this study was to describe the morphological changes, as seen on CT, found in the right temporal bone of Djed-Hor, an around 2300 year old Heidelberg's Egyptian mummy, and to discuss their possible causal relation to his death. Here we showed the presence of a compress on the auricle, and of probable pus in the mastoid, middle ear, and external ear with erosion of the tegmen tympani probably related to a fatal acute mastoiditis. These typical morphological changes of such a disease were demonstrated in the same way as in living patients of today. This would be the first depiction of a compress on an auricle associated with pus in the ear of an Egyptian mummy.
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Affiliation(s)
- R Sokiranski
- Medical University-Varna, Department of Anatomy and Cell Biology, Ul. "Professor-Marin-Drinov" 55, 9002 Varna Center, Bulgaria
| | - D Faltings
- University of Heidelberg HCCH, Institute of Egyptology, Marstallstraße 6, 69117 Heidelberg, Germany
| | - S Sokiranski
- Department of Neurology, Asklepios Klinikum Wandsbek, Alphonsstraße 14, 22043 Hamburg, Germany
| | - W Pirsig
- Ulm University, Emeritus, Department of Otolaryngology, Head & Neck Surgery, Prittwitzstraße 43, 89075 Ulm, Germany
| | - A Mudry
- Department of Otolaryngology, Head & Neck Surgery, Stanford University School of Medicine, 801, Welch road, Stanford, CA 94305-5739, United States.
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13
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Sun Z, Silberstein J, Vaccarezza M. Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment. J Cardiovasc Dev Dis 2024; 11:22. [PMID: 38248892 PMCID: PMC10816599 DOI: 10.3390/jcdd11010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.
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Affiliation(s)
- Zhonghua Sun
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
| | - Jenna Silberstein
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
| | - Mauro Vaccarezza
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
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14
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Xie M, Wang H, Tang S, Chen M, Li T, He L. Application of dual-energy CT with prospective ECG-gating in cardiac CT angiography for children: Radiation and contrast agent dose. Eur J Radiol 2024; 170:111229. [PMID: 38056348 DOI: 10.1016/j.ejrad.2023.111229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE This research aimed to investigate the feasibility of utilizing dual-energy CT virtual monoenergetic images (VMI1) with prospective electrocardiogram (ECG2) gating for reducing radiation and contrast agent doses in pediatric patients with congenital heart disease (CHD3). METHODS There were 100 pediatric patients with CHD included in this study. Group A (n = 50) underwent dual-energy scanning with prospective ECG-gating, and group B (n = 50) underwent conventional scanning with retrospective ECG-gating. Comparative analysis of CT values of lumen, objective image quality assessment, subjective image quality evaluations, and diagnostic efficacy were performed. RESULTS CT values, image noise, signal-to-noise ratio (SNR4), and contrast-to-noise ratio (CNR5) were significantly affected by the VMI energy level, and they all increased with decreasing energy levels (P > 0.05). Combining subjective evaluation, the 45 keV VMI was considered the optimum image in group A. The 45 keV VMI exhibited higher CT values of lumen compared to conventional scanning images (P < 0.003 ∼ 0.836), but meanwhile, the image noise was also higher in the 45 keV VMI (P = 0.004). Differences between the two groups in SNR, CNR, and diagnostic accuracy were not statistically significant. Compared to group B, the 45 keV VMI showed fewer contrast-induced artifacts (P < 0.001) and higher image quality score (P = 0.037). Group A had a 64 % reduction in radiation dose and a 40 % decrease in iodine dose compared to group B. CONCLUSION The combination of dual-energy CT with prospective ECG-gating reduces radiation and iodine doses in pediatric patients with CHD. The 45 keV VMI can provide clinically acceptable image quality while declining contrast agent artifacts.
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Affiliation(s)
- Mingye Xie
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
| | - Haoru Wang
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
| | - Shilong Tang
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
| | - Mingjing Chen
- Department of Radiology, Jining No.1 People'S Hospital, Jining 272002, China.
| | - Ting Li
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
| | - Ling He
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
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15
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Browne WF, Sung J, Majdalany BS, Khaja MS, Calligaro K, Contrella BN, Ferencik M, Gunn AJ, Kapoor BS, Keefe NA, Kokabi N, Kramer CM, Kwun R, Shamoun F, Sharma AM, Steenburg SD, Trout AT, Vijay K, Wang DS, Steigner ML. ACR Appropriateness Criteria® Sudden Onset of Cold, Painful Leg: 2023 Update. J Am Coll Radiol 2023; 20:S565-S573. [PMID: 38040470 DOI: 10.1016/j.jacr.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
Acute onset of a cold, painful leg, also known as acute limb ischemia, describes the sudden loss of perfusion to the lower extremity and carries significant risk of morbidity and mortality. Acute limb ischemia requires rapid identification and the management of suspected vascular compromise and is inherently driven by clinical considerations. The objectives of initial imaging include confirmation of diagnosis, identifying the location and extent of vascular occlusion, and preprocedural/presurgical planning. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
| | - Jeffrey Sung
- Research Author, Weill Cornell Medical College, New York, New York
| | - Bill S Majdalany
- Panel Chair, University of Vermont Medical Center, Burlington, Vermont
| | - Minhaj S Khaja
- Panel Vice-Chair, University of Michigan, Ann Arbor, Michigan
| | - Keith Calligaro
- Pennsylvania Hospital, Philadelphia, Pennsylvania; Society for Vascular Surgery
| | | | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon; Society of Cardiovascular Computed Tomography
| | - Andrew J Gunn
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Nicole A Keefe
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Christopher M Kramer
- University of Virginia Health, Charlottesville, Virginia; Society for Cardiovascular Magnetic Resonance
| | - Richard Kwun
- Swedish Medical Center, Issaquah, Washington; American College of Emergency Physicians
| | - Fadi Shamoun
- Mayo Clinic Arizona, Phoenix, Arizona; American Society of Echocardiography
| | - Aditya M Sharma
- University of Virginia Health System, Charlottesville, Virginia, Primary care physician
| | - Scott D Steenburg
- Indiana University School of Medicine and Indiana University Health, Indianapolis, Indiana; Committee on Emergency Radiology-GSER
| | - Andrew T Trout
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Commission on Nuclear Medicine and Molecular Imaging
| | - Kanupriya Vijay
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - David S Wang
- Stanford University Medical Center, Stanford, California
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16
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Jeong J, Wentland A, Mastrodicasa D, Fananapazir G, Wang A, Banerjee I, Patel BN. Synthetic dual-energy CT reconstruction from single-energy CT Using artificial intelligence. Abdom Radiol (NY) 2023; 48:3537-3549. [PMID: 37665385 DOI: 10.1007/s00261-023-04004-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE To develop and assess the utility of synthetic dual-energy CT (sDECT) images generated from single-energy CT (SECT) using two state-of-the-art generative adversarial network (GAN) architectures for artificial intelligence-based image translation. METHODS In this retrospective study, 734 patients (389F; 62.8 years ± 14.9) who underwent enhanced DECT of the chest, abdomen, and pelvis between January 2018 and June 2019 were included. Using 70-keV as the input images (n = 141,009) and 50-keV, iodine, and virtual unenhanced (VUE) images as outputs, separate models were trained using Pix2PixHD and CycleGAN. Model performance on the test set (n = 17,839) was evaluated using mean squared error, structural similarity index, and peak signal-to-noise ratio. To objectively test the utility of these models, synthetic iodine material density and 50-keV images were generated from SECT images of 16 patients with gastrointestinal bleeding performed at another institution. The conspicuity of gastrointestinal bleeding using sDECT was compared to portal venous phase SECT. Synthetic VUE images were generated from 37 patients who underwent a CT urogram at another institution and model performance was compared to true unenhanced images. RESULTS sDECT from both Pix2PixHD and CycleGAN were qualitatively indistinguishable from true DECT by a board-certified radiologist (avg accuracy 64.5%). Pix2PixHD had better quantitative performance compared to CycleGAN (e.g., structural similarity index for iodine: 87% vs. 46%, p-value < 0.001). sDECT using Pix2PixHD showed increased bleeding conspicuity for gastrointestinal bleeding and better removal of iodine on synthetic VUE compared to CycleGAN. CONCLUSIONS sDECT from SECT using Pix2PixHD may afford some of the advantages of DECT.
