Doris Leithner1, Scherwin Mahmoudi1, Julian L Wichmann2, Simon S Martin1, Lukas Lenga1, Moritz H Albrecht3, Christian Booz1, Christophe T Arendt1, Martin Beeres1, Tommaso D'Angelo4, Boris Bodelle1, Thomas J Vogl1, Jan-Erik Scholtz5. 1. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany. 2. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany. Electronic address: julian.wichmann@kgu.de. 3. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC, USA. 4. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; University of Messina, Department of Biomedical Sciences and Morphological and Functional Imaging, Messina, Italy. 5. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; Massachusetts General Hospital, Harvard Medical School, Cardiac MR PET CT Program, Boston MA, USA.
Abstract
PURPOSE: To investigate the impact of traditional (VMI) and noise-optimized virtual monoenergetic imaging (VMI+) algorithms on quantitative and qualitative image quality, and the assessment of stenosis in carotid and intracranial dual-energy CTA (DE-CTA). MATERIALS AND METHODS: DE-CTA studies of 40 patients performed on a third-generation 192-slice dual-source CT scanner were included in this retrospective study. 120-kVp image-equivalent linearly-blended, VMI and VMI+ series were reconstructed. Quantitative analysis included evaluation of contrast-to-noise ratios (CNR) of the aorta, common carotid artery, internal carotid artery, middle cerebral artery, and basilar artery. VMI and VMI+ with highest CNR, and linearly-blended series were rated qualitatively. Three radiologists assessed artefacts and suitability for evaluation at shoulder height, carotid bifurcation, siphon, and intracranial using 5-point Likert scales. Detection and grading of stenosis were performed at carotid bifurcation and siphon. RESULTS: Highest CNR values were observed for 40-keV VMI+ compared to 65-keV VMI and linearly-blended images (P < 0.001). Artefacts were low in all qualitatively assessed series with excellent suitability for supraaortic artery evaluation at shoulder and bifurcation height. Suitability was significantly higher in VMI+ and VMI compared to linearly-blended images for intracranial and ICA assessment (P < 0.002). VMI and VMI+ showed excellent accordance for detection and grading of stenosis at carotid bifurcation and siphon with no differences in diagnostic performance. CONCLUSION: 40-keV VMI+ showed improved quantitative image quality compared to 65-keV VMI and linearly-blended series in supraaortic DE-CTA. VMI and VMI+ provided increased suitability for carotid and intracranial artery evaluation with excellent assessment of stenosis, but did not translate into increased diagnostic performance.
PURPOSE: To investigate the impact of traditional (VMI) and noise-optimized virtual monoenergetic imaging (VMI+) algorithms on quantitative and qualitative image quality, and the assessment of stenosis in carotid and intracranial dual-energy CTA (DE-CTA). MATERIALS AND METHODS: DE-CTA studies of 40 patients performed on a third-generation 192-slice dual-source CT scanner were included in this retrospective study. 120-kVp image-equivalent linearly-blended, VMI and VMI+ series were reconstructed. Quantitative analysis included evaluation of contrast-to-noise ratios (CNR) of the aorta, common carotid artery, internal carotid artery, middle cerebral artery, and basilar artery. VMI and VMI+ with highest CNR, and linearly-blended series were rated qualitatively. Three radiologists assessed artefacts and suitability for evaluation at shoulder height, carotid bifurcation, siphon, and intracranial using 5-point Likert scales. Detection and grading of stenosis were performed at carotid bifurcation and siphon. RESULTS: Highest CNR values were observed for 40-keV VMI+ compared to 65-keV VMI and linearly-blended images (P < 0.001). Artefacts were low in all qualitatively assessed series with excellent suitability for supraaortic artery evaluation at shoulder and bifurcation height. Suitability was significantly higher in VMI+ and VMI compared to linearly-blended images for intracranial and ICA assessment (P < 0.002). VMI and VMI+ showed excellent accordance for detection and grading of stenosis at carotid bifurcation and siphon with no differences in diagnostic performance. CONCLUSION: 40-keV VMI+ showed improved quantitative image quality compared to 65-keV VMI and linearly-blended series in supraaortic DE-CTA. VMI and VMI+ provided increased suitability for carotid and intracranial artery evaluation with excellent assessment of stenosis, but did not translate into increased diagnostic performance.
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
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Authors: David Zopfs; Simon Lennartz; Nuran Abdullayev; Thorsten Lichtenstein; Kai Roman Laukamp; Robert Peter Reimer; Christoph Kabbasch; Jan Borggrefe; Marc Schlamann; Victor Neuhaus; Nils Große Hokamp Journal: Quant Imaging Med Surg Date: 2021-08
Authors: Lukas Lenga; Marvin Lange; Simon S Martin; Moritz H Albrecht; Christian Booz; Ibrahim Yel; Christophe T Arendt; Thomas J Vogl; Doris Leithner Journal: Br J Radiol Date: 2021-04-29 Impact factor: 3.039
Authors: Tommaso D'Angelo; Moritz H Albrecht; Danilo Caudo; Silvio Mazziotti; Thomas J Vogl; Julian L Wichmann; Simon Martin; Ibrahim Yel; Giorgio Ascenti; Vitali Koch; Giuseppe Cicero; Alfredo Blandino; Christian Booz Journal: Eur Radiol Exp Date: 2021-09-03