Simon S Martin1, Julian L Wichmann2, Hendrik Weyer1, Jan-Erik Scholtz3, Doris Leithner1, Adam Spandorfer4, Boris Bodelle1, Volkmar Jacobi1, Thomas J Vogl1, Moritz H Albrecht5. 1. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany. 2. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany. Electronic address: docwichmann@gmail.com. 3. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany; Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 4. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA. 5. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Abstract
PURPOSE: To assess image quality and diagnostic performance of a noise-optimized algorithm to reconstruct virtual monoenergetic images (VMI+) for the detection of endoleaks after endovascular abdominal aortic aneurysm repair (EVAR) using dual-energy CT angiography (DE-CTA). MATERIALS AND METHODS: Seventy-five patients (42 men; 66.2±11.7years) underwent DE-CTA following EVAR. Arterial phase images were acquired in dual-energy mode for the reconstruction of standard linearly-blended M_0.5, VMI+ and traditional monoenergetic images (VMI) at 40-100keV in 10-keV intervals. Contrast-to-noise ratios (CNR) were calculated for the area of leakage in patients with endoleaks. Diagnostic accuracy for endoleak detection was evaluated by three blinded radiologists using the objectively best series for each reconstruction technique. RESULTS: Thirty-four out of 75 patients showed endoleaks. Quantitative image parameters were highest at 40-keV VMI+ (CNR, 21.3±11.1), compared to M_0.5 (CNR, 10.9±5.5) and all VMI series that showed highest values at 70keV (CNR, 13.5±6.6; all P<0.001). ROC analysis for endoleak detection revealed an area under the curve (AUC) of 0.992 for 40-keV VMI+ series, which was significantly higher (P≤0.039) compared to 70-keV VMI (0.914) and M_0.5 series (0.916). CONCLUSIONS: Noise-optimized VMI+ series at 40keV improve diagnostic accuracy for the detection and rule-out of endoleaks after EVAR.
PURPOSE: To assess image quality and diagnostic performance of a noise-optimized algorithm to reconstruct virtual monoenergetic images (VMI+) for the detection of endoleaks after endovascular abdominal aortic aneurysm repair (EVAR) using dual-energy CT angiography (DE-CTA). MATERIALS AND METHODS: Seventy-five patients (42 men; 66.2±11.7years) underwent DE-CTA following EVAR. Arterial phase images were acquired in dual-energy mode for the reconstruction of standard linearly-blended M_0.5, VMI+ and traditional monoenergetic images (VMI) at 40-100keV in 10-keV intervals. Contrast-to-noise ratios (CNR) were calculated for the area of leakage in patients with endoleaks. Diagnostic accuracy for endoleak detection was evaluated by three blinded radiologists using the objectively best series for each reconstruction technique. RESULTS: Thirty-four out of 75 patients showed endoleaks. Quantitative image parameters were highest at 40-keV VMI+ (CNR, 21.3±11.1), compared to M_0.5 (CNR, 10.9±5.5) and all VMI series that showed highest values at 70keV (CNR, 13.5±6.6; all P<0.001). ROC analysis for endoleak detection revealed an area under the curve (AUC) of 0.992 for 40-keV VMI+ series, which was significantly higher (P≤0.039) compared to 70-keV VMI (0.914) and M_0.5 series (0.916). CONCLUSIONS: Noise-optimized VMI+ series at 40keV improve diagnostic accuracy for the detection and rule-out of endoleaks after EVAR.
Authors: Tommaso D'Angelo; Giuseppe Cicero; Silvio Mazziotti; Giorgio Ascenti; Moritz H Albrecht; Simon S Martin; Ahmed E Othman; Thomas J Vogl; Julian L Wichmann Journal: Br J Radiol Date: 2019-04-09 Impact factor: 3.039
Authors: Doris Leithner; Tatjana Gruber-Rouh; Martin Beeres; Julian L Wichmann; Scherwin Mahmoudi; Simon S Martin; Lukas Lenga; Moritz H Albrecht; Christian Booz; Thomas J Vogl; Jan-Erik Scholtz Journal: Br J Radiol Date: 2018-06-05 Impact factor: 3.039
Authors: Giuseppe Cicero; Giorgio Ascenti; Moritz H Albrecht; Alfredo Blandino; Marco Cavallaro; Tommaso D'Angelo; Maria Ludovica Carerj; Thomas J Vogl; Silvio Mazziotti Journal: Radiol Med Date: 2020-01-10 Impact factor: 3.469
Authors: Simon S Martin; Franziska Trapp; Julian L Wichmann; Moritz H Albrecht; Lukas Lenga; James Durden; Christian Booz; Thomas J Vogl; Tommaso D'Angelo Journal: Eur Radiol Date: 2018-11-28 Impact factor: 5.315
Authors: Georg Apfaltrer; Francesco Lavra; U Joseph Schoepf; Marco Scarabello; Ricardo Yamada; Marly van Assen; Akos Varga-Szemes; Brian E Jacobs; Maximilian J Bauer; William T Greenberg; Marcelo Guimaraes; Luca Saba; Carlo N De Cecco Journal: PLoS One Date: 2021-01-07 Impact factor: 3.240