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Affiliation(s)
- Jiwoong Jeong
- Department of Radiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
- School of Computing and Augmented Intelligence, Arizona State University, 699 S Mill Ave, Tempe, AZ, 85281, USA.
| | - Andrew Wentland
- Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA
| | - Domenico Mastrodicasa
- Department of Radiology, Stanford University, 300 Pasteur Dr., Stanford, CA, 94305, USA
| | - Ghaneh Fananapazir
- Department of Radiology, University of California Davis, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA
| | - Adam Wang
- Department of Radiology, Stanford University, 300 Pasteur Dr., Stanford, CA, 94305, USA
| | - Imon Banerjee
- Department of Radiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Bhavik N Patel
- Department of Radiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
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17
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Rajiah PS, Kambadakone A, Ananthakrishnan L, Sutphin P, Kalva SP. Vascular Applications of Dual-Energy Computed Tomography. Radiol Clin North Am 2023; 61:1011-1029. [PMID: 37758354 DOI: 10.1016/j.rcl.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Dual- or multi-energy CT imaging provides several advantages over conventional CT in the context of vascular imaging. Specific advantages include the use of low-energy virtual monoenergetic images (VMIs) to boost iodine attenuation to salvage suboptimal enhanced studies, perform low-contrast material dose studies, and increase conspicuity of small vessels and lesions. Alternatively, high-energy VMIs reduce artifacts caused by some metals, endoprosthesis, calcium blooming, and beam hardening. Virtual non-contrast (VNC) images reduce radiation dose by eliminating the need for a true non-contrast acquisition in multiphasic CT studies. Iodine maps can be used to evaluate perfusion of tissues and lesions.
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Affiliation(s)
- Prabhakar S Rajiah
- Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
| | | | | | - Patrick Sutphin
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Sanjeeva P Kalva
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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18
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Wang J, Wang X, Zhong H, Xie W, Xi Q. Prospective observational study on the prognosis of ureteral lesions caused by impacted stones via dual-energy spectral computed tomography. Asian J Urol 2023; 10:534-540. [PMID: 38024436 PMCID: PMC10659980 DOI: 10.1016/j.ajur.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/29/2021] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture. On this basis, the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture. Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019. They underwent an abdominal scan on a dual-energy spectral computed tomography. During surgery, the operator used ureteroscopy to identify ureteral lesions, which were classified into four categories: edema, polyps, pallor, and hardening. Seven months later, 90 patients were reviewed for the degree of hydronephrosis. Results Endoscopic observations revealed 38 (41%) cases of ureteral edema, 20 (22%) cases of polyps, 13 (14%) cases of pallor, and 22 (24%) cases of hardening. There were significant differences in hydronephrosis, the period of impaction, the calcium concentration of the ureter, and the slope of the spectral Hounsfield unit curve between the four groups. After that, we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening. Receiver operating characteristic curve analysis showed that 5.3 mg/cm³ calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening. The result of follow-up showed that 80 patients had complete remission of hydronephrosis, with a complete remission rate of 61.9% (13/21) in the hardening group and 97.1% (67/69) in the non-hardening group (p<0.001). Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening. Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy. When the calcium concentration of the ureter is less than 5.3 mg/cm³, ureteral lesions should be actively treated.
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Affiliation(s)
- Junjie Wang
- Department of Urology, The Sixth People's Hospital of Chengdu, Chengdu, China
| | - Ximing Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haozhou Zhong
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wengui Xie
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qilin Xi
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
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19
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Bird E, Hasenstab K, Kim N, Madani M, Malhotra A, Hahn L, Kligerman S, Hsiao A, Contijoch F. Mapping the Spatial Extent of Hypoperfusion in Chronic Thromboembolic Pulmonary Hypertension Using Multienergy CT. Radiol Cardiothorac Imaging 2023; 5:e220221. [PMID: 37693197 PMCID: PMC10483250 DOI: 10.1148/ryct.220221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 06/05/2023] [Accepted: 07/03/2023] [Indexed: 09/12/2023]
Abstract
Purpose To assess if a novel automated method to spatially delineate and quantify the extent of hypoperfusion on multienergy CT angiograms can aid the evaluation of chronic thromboembolic pulmonary hypertension (CTEPH) disease severity. Materials and Methods Multienergy CT angiograms obtained between January 2018 and December 2020 in 51 patients with CTEPH (mean age, 47 years ± 17 [SD]; 27 women) were retrospectively compared with those in 110 controls with no imaging findings suggestive of pulmonary vascular abnormalities (mean age, 51 years ± 16; 81 women). Parenchymal iodine values were automatically isolated using deep learning lobar lung segmentations. Low iodine concentration was used to delineate areas of hypoperfusion and calculate hypoperfused lung volume (HLV). Receiver operating characteristic curves, correlations with preoperative and postoperative changes in invasive hemodynamics, and comparison with visual assessment of lobar hypoperfusion by two expert readers were evaluated. Results Global HLV correctly separated patients with CTEPH from controls (area under the receiver operating characteristic curve = 0.84; 10% HLV cutoff: 90% sensitivity, 72% accuracy, and 64% specificity) and correlated moderately with hemodynamic severity at time of imaging (pulmonary vascular resistance [PVR], ρ = 0.67; P < .001) and change after surgical treatment (∆PVR, ρ = -0.61; P < .001). In patients surgically classified as having segmental disease, global HLV correlated with preoperative PVR (ρ = 0.81) and postoperative ∆PVR (ρ = -0.70). Lobar HLV correlated moderately with expert reader lobar assessment (ρHLV = 0.71 for reader 1; ρHLV = 0.67 for reader 2). Conclusion Automated quantification of hypoperfused areas in patients with CTEPH can be performed from clinical multienergy CT examinations and may aid clinical evaluation, particularly in patients with segmental-level disease.Keywords: CT-Spectral Imaging (Multienergy), Pulmonary, Pulmonary Arteries, Embolism/Thrombosis, Chronic Thromboembolic Pulmonary Hypertension, Multienergy CT, Hypoperfusion© RSNA, 2023.
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Affiliation(s)
- Elizabeth Bird
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Kyle Hasenstab
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Nick Kim
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Michael Madani
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Atul Malhotra
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Lewis Hahn
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Seth Kligerman
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Albert Hsiao
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Francisco Contijoch
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
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20
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Kawashima H, Ichikawa K, Ueta H, Takata T, Mitsui W, Nagata H. Virtual monochromatic images of dual-energy CT as an alternative to single-energy CT: performance comparison using a detectability index for different acquisition techniques. Eur Radiol 2023; 33:5752-5760. [PMID: 36892640 DOI: 10.1007/s00330-023-09491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/24/2022] [Accepted: 01/27/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES To investigate the performance of virtual monochromatic (VM) images with the same dose and iodine contrast as those for single-energy (SE) images using five dual-energy (DE) scanners with DE techniques: two generations of fast kV switching (FKS), two generations of dual source (DS), and one split filter (SF). METHODS A water-bath phantom with a diameter of 300 mm, which contains one rod-shaped phantom made of a material equivalent to soft-tissue and two rod-shaped phantoms made of diluted iodine (2 and 12 mg/mL), was scanned using both SE (120, 100, and 80 kV) and DE techniques with the same CT dose index in each scanner. The VM energy at which the CT number of the iodine rod is closest to that of each SE tube voltage was determined as the equivalent energy (Eeq). A detectability index (d') was calculated from the noise power spectrum, the task transfer functions, and a task function corresponding to each rod. The percentage of the d' value of the VM image to that of the corresponding SE image was calculated for performance comparison. RESULTS The average percentages of d' of FKS1, FKS2, DS1, DS2, and SF were 84.6%, 96.2%, 94.3%, 107%, and 104% for 120 kV-Eeq; 75.9%, 91.2%, 88.2%, 99.2%, and 82.6% for 100 kV-Eeq; 71.6%, 88.9%, 82.6%, 85.2%, and 62.3% for 80 kV-Eeq, respectively. CONCLUSION The performance of VM images was on the whole inferior to that of SE images especially at low equivalent energy levels, depending on the DE techniques and their generations. KEY POINTS • This study evaluated the performance of VM images with the same dose and iodine contrast as those for SE images using five DE scanners. • The performance of VM images varied with the DE techniques and their generations and was mostly inferior at low equivalent energy levels. • The results highlight the importance of distribution of available dose over the two energy levels and spectral separation for the performance improvement of VM images.
