Jing-Juan Liu1, Wei Liu2, Zheng-Yu Jin3, Hua-Dan Xue1, Yi-Ning Wang1, Sheng-Hui Yu4, Jin Chen1, Yun Wang1, Jian-Chun Yu5. 1. Department of Radiology, Peking Union Medical College Hospital, Shuaifuyuan No. 1, Dongcheng District, 100730, Beijing, China. 2. Department of Radiology, Peking Union Medical College Hospital, Shuaifuyuan No. 1, Dongcheng District, 100730, Beijing, China. Electronic address: lwpumch@163.com. 3. Department of Radiology, Peking Union Medical College Hospital, Shuaifuyuan No. 1, Dongcheng District, 100730, Beijing, China. Electronic address: jinzy@pumch.cn. 4. Philips (China) Investment Co., Ltd, No. 16 Tianze Road, Chaoyang District, 100600, Beijing, China. 5. Department of General Surgery, Peking Union Medical College Hospital, Shuaifuyuan No. 1, Dongcheng Distric, 100730, Beijing, China.
Abstract
RATIONALE AND OBJECTIVES: To determine the optimal keV for the visualization of gastric cancer and to investigate its value in depicting lesions and in identifying depth invasion using virtual monoenergetic images (VMIs) on a novel dual-layer spectral detector CT. MATERIALS AND METHODS: Eighty-two gastric cancer patients were retrospectively enrolled, and 41 patients who did not undergo surgery were evaluated for image quality in VMIs at different keVs (40 keV-70 keV with 10 keV increments) and in conventional 120 kVp polyenergetic images (PEIs) reconstructed from the portal venous phase. Objective image quality was assessed by the contrast-to-noise ratio of the gastric cancer, while subjective performance was compared using a 5-point Likert scale. Another 41 patients who underwent surgery were examined to compare the diagnostic performance of the VMIs taken at the optimal keV and that of the 120 kVp-PEIs. RESULTS: The contrast-to-noise ratio of gastric cancer at 40 keV (10.4 ± 4.6) was the highest among all the VMIs and was significantly superior to that of the 120 kVp-PEIs (3.5 ± 1.5, p < 0.001). Gastric-specific image quality was rated highest for the 40 keV-VMIs (4.92 ± 0.26), which was significantly superior to that of the 120 kVp-PEIs (4.15 ± 0.82, p < 0.001). In the diagnostic group, there were 13 pT1, 10 pT2, 9 pT3, and 9 pT4 gastric cancer patients. Compared with the 120 kVp-PEIs, the VMIs at 40 keV tended to have a higher detection rate of gastric cancer (82.9% vs. 92.7%, respectively, p = 0.125) and a significantly improved diagnostic accuracy in the T stage (from 41.5% to 78.11%, respectively) (p < 0.001), particularly in pT1 patients, whose diagnostic accuracy was improved by 53.8% (7.7% vs. 61.5%, respectively, p = 0.016). CONCLUSION: VMIs at 40 keV performed the best, both objectively and subjectively, for gastric cancer, leading to improved lesion depiction and higher T stage accuracy.
RATIONALE AND OBJECTIVES: To determine the optimal keV for the visualization of gastric cancer and to investigate its value in depicting lesions and in identifying depth invasion using virtual monoenergetic images (VMIs) on a novel dual-layer spectral detector CT. MATERIALS AND METHODS: Eighty-two gastric cancerpatients were retrospectively enrolled, and 41 patients who did not undergo surgery were evaluated for image quality in VMIs at different keVs (40 keV-70 keV with 10 keV increments) and in conventional 120 kVp polyenergetic images (PEIs) reconstructed from the portal venous phase. Objective image quality was assessed by the contrast-to-noise ratio of the gastric cancer, while subjective performance was compared using a 5-point Likert scale. Another 41 patients who underwent surgery were examined to compare the diagnostic performance of the VMIs taken at the optimal keV and that of the 120 kVp-PEIs. RESULTS: The contrast-to-noise ratio of gastric cancer at 40 keV (10.4 ± 4.6) was the highest among all the VMIs and was significantly superior to that of the 120 kVp-PEIs (3.5 ± 1.5, p < 0.001). Gastric-specific image quality was rated highest for the 40 keV-VMIs (4.92 ± 0.26), which was significantly superior to that of the 120 kVp-PEIs (4.15 ± 0.82, p < 0.001). In the diagnostic group, there were 13 pT1, 10 pT2, 9 pT3, and 9 pT4 gastric cancerpatients. Compared with the 120 kVp-PEIs, the VMIs at 40 keV tended to have a higher detection rate of gastric cancer (82.9% vs. 92.7%, respectively, p = 0.125) and a significantly improved diagnostic accuracy in the T stage (from 41.5% to 78.11%, respectively) (p < 0.001), particularly in pT1 patients, whose diagnostic accuracy was improved by 53.8% (7.7% vs. 61.5%, respectively, p = 0.016). CONCLUSION: VMIs at 40 keV performed the best, both objectively and subjectively, for gastric cancer, leading to improved lesion depiction and higher T stage accuracy.
Authors: Da Xu; Rong Liu; Huiping Xu; Zhijian Zhang; Wei Li; Yi Zhang; Wenjun Zhang Journal: Comput Math Methods Med Date: 2022-04-30 Impact factor: 2.238