Scholars@Duke publication: Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study.

Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study.

Publication , Journal Article

Mileto, A; Nelson, RC; Samei, E; Jaffe, TA; Paulson, EK; Barina, A; Choudhury, KR; Wilson, JM; Marin, D

Published in: Radiology

September 2014

PURPOSE: To investigate whether dual-energy multi-detector row computed tomography (CT) with virtual monochromatic imaging can overcome renal cyst pseudoenhancement in a phantom experiment and a clinical study. MATERIALS AND METHODS: This retrospective single-center HIPAA-compliant study was approved by the institutional review board, with waiver of informed consent. Four renal compartments inserted into torso phantoms were filled with saline to simulate the unenhanced state and with iodinated solutions to simulate the three levels of renal parenchyma enhancement (140, 180, and 240 HU). Saline-filled spheres simulating renal cysts (15 and 18 mm in diameter) were serially suspended in the renal compartments and imaged with dual-energy and single-energy multi-detector row CT at four different energy levels (80, 100, 120, and 140 kVp). In addition, 28 patients (mean age, 66 years ± 10; mean body mass index, 31.3 kg/m(2) ± 6.2) with 34 intrarenal cysts were included. Virtual monochromatic images were reconstructed in 10-keV increments at energy levels ranging from 40 to 140 keV. Phantom and clinical data were analyzed by using multivariate regression analysis. RESULTS: In the phantom experiment, all polychromatic image data sets showed pseudoenhancement (postcontrast attenuation increase >10 HU) in all investigated conditions, with a significant effect on cyst size (P <.001), location (P <.001), and renal background attenuation level (P <.001). Virtual monochromatic images at energy levels ranging from 80 to 140 keV did not show pseudoenhancement, with the minimum attenuation increase (mean, 6.1 HU ± 1.6; range, 1.6-7.7 HU) on 80-keV images. In patients, pseudoenhancement never occurred on virtual monochromatic images at energy levels ranging from 90 to 140 keV. Patient body size had a significant effect (P = .007) on selection of the optimal monochromatic energy level. CONCLUSION: Dual-energy multi-detector row CT with reconstruction of virtual monochromatic images at an optimal energy level can overcome renal cyst pseudoenhancement.

Duke Scholars

Author Tracy Anne Jaffe Radiology, Abdominal Imaging

Author Kingshuk Roy Choudhury Biostatistics & Bioinformatics, Division of Biostatistics

Author Rendon C. Nelson Radiology

Author Ehsan Samei Radiology

Author Erik Karl Paulson Radiology, Abdominal Imaging

Author Joshua Wilson Radiology

Author Daniele Marin Radiology, Abdominal Imaging

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Published In

Radiology

DOI

10.1148/radiol.14132856

EISSN

1527-1315

Publication Date

September 2014

Volume

272

Issue

Start / End Page

767 / 776

Location

United States

Related Subject Headings

Sensitivity and Specificity
Retrospective Studies
Reproducibility of Results
Radiography, Dual-Energy Scanned Projection
Radiographic Image Interpretation, Computer-Assisted
Radiographic Image Enhancement
Phantoms, Imaging
Nuclear Medicine & Medical Imaging
Multidetector Computed Tomography
Models, Theoretical

Citation

APA

Chicago

ICMJE

MLA

NLM

Mileto, A., Nelson, R. C., Samei, E., Jaffe, T. A., Paulson, E. K., Barina, A., … Marin, D. (2014). Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study. Radiology, 272(3), 767–776. https://doi.org/10.1148/radiol.14132856

Mileto, Achille, Rendon C. Nelson, Ehsan Samei, Tracy A. Jaffe, Erik K. Paulson, Andrew Barina, Kingshuk Roy Choudhury, Joshua M. Wilson, and Daniele Marin. “Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study.” Radiology 272, no. 3 (September 2014): 767–76. https://doi.org/10.1148/radiol.14132856.

Mileto A, Nelson RC, Samei E, Jaffe TA, Paulson EK, Barina A, et al. Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study. Radiology. 2014 Sep;272(3):767–76.

Mileto, Achille, et al. “Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study.” Radiology, vol. 272, no. 3, Sept. 2014, pp. 767–76. Pubmed, doi:10.1148/radiol.14132856.

Mileto A, Nelson RC, Samei E, Jaffe TA, Paulson EK, Barina A, Choudhury KR, Wilson JM, Marin D. Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study. Radiology. 2014 Sep;272(3):767–776.