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Affiliation(s)
- Hiroki Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan.
| | - Katsuhiro Ichikawa
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan
| | - Hiroshi Ueta
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Tadanori Takata
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Wataru Mitsui
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Hiroji Nagata
- Section of Radiological Technology, Department of Medical Technology, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada, Kahoku, 920-0293, Japan
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21
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Alizadeh LS, Vogl TJ, Waldeck SS, Overhoff D, D'Angelo T, Martin SS, Yel I, Gruenewald LD, Koch V, Fulisch F, Booz C. Dual-Energy CT in Cardiothoracic Imaging: Current Developments. Diagnostics (Basel) 2023; 13:2116. [PMID: 37371011 DOI: 10.3390/diagnostics13122116] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This article describes the technical principles and clinical applications of dual-energy computed tomography (DECT) in the context of cardiothoracic imaging with a focus on current developments and techniques. Since the introduction of DECT, different vendors developed distinct hard and software approaches for generating multi-energy datasets and multiple DECT applications that were developed and clinically investigated for different fields of interest. Benefits for various clinical settings, such as oncology, trauma and emergency radiology, as well as musculoskeletal and cardiovascular imaging, were recently reported in the literature. State-of-the-art applications, such as virtual monoenergetic imaging (VMI), material decomposition, perfused blood volume imaging, virtual non-contrast imaging (VNC), plaque removal, and virtual non-calcium (VNCa) imaging, can significantly improve cardiothoracic CT image workflows and have a high potential for improvement of diagnostic accuracy and patient safety.
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Affiliation(s)
- Leona S Alizadeh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Stephan S Waldeck
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Mainz, 55131 Mainz, Germany
| | - Daniel Overhoff
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Mannheim, 68167 Mannheim, Germany
| | - Tommaso D'Angelo
- Diagnostic and Interventional Radiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, 98124 Messina, Italy
| | - Simon S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Leon D Gruenewald
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Florian Fulisch
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
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22
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Durma AD, Saracyn M, Zegadło A, Kamiński G. Utility of non-contrast Dual Energy Computed Tomography in diagnosis of differentiated thyroid cancer - two case study. Cancer Imaging 2023; 23:39. [PMID: 37072868 PMCID: PMC10114424 DOI: 10.1186/s40644-023-00555-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/10/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Dual Energy Computed Tomography (DECT) is a technology that allows for viewing computed tomography spectral images. This method, due to ability of presenting specific elements and substances (like water, calcium and iodine), can be used to locate selected type of tissues. Thyroid tissue due to being rich in endogenous iodine, can be located even without administration of contrast agent. CASE PRESENTATION In presented cases authors used a feature of accumulating endogenous iodine in thyroid derivative tissue for diagnosis of differentiated thyroid cancer metastases. In Patient One DECT was a decisive parameter qualifying for the surgery. Due to use of DECT in Patient Two it was possible to directly localize thyroid cancer metastases, which was unfeasible using standard techniques (scintigraphy and [18 F]FDG PET/CT). It helped to perform targeted biopsy and confirm diagnosis of thyroid cancer metastases, allowing to introduce treatment with sorafenibe. CONCLUSION DECT confirmed its utility in locating thyroid tissues, including differentiated thyroid cancer (DTC) metastases. The method could be used in the future, especially in borderline or ambiguous cases with no localization of DTC in ultrasonography, RAI scintigraphy, or [18 F]FDG PET/CT, and among patients having contraindications for contrast-CT.
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Affiliation(s)
- Adam Daniel Durma
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine - National Research Institute, Warsaw, Poland.
| | - Marek Saracyn
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | - Arkadiusz Zegadło
- Department of Medical Radiology, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | - Grzegorz Kamiński
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine - National Research Institute, Warsaw, Poland
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23
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Agarwal A, Kumar KP, Madhusudhan KS. Utility of dual energy CT angiography in the evaluation of acute non-variceal gastrointestinal hemorrhage: comparison with digital subtraction angiography. Abdom Radiol (NY) 2023; 48:1880-1890. [PMID: 36939912 DOI: 10.1007/s00261-023-03864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE To evaluate the utility of dual energy CT angiography (DECTA) in acute non-variceal gastrointestinal hemorrhage (ANVGIH) compared to digital subtraction angiography (DSA) as gold standard. MATERIALS AND METHODS 111 Patients (mean age: 39.2 years; 94 males) of ANVGIH who underwent both DECTA and DSA between January 2016 and September 2021 were included. Virtual monochromatic (VM) images at 10 keV increments from 40 to 70 keV and blended (120kVp equivalent) images of arterial phase of DECTA were evaluated independently by two readers blinded to DSA information. Quantitative analysis included measurement of attenuation in the major arteries (abdominal aorta, celiac artery, superior mesenteric artery), suspected vascular lesion, and lesion feeding artery to calculate contrast-to-noise ratios (CNRs) and signal-to-noise ratios (SNRs). Qualitative analysis assessed the image quality of each data set using a 3-point Likert scale. Findings on DSA were evaluated by a third reader and both DECTA and DSA were compared. RESULTS On linear blended images, vascular lesion was identified by reader 1 in 88 (79.3%) and by reader 2 in 87 (78.4%) patients and DSA showed lesion in 92 (82.9%) patients. The sensitivity and specificity of blended images and VM images of DECTA for lesion detection were not significantly different from each other. The CNR and SNR of arteries, vascular lesion and feeding artery were significantly higher at 70 keV (p < 0.005) compared to blended and other VM images. Although subjective scores for image quality were higher for 60 keV images by both readers, the difference was not statistically significant (p = 0.3). The interobserver agreement was mostly good. CONCLUSION In the assessment of ANVGIH, the 60 keV and 70 keV VM images improved the image quality and contrast, respectively, but there was no increase in diagnostic accuracy of VM image datasets compared to linearly blended images. Hence, the diagnostic utility of DECTA in ANVGIH is still uncertain.
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Affiliation(s)
- Ayushi Agarwal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Korukanti Pradeep Kumar
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Kumble Seetharama Madhusudhan
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
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24
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Saito T, Endo H, Ando D, Miyagi I, Kawabata Y, Watanabe M, Saito A, Fujimura M, Yazawa Y. Evaluation of cholesterol crystals in carotid plaque by dual energy computed tomography. Neuroradiology 2023; 65:979-982. [PMID: 36869934 DOI: 10.1007/s00234-023-03138-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023]
Abstract
Cholesterol crystals (CCs) in carotid plaques might be an indicator of vulnerability, although they have not been fully investigated and non-invasive methods of assessment have not been established. This study examines the validity of assessing CCs using dual-energy computed tomography (DECT) that uses X-rays with different tube voltages for imaging, allowing material discrimination. We retrospectively evaluated patients who had undergone preoperative cervical computed tomography angiography and carotid endarterectomy between December 2019 and July 2020. We developed CC-based material decomposition images (MDIs) by scanning CCs crystallized in the laboratory using DECT. We compared the percentage of CCs in stained slides defined by cholesterol clefts with the percentage of CCs displayed by CC-based MDIs. Thirty-seven pathological sections were obtained from 12 patients. Thirty-two sections had CCs; of these, 30 had CCs on CC-based MDIs. CC-based MDIs and pathological specimens showed a strong correlation. Thus, DECT allows the evaluation of CCs in carotid artery plaques.
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Affiliation(s)
- Takuya Saito
- Department of Stroke Neurology, Kohnan Hospital, 4-20-1, Nagamachi-Minami, Taihaku-Ku, Sendai, 982-8523, Japan.
| | - Hidenori Endo
- Department of Neurosurgery, Kohnan Hospital, Sendai, Japan
| | - Daisuke Ando
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Itsuki Miyagi
- Department of Radiology, Kohnan Hospital, Sendai, Japan
| | - Yuichi Kawabata
- Department of Stroke Neurology, Kohnan Hospital, 4-20-1, Nagamachi-Minami, Taihaku-Ku, Sendai, 982-8523, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
| | - Atsushi Saito
- Department of Neurosurgery, Hirosaki University, Hirosaki, Japan
| | - Miki Fujimura
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yukako Yazawa
- Department of Stroke Neurology, Kohnan Hospital, 4-20-1, Nagamachi-Minami, Taihaku-Ku, Sendai, 982-8523, Japan
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25
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Park S, Cho Y, Oh YW, Ko M, Lim DS, Yu CW, Park SM, Kim MN, Hwang SH. Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT. Eur Radiol 2023; 33:1963-1972. [PMID: 36112191 DOI: 10.1007/s00330-022-09133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/21/2022] [Accepted: 08/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS). METHODS A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs. RESULTS A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64, p < 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%. CONCLUSIONS When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR. KEY POINTS • A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images. • The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR. • Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.2.
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Affiliation(s)
- Soojung Park
- Department of Radiology, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Yongwon Cho
- Department of Radiology, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Yu-Whan Oh
- Department of Radiology, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Minseok Ko
- Korea University College of Medicine, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Do-Sun Lim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Cheol Woong Yu
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Mi-Na Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea.
