David Zopfs1, Kai Roman Laukamp2, Daniel Pinto Dos Santos1, Marcel Sokolowski1, Nils Große Hokamp1, David Maintz1, Jan Borggrefe1, Thorsten Persigehl1, Simon Lennartz3. 1. University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany. 2. University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany; Department of Radiology, Case Western Reserve University and University Hospitals, 11100 Euclid Ave, Cleveland, Ohio, USA. 3. University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany; Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne, Weyertal 115b, 50931, Cologne, Germany. Electronic address: Simon.Lennartz@uk-koeln.de.
Abstract
OBJECTIVES: To compare objective and subjective image quality between low keV virtual monoenergetic images (VMI) of the excretory phase and conventional venous phase images derived from spectral dual-energy CT (DECT) in the assessment of urothelial carcinoma. METHODS: 26 consecutive patients with histologically confirmed urothelial carcinoma who received clinically indicated venous- and excretory phase abdominal CT scans were included retrospectively. Attenuation, image noise as well as signal- and contrast-to-noise-ratio (SNR, CNR) in venous and excretory phase CT and excretory phase VMI from 40 to 70 keV were obtained from ROI-based measurements in the following regions: urothelial carcinoma, liver, pancreas, renal cortex, subcutaneous fat, renal vein/artery, portal vein, urinary bladder wall, lymph nodes, prostate/uterus. Subjective vessel contrast and delineation of primary tumor manifestations and distant metastases were rated on 5-point Likert scales. RESULTS: In comparison to venous phase CT, attenuation and SNR in excretory phase VMI40keV were higher (p < 0.001), except for liver parenchyma, where they were comparable (p = 0.07 and p = 0.17, respectively). Regarding image noise, no significant difference was found between venous phase CT and excretory phase VMI40keV (p-range: 0.08-1.00), except for liver, portal vein and renal artery, where it was lower in VMI40keV (p < 0.05). CNR of urothelial carcinoma to circumjacent bladder wall was significantly higher in excretory phase VMI40keV compared to venous phase CT. Subjective vessel contrast and delineation of primary tumor and distant metastases received equivalent or higher Likert scores in excretory phase VMI40keV than in venous phase CT. CONCLUSION: This feasibility study indicates that in the assessment of urothelial carcinoma, virtual monoenergetic excretory phase images at 40 keV acquired with spectral DECT could be feasible to maintain subjective and objective image quality as provided by conventional venous phase images. Still, equivalence with regards to metastatic lesion detection requires further investigation before employing this technique in a potential signal-scan, single-bolus approach.
OBJECTIVES: To compare objective and subjective image quality between low keV virtual monoenergetic images (VMI) of the excretory phase and conventional venous phase images derived from spectral dual-energy CT (DECT) in the assessment of urothelial carcinoma. METHODS: 26 consecutive patients with histologically confirmed urothelial carcinoma who received clinically indicated venous- and excretory phase abdominal CT scans were included retrospectively. Attenuation, image noise as well as signal- and contrast-to-noise-ratio (SNR, CNR) in venous and excretory phase CT and excretory phase VMI from 40 to 70 keV were obtained from ROI-based measurements in the following regions: urothelial carcinoma, liver, pancreas, renal cortex, subcutaneous fat, renal vein/artery, portal vein, urinary bladder wall, lymph nodes, prostate/uterus. Subjective vessel contrast and delineation of primary tumor manifestations and distant metastases were rated on 5-point Likert scales. RESULTS: In comparison to venous phase CT, attenuation and SNR in excretory phase VMI40keV were higher (p < 0.001), except for liver parenchyma, where they were comparable (p = 0.07 and p = 0.17, respectively). Regarding image noise, no significant difference was found between venous phase CT and excretory phase VMI40keV (p-range: 0.08-1.00), except for liver, portal vein and renal artery, where it was lower in VMI40keV (p < 0.05). CNR of urothelial carcinoma to circumjacent bladder wall was significantly higher in excretory phase VMI40keV compared to venous phase CT. Subjective vessel contrast and delineation of primary tumor and distant metastases received equivalent or higher Likert scores in excretory phase VMI40keV than in venous phase CT. CONCLUSION: This feasibility study indicates that in the assessment of urothelial carcinoma, virtual monoenergetic excretory phase images at 40 keV acquired with spectral DECT could be feasible to maintain subjective and objective image quality as provided by conventional venous phase images. Still, equivalence with regards to metastatic lesion detection requires further investigation before employing this technique in a potential signal-scan, single-bolus approach.
Authors: Simon Lennartz; Nils Große Hokamp; Charlotte Zäske; David Zopfs; Grischa Bratke; Andreas Glauner; David Maintz; Thorsten Persigehl; De-Hua Chang; Tilman Hickethier Journal: Br J Radiol Date: 2020-07-24 Impact factor: 3.039
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: R P Reimer; N Große Hokamp; A Fehrmann Efferoth; A Krauskopf; D Zopfs; J R Kröger; T Persigehl; D Maintz; A C Bunck Journal: Eur Radiol Date: 2020-11-12 Impact factor: 5.315