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Energy-Specific Optimization of Attenuation Thresholds for Low-Energy Virtual Monoenergetic Images in Renal Lesion Evaluation.

Publication ,  Journal Article
Patel, BN; Farjat, A; Schabel, C; Duvnjak, P; Mileto, A; Ramirez-Giraldo, JC; Marin, D
Published in: AJR Am J Roentgenol
May 2018

OBJECTIVE: The purpose of this study was to determine in vitro and in vivo the optimal threshold for renal lesion vascularity at low-energy (40-60 keV) virtual monoenergetic imaging. MATERIALS AND METHODS: A rod simulating unenhanced renal parenchymal attenuation (35 HU) was fitted with a syringe containing water. Three iodinated solutions (0.38, 0.57, and 0.76 mg I/mL) were inserted into another rod that simulated enhanced renal parenchyma (180 HU). Rods were inserted into cylindric phantoms of three different body sizes and scanned with single- and dual-energy MDCT. In addition, 102 patients (32 men, 70 women; mean age, 66.8 ± 12.9 [SD] years) with 112 renal lesions (67 nonvascular, 45 vascular) measuring 1.1-8.9 cm underwent single-energy unenhanced and contrast-enhanced dual-energy CT. Optimal threshold attenuation values that differentiated vascular from nonvascular lesions at 40-60 keV were determined. RESULTS: Mean optimal threshold values were 30.2 ± 3.6 (standard error), 20.9 ± 1.3, and 16.1 ± 1.0 HU in the phantom, and 35.9 ± 3.6, 25.4 ± 1.8, and 17.8 ± 1.8 HU in the patients at 40, 50, and 60 keV. Sensitivity and specificity for the thresholds did not change significantly between low-energy and 70-keV virtual monoenergetic imaging (sensitivity, 87-98%; specificity, 90-91%). The AUC from 40 to 70 keV was 0.96 (95% CI, 0.93-0.99) to 0.98 (95% CI, 0.95-1.00). CONCLUSION: Low-energy virtual monoenergetic imaging at energy-specific optimized attenuation thresholds can be used for reliable characterization of renal lesions.

Duke Scholars

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Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

May 2018

Volume

210

Issue

5

Start / End Page

W205 / W217

Location

United States

Related Subject Headings

  • Signal-To-Noise Ratio
  • Sensitivity and Specificity
  • Radiographic Image Interpretation, Computer-Assisted
  • Phantoms, Imaging
  • Nuclear Medicine & Medical Imaging
  • Multidetector Computed Tomography
  • Male
  • Kidney Neoplasms
  • Kidney
  • Iodine
 

Citation

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Patel, B. N., Farjat, A., Schabel, C., Duvnjak, P., Mileto, A., Ramirez-Giraldo, J. C., & Marin, D. (2018). Energy-Specific Optimization of Attenuation Thresholds for Low-Energy Virtual Monoenergetic Images in Renal Lesion Evaluation. AJR Am J Roentgenol, 210(5), W205–W217. https://doi.org/10.2214/AJR.17.18641
Patel, Bhavik N., Alfredo Farjat, Christoph Schabel, Petar Duvnjak, Achille Mileto, Juan Carlos Ramirez-Giraldo, and Daniele Marin. “Energy-Specific Optimization of Attenuation Thresholds for Low-Energy Virtual Monoenergetic Images in Renal Lesion Evaluation.AJR Am J Roentgenol 210, no. 5 (May 2018): W205–17. https://doi.org/10.2214/AJR.17.18641.
Patel BN, Farjat A, Schabel C, Duvnjak P, Mileto A, Ramirez-Giraldo JC, et al. Energy-Specific Optimization of Attenuation Thresholds for Low-Energy Virtual Monoenergetic Images in Renal Lesion Evaluation. AJR Am J Roentgenol. 2018 May;210(5):W205–17.
Patel, Bhavik N., et al. “Energy-Specific Optimization of Attenuation Thresholds for Low-Energy Virtual Monoenergetic Images in Renal Lesion Evaluation.AJR Am J Roentgenol, vol. 210, no. 5, May 2018, pp. W205–17. Pubmed, doi:10.2214/AJR.17.18641.
Patel BN, Farjat A, Schabel C, Duvnjak P, Mileto A, Ramirez-Giraldo JC, Marin D. Energy-Specific Optimization of Attenuation Thresholds for Low-Energy Virtual Monoenergetic Images in Renal Lesion Evaluation. AJR Am J Roentgenol. 2018 May;210(5):W205–W217.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

May 2018

Volume

210

Issue

5

Start / End Page

W205 / W217

Location

United States

Related Subject Headings

  • Signal-To-Noise Ratio
  • Sensitivity and Specificity
  • Radiographic Image Interpretation, Computer-Assisted
  • Phantoms, Imaging
  • Nuclear Medicine & Medical Imaging
  • Multidetector Computed Tomography
  • Male
  • Kidney Neoplasms
  • Kidney
  • Iodine