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26
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Pack JD, Xu M, Wang G, Baskaran L, Min J, De Man B. Cardiac CT blooming artifacts: clinical significance, root causes and potential solutions. Vis Comput Ind Biomed Art 2022; 5:29. [PMID: 36484886 PMCID: PMC9733770 DOI: 10.1186/s42492-022-00125-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/03/2022] [Indexed: 12/13/2022] Open
Abstract
This review paper aims to summarize cardiac CT blooming artifacts, how they present clinically and what their root causes and potential solutions are. A literature survey was performed covering any publications with a specific interest in calcium blooming and stent blooming in cardiac CT. The claims from literature are compared and interpreted, aiming at narrowing down the root causes and most promising solutions for blooming artifacts. More than 30 journal publications were identified with specific relevance to blooming artifacts. The main reported causes of blooming artifacts are the partial volume effect, motion artifacts and beam hardening. The proposed solutions are classified as high-resolution CT hardware, high-resolution CT reconstruction, subtraction techniques and post-processing techniques, with a special emphasis on deep learning (DL) techniques. The partial volume effect is the leading cause of blooming artifacts. The partial volume effect can be minimized by increasing the CT spatial resolution through higher-resolution CT hardware or advanced high-resolution CT reconstruction. In addition, DL techniques have shown great promise to correct for blooming artifacts. A combination of these techniques could avoid repeat scans for subtraction techniques.
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Affiliation(s)
- Jed D. Pack
- grid.418143.b0000 0001 0943 0267GE Research, Niskayuna, NY 12309 USA
| | - Mufeng Xu
- grid.33647.350000 0001 2160 9198Rensselaer Polytechnic Institute, Troy, NY 12180 USA
| | - Ge Wang
- grid.33647.350000 0001 2160 9198Rensselaer Polytechnic Institute, Troy, NY 12180 USA
| | - Lohendran Baskaran
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY 10065 USA ,grid.419385.20000 0004 0620 9905National Heart Centre, Singapore, 169609 Singapore
| | - James Min
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY 10065 USA ,Cleerly, New York, NY 10065 USA
| | - Bruno De Man
- grid.418143.b0000 0001 0943 0267GE Research, Niskayuna, NY 12309 USA
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27
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Dual-energy CT iodine map in predicting the efficacy of neoadjuvant chemotherapy for hypopharyngeal carcinoma: a preliminary study. Sci Rep 2022; 12:21356. [PMID: 36494378 PMCID: PMC9734148 DOI: 10.1038/s41598-022-25828-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Neoadjuvant chemotherapy has become one of the important means for advanced hypopharyngeal carcinoma. So far, there is no effective index to predict the curative effect. To investigate the value of iodine map of dual-energy computed tomography (CT) in predicting the efficacy of neoadjuvant chemotherapy for hypopharyngeal carcinoma. A total of 54 hypopharyngeal carcinomapatients who underwent two courses of TPF neoadjuvant chemotherapy were recruited in this study. Three cases had a complete response (CR), thirty-six cases had a partial response (PR), eleven cases had stable disease (SD), and four cases had a progressive disease (PD) after the chemotherapy. All patients underwent a dual-source CT scan before chemotherapy and rescanned after chemotherapy. The normalized iodine-related attenuation (NIRA) of the mean of maximum slice and most enhanced region of lesion at arterial and parenchymal phase were measured: NIRAmean-A, NIRAmax-A, NIRAmean-P, and NIRAmax-P, respectively. Correlation analysis was conducted between different metrics of NIRA and the diameter change rate of lesions, and the curative effect was evaluated based on the receiver operating characteristic (ROC) curve. There were a significant correlation between NIRAmean-A, NIRAmax-A, NIRAmean-P, NIRAmax-P and the change rate of lesion's maximum diameter (ΔD%) (all P < 0.01). The NIRAmax-A, NIRAmean-P, NIRAmax-P had significant differences between CR, PR, SD, PD groups, but NIRAmean-A did not reach a significant difference. All NIRAmean-A, NIRAmax-A, NIRAmean-P, NIRAmax-P had significant differences between effective (CR + PR) and ineffective (SD + PD) groups. The ROC analysis revealed that NIRAmean-P had the largest AUC and prediction efficacy (AUC = 0.809). Dual-energy CT iodine map could predict the efficacy of neoadjuvant chemotherapy and provides imaging evidence to assist in treatment decisions for hypopharyngeal carcinoma patients.
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28
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Wang M, Dai Y, Jiang H, Sansone A, Jannini EA, Zhang X. Application of dual-energy CT angiography in diagnosis of arterial erectile dysfunction: new scanning technology, new scanning area. Aging Male 2022; 25:257-265. [PMID: 36102620 DOI: 10.1080/13685538.2022.2121815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To explore the value of dual-energy computed tomography (DE-CT) angiography in diagnosis of arteriogenic erectile dysfunction (ED) patients and feasibility of new scanning area that excludes the testis. MATERIALS AND METHODS Ninety-three patients suspected of suffering arterial ED and 40 health volunteers underwent penile duplex Doppler ultrasound and DE-CT angiography (DE-CTA). The scanning range of DE-CTA covered whole arterial system of pelvis and testis was excluded. Two blinded investigators independently evaluated the arterial system that supplies the penis. RESULTS Finally, 1596 segments were evaluated and 470 segments were judged to be abnormal. The distribution was: 2 (0.4%) in common iliac artery, 7 (1.5%) in internal iliac artery, 82 (17.5%) in internal pudendal artery, 89 (18.9%) in penile artery, 120 (25.5%) in dorsal artery, and 170 (36.2%) in cavernosal artery. The specificity, sensitivity, positive predictive value, and negative predictive value of DE-CTA in diagnostic were 86.02%, 87.50%, 94.12%, and 72.92%. Besides, the new scan area allowed for effective evaluation of the arteries while excluding the testis. CONCLUSION DE-CTA can provide unbiased, safe evaluation of the vascular status of the penile bed in patients with ED.
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Affiliation(s)
- Ming Wang
- Department of Urology, First affiliated hospital of Anhui medical university, Hefei, China
| | - Yutian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Hui Jiang
- Department of Andrology, Peking University Third Hospital, Beijing, China
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Xiansheng Zhang
- Department of Urology, First affiliated hospital of Anhui medical university, Hefei, China
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29
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Azene EM, Steigner ML, Aghayev A, Ahmad S, Clough RE, Ferencik M, Hedgire SS, Hicks CW, Kirsch DS, Lee YJ, Myers LA, Nagpal P, Osborne N, Pillai AK, Ripley B, Singh N, Thomas R, Kalva SP. ACR Appropriateness Criteria® Lower Extremity Arterial Claudication-Imaging Assessment for Revascularization: 2022 Update. J Am Coll Radiol 2022; 19:S364-S373. [PMID: 36436963 PMCID: PMC9876734 DOI: 10.1016/j.jacr.2022.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
Arterial claudication is a common manifestation of peripheral artery disease. This document focuses on necessary imaging before revascularization for claudication. Appropriate use of ultrasound, invasive arteriography, MR angiography, and CT angiography are discussed. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- Ezana M Azene
- Director of PERT, Chair Cancer Advisory Council, Medical Governor, Gundersen Health System, La Crosse, Wisconsin.
| | - Michael L Steigner
- Panel Chair; Director, Vascular CT/MR, Medical Director 3D Lab, Brigham & Women's Hospital, Boston, Massachusetts
| | - Ayaz Aghayev
- Panel Vice-Chair, Brigham & Women's Hospital, Boston, Massachusetts
| | - Sarah Ahmad
- University of Toronto, Toronto, Ontario, Canada; American College of Physicians
| | - Rachel E Clough
- St. Thomas' Hospital, King's College, School of Biomedical Engineering and Imaging Science, London, United Kingdom; Society for Cardiovascular Magnetic Resonance
| | - Maros Ferencik
- Section Head of Cardiovascular Imaging, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon; Society of Cardiovascular Computed Tomography
| | - Sandeep S Hedgire
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Caitlin W Hicks
- Director of Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins University School of Medicine, Baltimore, Maryland; Editor-in-Chief, Seminars in Vascular Surgery; Society for Vascular Surgery
| | | | - Yoo Jin Lee
- University of California, San Francisco, San Francisco, California
| | - Lee A Myers
- Keck School of Medicine of USC, Los Angeles, California; Committee on Emergency Radiology-GSER
| | - Prashant Nagpal
- Head, Cardiovascular Imaging, University of Wisconsin, Madison, Wisconsin
| | - Nicholas Osborne
- University of Michigan, Ann Arbor, Michigan; Society for Vascular Surgery
| | - Anil K Pillai
- Section Chief, Interventional Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Beth Ripley
- VA Puget Sound Health Care System and University of Washington, Seattle, Washington
| | | | - Richard Thomas
- Section Chief of Thoracic Imaging and Cardiac CT and Associate Magnetic Resonance Medical Director, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Sanjeeva P Kalva
- Specialty Chair; Chief of Interventional Radiology, Massachusetts General Hospital, Boston, Massachusetts
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Spectral imaging in the pediatric chest: past, present and future. Pediatr Radiol 2022; 52:1910-1920. [PMID: 35726069 DOI: 10.1007/s00247-022-05404-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/28/2022] [Accepted: 05/14/2022] [Indexed: 12/14/2022]
Abstract
Computed tomography technology continues to undergo evolution and improvement with each passing decade. From its inception in 1971, to the advent of commercially available dual-energy CT just over a decade ago, and now to the latest innovation, photon-counting detector CT, CT's utility for resolving and discriminating tissue types improves. In this review we discuss the impact of spectral imaging, including dual-energy CT and the recently available photon-counting detector CT, on the imaging of the pediatric chest. We describe the current capabilities and future directions of CT imaging, encompassing both the lungs and the surrounding tissues.
