Carlo N De Cecco1, Damiano Caruso2, U Joseph Schoepf1, Julian L Wichmann3, Janet R Ter Louw4, Jonathan D Perry4, Melissa M Picard4, Amanda R Schaefer4, Leland W Parker4, Andrew D Hardie5. 1. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425, United States. 2. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425, United States; Department of Radiological Sciences, Oncological and Pathological Sciences University of Rome "Sapienza", via Franco Faggiana 1668, 04100 Latina, Italy. 3. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425, United States; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. 4. Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425, United States. 5. Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425, United States. Electronic address: andrewdhardie@gmail.com.
Abstract
OBJECTIVES: To evaluate optimal window settings for display of virtual monoenergetic reconstructions in third-generation dual-source, dual-energy computed tomography (DECT) of the liver. METHODS: Twenty-nine subjects were prospectively evaluated with DECT in arterial (AP) and portal venous (PVP) phases. Three reconstructed datasets were calculated: standard linearly-blended (LB120), 70-keV standard virtual monoenergetic (M70), and 50-keV advanced image-based virtual monoenergetic (M50+). Two readers assessed optimal window settings (width and level, W/L), establishing a mean for each reconstruction which was used for a blinded assessment of liver lesions. RESULTS: The optimal W/L for M50+ were significantly higher for both AP (W=429.3 ± 44.6 HU, L=129.4 ± 9.7 HU) and PVP (W=376.1 ± 14.2HU, L=146.6 ± 7.0 HU) than for LB120 (AP, W=215.9 ± 16.9 HU, L=82.3 ± 9.4 HU) (PVP, W=173.4 ± 8.9 HU, L=69.3 ± 6.0 HU) and M70 (AP, W=247.1 ± 22.2 HU, L=72.9 ± 6.8 HU) (PVP, W=232.0 ± 27.9 HU, L=91.6 ± 14.4 HU). Use of the optimal window setting for M50+ vs. LB120 resulted in higher sensitivity (AP, 100% vs. 86%; PVP, 96% vs. 63%). CONCLUSIONS: Application of dedicated window settings results in improved liver lesion detection rates in advanced image-based virtual monoenergetic DECT when customized for arterial and portal venous phases.
OBJECTIVES: To evaluate optimal window settings for display of virtual monoenergetic reconstructions in third-generation dual-source, dual-energy computed tomography (DECT) of the liver. METHODS: Twenty-nine subjects were prospectively evaluated with DECT in arterial (AP) and portal venous (PVP) phases. Three reconstructed datasets were calculated: standard linearly-blended (LB120), 70-keV standard virtual monoenergetic (M70), and 50-keV advanced image-based virtual monoenergetic (M50+). Two readers assessed optimal window settings (width and level, W/L), establishing a mean for each reconstruction which was used for a blinded assessment of liver lesions. RESULTS: The optimal W/L for M50+ were significantly higher for both AP (W=429.3 ± 44.6 HU, L=129.4 ± 9.7 HU) and PVP (W=376.1 ± 14.2HU, L=146.6 ± 7.0 HU) than for LB120 (AP, W=215.9 ± 16.9 HU, L=82.3 ± 9.4 HU) (PVP, W=173.4 ± 8.9 HU, L=69.3 ± 6.0 HU) and M70 (AP, W=247.1 ± 22.2 HU, L=72.9 ± 6.8 HU) (PVP, W=232.0 ± 27.9 HU, L=91.6 ± 14.4 HU). Use of the optimal window setting for M50+ vs. LB120 resulted in higher sensitivity (AP, 100% vs. 86%; PVP, 96% vs. 63%). CONCLUSIONS: Application of dedicated window settings results in improved liver lesion detection rates in advanced image-based virtual monoenergetic DECT when customized for arterial and portal venous phases.
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