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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

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

September 2014

Volume

272

Issue

3

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.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

September 2014

Volume

272

Issue

3

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