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Zheng H, Yang M, Jia Y, Zhang L, Sun X, Zhang Y, Nie Z, Wu H, Zhang X, Lei Z, Jing W. A Novel Subtraction Method to Reduce Metal Artifacts of Cerebral Aneurysm Embolism Coils. Clin Neuroradiol 2022; 32:687-694. [DOI: 10.1007/s00062-021-01125-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/17/2021] [Indexed: 11/03/2022]
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Tatsugami F, Higaki T, Nakamura Y, Honda Y, Awai K. Dual-energy CT: minimal essentials for radiologists. Jpn J Radiol 2022; 40:547-559. [PMID: 34981319 PMCID: PMC9162973 DOI: 10.1007/s11604-021-01233-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/02/2021] [Indexed: 12/11/2022]
Abstract
Dual-energy CT, the object is scanned at two different energies, makes it possible to identify the characteristics of materials that cannot be evaluated on conventional single-energy CT images. This imaging method can be used to perform material decomposition based on differences in the material-attenuation coefficients at different energies. Dual-energy analyses can be classified as image data-based- and raw data-based analysis. The beam-hardening effect is lower with raw data-based analysis, resulting in more accurate dual-energy analysis. On virtual monochromatic images, the iodine contrast increases as the energy level decreases; this improves visualization of contrast-enhanced lesions. Also, the application of material decomposition, such as iodine- and edema images, increases the detectability of lesions due to diseases encountered in daily clinical practice. In this review, the minimal essentials of dual-energy CT scanning are presented and its usefulness in daily clinical practice is discussed.
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Affiliation(s)
- Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Toru Higaki
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yuko Nakamura
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yukiko Honda
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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33
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Dual-energy CT angiography in imaging surveillance of endovascular aneurysm repair – preliminary study results. Eur J Radiol 2022; 148:110165. [DOI: 10.1016/j.ejrad.2022.110165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/12/2021] [Accepted: 01/15/2022] [Indexed: 11/18/2022]
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34
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Tarkowski P, Czekajska-Chehab E. Dual-Energy Heart CT: Beyond Better Angiography-Review. J Clin Med 2021; 10:jcm10215193. [PMID: 34768713 PMCID: PMC8584316 DOI: 10.3390/jcm10215193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 12/30/2022] Open
Abstract
Heart CT has undergone substantial development from the use of calcium scores performed on electron beam CT to modern 256+-row CT scanners. The latest big step in its evolution was the invention of dual-energy scanners with much greater capabilities than just performing better ECG-gated angio-CT. In this review, we present the unique features of dual-energy CT in heart diagnostics.
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Majeed NF, Ali SM, Therrien J, Wald C, Wortman JR. Virtual Monoenergetic Spectral Detector CT for Preoperative CT Angiography in Liver Donors. Curr Probl Diagn Radiol 2021; 51:517-523. [PMID: 34839975 DOI: 10.1067/j.cpradiol.2021.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the use of virtual monoenergetic images (VMI) in pre-operative CT angiography of potential donors for living donor adult liver transplantation (LDALT), and to determine the optimal energy level to maximize vascular signal-to-noise and contrast-to-noise ratios (SNR and CNR, respectively). MATERIALS AND METHODS We retrospectively evaluated 29 CT angiography studies performed preoperatively in potential liver donors on a spectral detector CT scanner. All studies included arterial, early venous, and delayed venous phase imaging. Conventional polyenergetic images were generated for each patient, as well as virtual monoenergetic images in 10 keV increments from 40 -100 keV. Arteries (aorta and celiac, superior mesenteric, common hepatic, right and left hepatic arteries) were assessed on arterial phase images; portal venous system branches (splenic, superior mesenteric, main, right, and left portal veins) on early venous phase images; and hepatic veins on late venous phase images. Vascular attenuation, background parenchymal attenuation, and noise were measured on each set of virtual monoenergetic and conventional images. RESULTS Background hepatic and vascular noise decreased with increasing keV, with the lowest noise at 100 keV. Vascular SNR and CNR increased with decreasing keV and were highest at 40 keV, with statistical significance compared with conventional ( P < 0.05). CONCLUSIONS In preoperative CT angiography for potential liver donors, the optimal keV for assessing the vasculature to improve SNR and CNR is 40 keV. Use of low keV VMI in LDALT CT protocols may facilitate detection of vascular anatomical variants that can impact surgical planning.
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Affiliation(s)
- Noor Fatima Majeed
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA.
| | - Sarah Maria Ali
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
| | - Jaclyn Therrien
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
| | - Christoph Wald
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
| | - Jeremy R Wortman
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA
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Zhang L, Li L, Feng G, Fan T, Jiang H, Wang Z. Advances in CT Techniques in Vascular Calcification. Front Cardiovasc Med 2021; 8:716822. [PMID: 34660718 PMCID: PMC8511450 DOI: 10.3389/fcvm.2021.716822] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
Vascular calcification, a common pathological phenomenon in atherosclerosis, diabetes, hypertension, and other diseases, increases the incidence and mortality of cardiovascular diseases. Therefore, the prevention and detection of vascular calcification play an important role. At present, various techniques have been applied to the analysis of vascular calcification, but clinical examination mainly depends on non-invasive and invasive imaging methods to detect and quantify. Computed tomography (CT), as a commonly used clinical examination method, can analyze vascular calcification. In recent years, with the development of technology, in addition to traditional CT, some emerging types of CT, such as dual-energy CT and micro CT, have emerged for vascular imaging and providing anatomical information for calcification. This review focuses on the latest application of various CT techniques in vascular calcification.
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Affiliation(s)
- Lijie Zhang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Lihua Li
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Guoquan Feng
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Tingpan Fan
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Han Jiang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhongqun Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Li T, Zhou HP, Zhou ZJ, Guo LQ, Zhou L. Computed tomography-identified phenotypes of small airway obstructions in chronic obstructive pulmonary disease. Chin Med J (Engl) 2021; 134:2025-2036. [PMID: 34517376 PMCID: PMC8440009 DOI: 10.1097/cm9.0000000000001724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Indexed: 12/02/2022] Open
Abstract
ABSTRACT Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.
