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Optimization of window settings for standard and advanced virtual monoenergetic imaging in abdominal dual-energy CT angiography

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Abstract

Objectives

To determine the optimal window setting for displaying virtual monoenergetic reconstructions of third generation dual-source, dual-energy CT (DECT) angiography of the abdomen.

Methods

Forty-five patients were evaluated with DECT angiography (90/150 kV, 180/90 ref. mAs). Three datasets were reconstructed: standard linear blending (M_0.6), 70 keV traditional virtual monoenergetic (M70), and 40 keV advanced noise-optimized virtual monoenergetic (M40+). The best window setting (width and level, W/L) was assessed by two blinded observers and was correlated with aortic attenuation to obtain the Optimized W/L setting (O-W/L). Subjective image quality was assessed, and vessel diameters were measured to determine any possible influences between different W/L settings. Repeated measures of variance were used to evaluate comparison of W/L values, image quality, and vessel sizing between M_0.6, M70, and M40+.

Results

The Best W/L (B-W/L) for M70 and M40+ was 880/280 and 1410/450, respectively. Results from regression analysis inferred an O-W/L of 850/270 for M70 and 1350/430 for M40+. Significant differences for W and L were found between the Best and the Optimized W/L for M40+, and between M70 and M40+ for both the Best and Optimized W/L. No significant differences for vessel measurements were found using the O-W/L for M40+ compared to the standard M_0.6 (p ≥ 0.16), and significant differences were observed when using the B-W/L with M40+ compared to M_0.6 (p ≤ 0.04).

Conclusion

In order to optimize virtual monoenergetic imaging with both traditional M70 and advanced M40+, adjusting the W/L settings is necessary. Our results suggest a W/L setting of 850/270 for M70 and 1350/430 for M40+.

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Abbreviations

M_0.6:

Standard linearly blended image

M70:

Traditional virtual monoenergetic image at 70 keV

M40+:

Advanced virtual monoenergetic image at 40 keV

B-W/L :

Best W/L setting

O-W/L :

Optimized W/L setting

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Authors and Affiliations

  1. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA

    Damiano Caruso, Ashley H. Parinella, U. Joseph Schoepf, Maxwell H. Stroebel, Stefanie Mangold, Julian L. Wichmann, Akos Varga-Szemes, B. Devon Ball Jr, Domenico De Santis & Carlo N. De Cecco

  2. Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome “Sapienza”, Latina, Italy

    Damiano Caruso, Domenico De Santis & Andrea Laghi

  3. Division of Cardiology, Department of MedicineMedical, University of South Carolina, Charleston, SC, USA

    U. Joseph Schoepf

  4. Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany

    Stefanie Mangold

  5. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany

    Julian L. Wichmann

Authors
  1. Damiano Caruso
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  2. Ashley H. Parinella
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  3. U. Joseph Schoepf
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  4. Maxwell H. Stroebel
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  5. Stefanie Mangold
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  6. Julian L. Wichmann
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  7. Akos Varga-Szemes
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  8. B. Devon Ball Jr
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  9. Domenico De Santis
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  11. Carlo N. De Cecco
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Corresponding author

Correspondence to U. Joseph Schoepf.

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Funding

No funding was received for this study.

Conflict of interest

Schoepf is a consultant for and/or receives research support from Astellas, Bayer, Bracco, GE, Guerbet, Medrad, and Siemens. The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Caruso, D., Parinella, A.H., Schoepf, U.J. et al. Optimization of window settings for standard and advanced virtual monoenergetic imaging in abdominal dual-energy CT angiography. Abdom Radiol 42, 772–780 (2017). https://doi.org/10.1007/s00261-016-0963-9

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  • DOI: https://doi.org/10.1007/s00261-016-0963-9

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