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Affiliation(s)
- Tao Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Department of Respiratory Medicine, Xuzhou First People's Hospital, Xuzhou, Jiangsu 221116, China
| | - Hao-Peng Zhou
- Department of Medicine, Jiangsu University School of Medicine, Zhenjiang, Jiangsu 212013, China
| | - Zhi-Jun Zhou
- Institute of Radio Frequency & Optical Electronics-Integrated Circuits, School of Information and Engineering, Southeast University, Nanjing, Jiangsu 210096, China
| | - Li-Quan Guo
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu 215163, China
| | - Linfu Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Institute of Integrative Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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Pan L, Jia X, Zhao X, Zhang B, Wang S, Fan T, Zhou M, Yuan Y, Wang G, Xue L. Study on the correlation between energy spectrum computed tomography imaging and the pathological characteristics and prognosis of cervical cancer. Transl Cancer Res 2021; 10:4096-4105. [PMID: 35116707 PMCID: PMC8798028 DOI: 10.21037/tcr-21-1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/26/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The purpose of this study is to investigate the correlation between energy spectrum computed tomography (CT) imaging and the pathological characteristics and prognosis of cervical cancer. METHODS All participants underwent energy spectrum CT plain scan and enhanced scan of the cervix, uterine body, and common iliac vein. The correlation between the slope of energy spectrum attenuation curve and pathological characteristics and curative effect was analyzed, and the receiver operating characteristic (ROC) curve of the slope of energy spectrum attenuation curve to distinguish some pathological characteristics and curative effect was constructed. RESULTS The energy spectrum curves of cervix, uterine body, and common iliac vein all showed a downward trend. The slope of cervix energy spectrum curve showed a significant difference in different differentiation degree (P<0.05), and the slope of energy spectrum curve showed an upward trend. The slope of energy spectrum curve of common iliac vein was significantly different between high and low cell proliferation antigen marker (Ki67) (P<0.05), and the slope of Ki67 high expression was higher than that of Ki67 low expression. Treatment was effective in 17 participants and ineffective in 11. After treatment, the energy spectrum curve slope of cervix and energy spectrum curve slope of common iliac vein in the effective group were significantly increased compared with before treatment (P<0.05), and the energy spectrum curve slope of cervix in the ineffective group was increased compared with before treatment, but the difference was not significant (P>0.05). The area under the curve (AUC) of distinguishing Ki67 expression of energy spectrum curve slope of common iliac vein was 0.7008, sensitivity was 66.67%, and specificity was 62.34%. The AUC of distinguishing the curative effect of cervical energy spectrum curve slope was 0.6131, sensitivity was 56.25%, and specificity was 59.09%. The AUC of distinguishing the curative effect of energy spectrum curve slope of common iliac vein was 0.6563, sensitivity was 60.42%, and specificity was 58.33%. CONCLUSIONS The energy spectrum curve slope has potential value in the prediction of certain specific pathological types of cervical cancer and the evaluation of curative effect.
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Affiliation(s)
- Libo Pan
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Xia Jia
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Xuewu Zhao
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Bei Zhang
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Shusheng Wang
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Tao Fan
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Min Zhou
- Department of Female Tumor, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Yuan Yuan
- Department of Female Tumor, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Guoqing Wang
- Department of Female Tumor, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Longmei Xue
- Department of Computed Tomography, Shaanxi Provincial Cancer Hospital, Xi’an, China
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Yamaguchi S, Sato E, Ieko Y, Ariga H, Yoshioka K. Development of a dose-rate dosimeter for x-ray CT scanner using silicon x-ray diode. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2021; 92:053103. [PMID: 34243345 DOI: 10.1063/5.0047546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/02/2021] [Indexed: 06/13/2023]
Abstract
In an x-ray diagnosis, it is important to evaluate the entrance dose rate, as the dose rate of exposure becomes highest in that position. To investigate the effect of the entrance dose rate of x-ray CT scanners, a dose-rate dosimeter comprising a silicon x-ray diode (Si-XD), a CMOS dual operational amplifier, resistors, capacitors, and a mini-substrate measuring 20 × 17 mm2 were developed. The Si-XD is desirable for measuring the changing entrance dose rate, as it enables the reduction of the response time, dimensions, and cost of the dosimeter. The dosimeter was connected to a microcomputer (mbed), and the output voltages from the dosimeter were measured using an analog-digital converter in the mbed. The output voltages were proportional to the tube currents at a constant tube voltage of 100 kV using an industrial x-ray tube, and the calibrated dose rates corresponded well to those obtained using a commercially available semiconductor dosimeter. However, owing to the energy dependence of the dosimeter, the calibrated dose rate was ∼10% higher than that of a commercially available semiconductor dosimeter at the lower tube voltage. In the angular dependence of the dosimeter, the flatness measured from 60° to 120° was ∼103% in this study. A fundamental study for measuring the dose-rate variations with rotation was performed. The results showed a different profile than the angular dependence due to the distance from the source and the complex factors of the scattered radiation.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Radiology, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan
| | - Eiichi Sato
- Department of Physics, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3694, Japan
| | - Yoshiro Ieko
- Department of Radiation Oncology, Iwate Medical University Hospital, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan
| | - Hisanori Ariga
- Department of Radiation Oncology, Iwate Medical University Hospital, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan
| | - Kunihiro Yoshioka
- Department of Radiation Oncology, Iwate Medical University Hospital, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan
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Yamagishi M, Tamaki N, Akasaka T, Ikeda T, Ueshima K, Uemura S, Otsuji Y, Kihara Y, Kimura K, Kimura T, Kusama Y, Kumita S, Sakuma H, Jinzaki M, Daida H, Takeishi Y, Tada H, Chikamori T, Tsujita K, Teraoka K, Nakajima K, Nakata T, Nakatani S, Nogami A, Node K, Nohara A, Hirayama A, Funabashi N, Miura M, Mochizuki T, Yokoi H, Yoshioka K, Watanabe M, Asanuma T, Ishikawa Y, Ohara T, Kaikita K, Kasai T, Kato E, Kamiyama H, Kawashiri M, Kiso K, Kitagawa K, Kido T, Kinoshita T, Kiriyama T, Kume T, Kurata A, Kurisu S, Kosuge M, Kodani E, Sato A, Shiono Y, Shiomi H, Taki J, Takeuchi M, Tanaka A, Tanaka N, Tanaka R, Nakahashi T, Nakahara T, Nomura A, Hashimoto A, Hayashi K, Higashi M, Hiro T, Fukamachi D, Matsuo H, Matsumoto N, Miyauchi K, Miyagawa M, Yamada Y, Yoshinaga K, Wada H, Watanabe T, Ozaki Y, Kohsaka S, Shimizu W, Yasuda S, Yoshino H. JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases. Circ J 2021; 85:402-572. [PMID: 33597320 DOI: 10.1253/circj.cj-19-1131] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine Graduate School
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | | | | | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School
| | | | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, University of Fukui
| | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | | | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa Universtiy
| | | | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Atsushi Nohara
- Division of Clinical Genetics, Ishikawa Prefectural Central Hospital
| | | | | | - Masaru Miura
- Department of Cardiology, Tokyo Metropolitan Children's Medical Center
| | | | | | | | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School
| | - Yuichi Ishikawa
- Department of Pediatric Cardiology, Fukuoka Children's Hospital
| | - Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Tokuo Kasai
- Department of Cardiology, Uonuma Kinen Hospital
| | - Eri Kato
- Department of Cardiovascular Medicine, Department of Clinical Laboratory, Kyoto University Hospital
| | | | - Masaaki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University
| | - Keisuke Kiso
- Department of Diagnostic Radiology, Tohoku University Hospital
| | - Kakuya Kitagawa
- Department of Advanced Diagnostic Imaging, Mie University Graduate School
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School
| | | | | | | | - Akira Kurata
- Department of Radiology, Ehime University Graduate School
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
| | - Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama Nagayama Hospital
| | - Akira Sato
- Department of Cardiology, University of Tsukuba
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | - Junichi Taki
- Department of Nuclear Medicine, Kanazawa University
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Japan
| | | | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Ryoichi Tanaka
- Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
| | | | | | - Akihiro Nomura
- Innovative Clinical Research Center, Kanazawa University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Hospital
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University
| | | | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Naoya Matsumoto
- Division of Cardiology, Department of Medicine, Nihon University
| | | | | | | | - Keiichiro Yoshinaga
- Department of Diagnostic and Therapeutic Nuclear Medicine, Molecular Imaging at the National Institute of Radiological Sciences
| | - Hideki Wada
- Department of Cardiology, Juntendo University Shizuoka Hospital
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Yukio Ozaki
- Department of Cardiology, Fujita Medical University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Wegner F, von Gladiss A, Haegele J, Grzyska U, Sieren MM, Stahlberg E, Oechtering TH, Lüdtke-Buzug K, Barkhausen J, Buzug TM, Friedrich T. Magnetic Particle Imaging: In vitro Signal Analysis and Lumen Quantification of 21 Endovascular Stents. Int J Nanomedicine 2021; 16:213-221. [PMID: 33469281 PMCID: PMC7810673 DOI: 10.2147/ijn.s284694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Endovascular stents are medical devices, which are implanted in stenosed blood vessels to ensure sufficient blood flow. Due to a high rate of in-stent re-stenoses, there is the need of a noninvasive imaging method for the early detection of stent occlusion. The evaluation of the stent lumen with computed tomography (CT) and magnetic resonance imaging (MRI) is limited by material-induced artifacts. The purpose of this work is to investigate the potential of the tracer-based modality magnetic particle imaging (MPI) for stent lumen visualization and quantification. Methods In this in vitro study, 21 endovascular stents were investigated in a preclinical MPI scanner. Therefore, the stents were implanted in vessel phantoms. For the signal analysis, the phantoms were scanned without tracer material, and the signal-to-noise-ratio was analyzed. For the evaluation of potential artifacts and the lumen quantification, the phantoms were filled with diluted tracer agent. To calculate the stent lumen diameter a calibrated threshold value was applied. Results We can show that it is possible to visualize the lumen of a variety of endovascular stents without material induced artifacts, as the stents do not generate sufficient signals in MPI. The stent lumen quantification showed a direct correlation between the calculated and nominal diameter (r = 0.98). Conclusion In contrast to MRI and CT, MPI is able to visualize and quantify stent lumina very accurately.
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Affiliation(s)
- Franz Wegner
- Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany
| | | | - Julian Haegele
- Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany.,Zentrum für Radiologie und Nuklearmedizin Rheinland, Dormagen, Germany
| | - Ulrike Grzyska
- Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany
| | - Malte Maria Sieren
- Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany
| | - Erik Stahlberg
- Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany
| | | | | | - Joerg Barkhausen
- Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany
| | - Thorsten M Buzug
- Institute of Medical Engineering, University of Lübeck, Lübeck, Germany.,Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
| | - Thomas Friedrich
- Institute of Medical Engineering, University of Lübeck, Lübeck, Germany.,Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
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Gabelloni M, Faggioni L, Accogli S, Aringhieri G, Neri E. Pulmonary sequestration: What the radiologist should know. Clin Imaging 2020; 73:61-72. [PMID: 33310586 DOI: 10.1016/j.clinimag.2020.11.040] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
Pulmonary sequestration consists of a nonfunctioning mass of lung tissue, either sharing the pleural envelope of the normal lung (intralobar) or with its own pleura (extralobar), lacking normal communication with the tracheobronchial tree and receiving its arterial supply by one or more systemic vessels. It is the second most common congenital lung anomaly according to pediatric case series, but its real prevalence is likely to be underestimated, and imaging plays a key role in the diagnosis and treatment management of the condition and its potential complications. We will give a brief overview of the pathophysiology, clinical presentation and imaging findings of intra- and extralobar pulmonary sequestration, with particular reference to multidetector computed tomography as part of a powerful and streamlined diagnostic approach.
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Affiliation(s)
- Michela Gabelloni
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
| | - Sandra Accogli
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Emanuele Neri
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
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Jiang Q, Shu L, Hong H. Application of spectral CT in the diagnosis of contrast encephalopathy following carotid artery stenting: a case report. BMC Neurol 2020; 20:413. [PMID: 33183248 PMCID: PMC7661202 DOI: 10.1186/s12883-020-01992-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 11/05/2020] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Contrast encephalopathy is a rare complication of carotid artery stenting (CAS). Contrast encephalopathy is a diagnosis of exclusion that often needs to be distinguished from high perfusion syndrome, cerebral haemorrhage, subarachnoid haemorrhage (SAH), cerebral infarction and so on. CASE PRESENTATION In this study, we report on a 70-year-old man who was admitted to the hospital with transient ischaemic attacks presenting paroxysmal weakness of limbs in the previous 2 years. He had severe stenosis of the left internal carotid artery diagnosed by digital subtraction angiography (DSA) and underwent CAS. Two hours after the operation, the patient developed paralysis of the right upper limb, unclear speech, fever and restlessness. Emergency skull computed tomography (CT) showed swelling and a linear high-density area in the left cerebral hemisphere. To clarify the components of this high-density area in the traditional CT, the patient had spectral CT, which made the diagnosis of the leakage of contrast clear. After 1 week of supportive treatment, the patient improved. CONCLUSIONS Spectral CT can easily distinguish the components of high-density areas on traditional CT, which is haemorrhage, calcification or iodine contrast leakage. Therefore, spectral CT is worth consideration for the differential diagnosis of complications of vascular intervention.
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Affiliation(s)
- Qiuhong Jiang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Liming Shu
- Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-sen University, No. 628, Xinhun Road, Shenzhen, P. R. China
| | - Hua Hong
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China.
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Rapp JB, Biko DM, Barrera CA, Kaplan SL, Otero HJ. Current and Future Applications of Thoracic Dual-Energy CT in Children: Pearls and Pitfalls of Technique and Interpretation. Semin Ultrasound CT MR 2020; 41:433-441. [PMID: 32980090 DOI: 10.1053/j.sult.2020.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Dual-energy computer tomography (DECT) technology has experienced rapid growth in recent years, now allowing for the collection of 2 CT data sets and opening the potential for functional data acquisition. Data from a single postcontrast phase are deconstructed and Iodine can be subtracted to create a virtual noncontrast image, or selectively represented as a contrast map that allows for the qualification and quantification of lung perfusion. Virtual monoenergetic images can also be used to reduce beam-hardening artifact from concentrated contrast or metal implants. In children, DECT is of particular interest because it has been shown to be dose neutral in most applications, dose-reducing in multiphase studies, and to increase the contrast to noise ratio in suboptimal studies. We review the basics of acquisition, postprocessing, and thoracic applications of DECT with a focus on pulmonary blood volumes as a surrogate for perfusion imaging. The discussed applications include pulmonary embolism, hypoplastic lung, pulmonary hypertension in bronchopulmonary dysplasia, and pediatric lung masses.
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Affiliation(s)
- Jordan B Rapp
- Children's Hospital of Philadelphia, Department of Radiology, 3401 Civic Center Blvd, Philadelphia, PA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
| | - David M Biko
- Children's Hospital of Philadelphia, Department of Radiology, 3401 Civic Center Blvd, Philadelphia, PA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Christian A Barrera
- Children's Hospital of Philadelphia, Department of Radiology, 3401 Civic Center Blvd, Philadelphia, PA
| | - Summer L Kaplan
- Children's Hospital of Philadelphia, Department of Radiology, 3401 Civic Center Blvd, Philadelphia, PA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Hansel J Otero
- Children's Hospital of Philadelphia, Department of Radiology, 3401 Civic Center Blvd, Philadelphia, PA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
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Aoyama R, Murata T, Ishikawa J, Harada K. Case report of non-ST-segment elevation myocardial infarction diagnosed in spectral detector-based computed tomography performed for the diagnosis of acute pulmonary embolism. Eur Heart J Case Rep 2020; 4:1-7. [PMID: 33426452 PMCID: PMC7780472 DOI: 10.1093/ehjcr/ytaa284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/15/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022]
Abstract
Background Contrast-enhanced spectral detector-based computed tomography (SDCT) allows for the comprehensive and retrospective analysis. We report a case of pulmonary thromboembolism (PE) accompanied by non-ST-segment elevation myocardial infarction (NSTEMI) diagnosed by SDCT. Case summary A 72-year-old man with diabetes mellitus, hypertension, and prostate cancer suddenly developed chest and back pain and had difficulty in breathing at rest. Electrocardiography showed a right bundle branch block without significant ST-segment change. The initial serum troponin I level was 0.05 ng/mL, and the d-dimer level was 14.7 μg/mL. Spectral detector-based computed tomography showed bilateral scattered PE. After admission, his chest pain persisted, and the serum troponin I level 3 h after admission was elevated to 0.90 ng/mL. Reconstruction of SDCT images showed a perfusion defect of the posterolateral left ventricle myocardium. A coronary angiogram showed total occlusion of the obtuse marginal branch (OM); percutaneous coronary intervention was performed. Furthermore, we administered him with oral anticoagulants (OACs) for PE. Spectral detector-based computed tomography tests performed 6 months after the treatment was initiated, until when the dual antiplatelet therapy and OAC therapy were continued, showed improvement in perfusion defects of both pulmonary fields and the myocardium. His treatment was deescalated to single antiplatelet therapy and OAC, and the patient has had a good course. Discussion Non-ST-segment elevation myocardial infarction is sometimes difficult to diagnose accurately, especially in the hyper-acute phase or in the OM branch. The reconstruction of spectral images from enhanced SDCT was helpful to diagnose this unique combination of PE and NSTEMI and may be useful for evaluating therapeutic effects in such patients.
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Affiliation(s)
- Rie Aoyama
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaechou, Itabashi-ku, Tokyo 173-0015, Japan
| | - Teppei Murata
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaechou, Itabashi-ku, Tokyo 173-0015, Japan
| | - Joji Ishikawa
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaechou, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kazumasa Harada
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaechou, Itabashi-ku, Tokyo 173-0015, Japan
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Potigailo V, Kohli A, Pakpoor J, Cain DW, Passi N, Mohsen N. Recent Advances in Computed Tomography and MR Imaging. PET Clin 2020; 15:381-402. [PMID: 32888544 DOI: 10.1016/j.cpet.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Numerous advanced MR imaging and computed tomographic techniques have been developed and implemented in clinical practice over the past several years resulting in increased diagnostic accuracy and improved patient care. In this article, the authors highlight recent and emerging imaging techniques in functional and structural MR imaging, perfusion and vascular imaging, standardization of imaging practices, and selected applications of artificial intelligence in clinical practice.
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Affiliation(s)
- Valeria Potigailo
- Department of Radiology, University of Colorado Anschutz Medical Center, 12401 East 17th Avenue, Leprino, Mail Stop L954, Aurora, CO 80045, USA
| | - Ajay Kohli
- Department of Radiology, University of Pennsylvania, Hospital of the University of Pennsylvania, 1 Silverstein Suite 130, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Jina Pakpoor
- Department of Radiology, University of Pennsylvania, Hospital of the University of Pennsylvania, 1 Silverstein Suite 130, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Donald Wesley Cain
- Department of Radiology, University of Colorado Anschutz Medical Center, 12401 East 17th Avenue, Leprino, Mail Stop L954, Aurora, CO 80045, USA
| | - Neena Passi
- University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Nancy Mohsen
- Department of Radiology, University of Pennsylvania, Hospital of the University of Pennsylvania, 1 Silverstein Suite 130, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Ding H, Wang C, Malkasian S, Johnson T, Molloi S. Characterization of arterial plaque composition with dual energy computed tomography: a simulation study. Int J Cardiovasc Imaging 2020; 37:331-341. [PMID: 32876901 DOI: 10.1007/s10554-020-01961-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/03/2020] [Indexed: 12/27/2022]
Abstract
To investigate the feasibility of quantifying the chemical composition of coronary artery plaque in terms of water, lipid, protein, and calcium contents using dual-energy computed tomography (CT) in a simulation study. A CT simulation package was developed based on physical parameters of a clinical CT scanner. A digital thorax phantom was designed to simulate coronary arterial plaques in the range of 2-5 mm in diameter. Both non-calcified and calcified plaques were studied. The non-calcified plaques were simulated as a mixture of water, lipid, and protein, while the calcified plaques also contained calcium. The water, lipid, protein, and calcium compositions of the plaques were selected to be within the expected clinical range. A total of 95 plaques for each lesion size were simulated using the CT simulation package at 80 and 135 kVp. Half-value layer measurements were made to make sure the simulated dose was within the range of clinical dual energy scanning protocols. Dual-energy material decomposition using a previously developed technique was performed to determine the volumetric fraction of water, lipid, protein, and calcium contents in each plaque. For non-calcified plaque, the total volume conservation provides the third constrain for three-material decomposition with dual energy CT. For calcified plaque, a fourth criterion was introduced from a previous report suggesting a linear correlation between water and protein contents in soft tissue. For non-calcified plaque, the root mean-squared error (RMSE) of the image-based decomposition was estimated to be 0.7%, 1.5%, and 0.3% for water, lipid, and protein contents, respectively. As for the calcified plaques, the RMSE of the 5 mm plaques were estimated to be 5.6%, 5.7%, 0.2%, and 3.1%, for water, lipid, calcium, and protein contents, respectively. The RMSE increases as the plaque size reduces. The simulation results indicate that chemical composition of coronary arterial plaques can be quantified using dual-energy CT. By accurately quantifying the content of a coronary plaque lesion, our decomposition method may provide valuable insight for the assessment and stratification of coronary artery disease.
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Affiliation(s)
- Huanjun Ding
- Department of Radiological Sciences, University of California, Irvine, CA, 92697, USA.
| | - Chenggong Wang
- Department of Radiological Sciences, University of California, Irvine, CA, 92697, USA
| | - Shant Malkasian
- Department of Radiological Sciences, University of California, Irvine, CA, 92697, USA
| | - Travis Johnson
- Department of Radiological Sciences, University of California, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, University of California, Irvine, CA, 92697, USA
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Intracranial calcifications in childhood: Part 1. Pediatr Radiol 2020; 50:1424-1447. [PMID: 32734340 DOI: 10.1007/s00247-020-04721-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/03/2020] [Accepted: 05/12/2020] [Indexed: 12/30/2022]
Abstract
This article is the first of a two-part series on intracranial calcification in childhood. Intracranial calcification can be either physiological or pathological. Physiological intracranial calcification is not an expected neuroimaging finding in the neonatal or infantile period but occurs, as children grow older, in the pineal gland, habenula, choroid plexus and occasionally the dura mater. Pathological intracranial calcification can be broadly divided into infectious, congenital, endocrine/metabolic, vascular and neoplastic. The main goals in Part 1 are to discuss the chief differences between physiological and pathological intracranial calcification, to discuss the histological characteristics of intracranial calcification and how intracranial calcification can be detected across neuroimaging modalities, to emphasize the importance of age at presentation and intracranial calcification location, and to propose a comprehensive neuroimaging approach toward the differential diagnosis of the causes of intracranial calcification. Finally, in Part 1 the authors discuss the most common causes of infectious intracranial calcification, especially in the neonatal period, and congenital causes of intracranial calcification. Various neuroimaging modalities have distinct utilities and sensitivities in the depiction of intracranial calcification. Age at presentation, intracranial calcification location, and associated neuroimaging findings are useful information to help narrow the differential diagnosis of intracranial calcification. Intracranial calcification can occur in isolation or in association with other neuroimaging features. Intracranial calcification in congenital infections has been associated with clastic changes, hydrocephalus, chorioretinitis, white matter abnormalities, skull changes and malformations of cortical development. Infections are common causes of intracranial calcification, especially neonatal TORCH (toxoplasmosis, other [syphilis, varicella-zoster, parvovirus B19], rubella, cytomegalovirus and herpes) infections.
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Rajiah P, Parakh A, Kay F, Baruah D, Kambadakone AR, Leng S. Update on Multienergy CT: Physics, Principles, and Applications. Radiographics 2020; 40:1284-1308. [DOI: 10.1148/rg.2020200038] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Prabhakar Rajiah
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Anushri Parakh
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Fernando Kay
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Dhiraj Baruah
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Avinash R. Kambadakone
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Shuai Leng
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
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Schmoee J, Dirrichs T, Fehrenbacher K, Tietz E, Hardt F, Schmid M, Gohmann RF, Reinartz SD. Virtual Monoenergetic Images (VMI+) in Dual-Source Dual-Energy CT Venography (DSDE-CTV) of the Lower Extremity Prior to Coronary Artery Bypass Graft (CABG): A Feasibility Study. Acad Radiol 2020; 27:1249-1254. [PMID: 31843393 DOI: 10.1016/j.acra.2019.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/24/2019] [Accepted: 11/02/2019] [Indexed: 12/29/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the image quality and suitability of Dual-Source Dual-Energy CT venography (DSDE-CTV) with asynchronous virtual monoenergetic images (VMI+) of the entire lower extremity in the context of pre-surgical assessment of complex cases prior to coronary bypass graft as a feasibility study. MATERIALS AND METHODS Fifteen consecutive patients, consisting of 5 females and 10 males with an average age of 52 ± 17 years underwent DSDE-CTV from the pubic symphysis to the ankles after intravenous injection of an iodinated contrast medium. DSDE-CTV was acquired with tube voltages of 80 kVp and sn140 kVp. Single spectrum images (A - 80 kVp; B - 140 kVp) as well as a linearly blended mixed data set (M_0.6) were reconstructed. By postprocessing, an VMI+ dataset at 40 keV was generated. Objective image quality parameters of the deep and superficial veins of thigh, knee, and calves were measured separately for each location. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Additionally, subjective image quality was assessed independently by two radiologists. RESULTS Mean vascular attenuation was 73.9 ± 17.8 HU at B, 113.7 ± 42.2 HU at M_0.6, 119.4 ± 45.5 HU at A, and 201.0 ± 89.7 HU at VMI+. Mean CNR was 6.7 ± 2.0 at 140 keV, 9.25 ± 2.3 in the M_0.6 datasets, 8.7 ± 3.0 at 80 keV, and 12.9 ± 4.3 at 40 keV. Attenuation values were approximately doubled when compared to the reference standard (M_0.6) with significantly improved SNR and CNR (p < 0.05). Subjective image quality scores were highest for VMI+ datasets (4.1 ± 0.5) and lowest for B datasets (2.3 ± 0.37), however differences between VMI+ datasets and M_0.6 datasets did not reach statistical significance. CONCLUSION Postprocessing of dual-energy CTV with VMI+ significantly increases attenuation of veins and markedly improves SNR and CNR values, thereby improving the diagnostic quality of CTV for the evaluation of deep and superficial veins of the entire lower limb prior to coronary bypass graft.
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