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Comparison of low kVp CT and dual-energy CT for the evaluation of hypervascular hepatocellular carcinoma

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare lesion conspicuity and image quality of arterial phase images obtained from low kVp (90-kVp) and dual-energy (DE) scans for the evaluation of hypervascular hepatocellular carcinoma (HCC).

Methods

This retrospective study included 229 patients with HCC who underwent either 90 kVp (n = 106) or DE scan (80- and 150-kVp with a tin filter) (n = 123) during the arterial phase. DE scans were reconstructed into a linearly blended image with a mixed ratio of 0.6 (60% 80kVp and 40% 150 kVp) and post-processed for 40 keV and 50 keV images. The contrast-to-noise ratio (CNR) of HCC to the liver and image noise was measured. Lesion conspicuity, liver parenchymal image quality, and overall image preference were assessed qualitatively by three independent radiologists.

Results

DE 40 keV images had the highest CNR of HCC, and DE blended images had the lowest image noise among four image sets (p = 0.01 and p < 0.001, respectively). There was no significant difference in mean volume CT dose index and dose-length product between DE and low kVp scan (ps > 0.05). For qualitative analyses, DE blended images had the highest scores for image quality and overall image preference (ps < 0.001).

Conclusion

At an equal radiation dose, DE 40 keV showed higher CNR of HCC and DE blended image showed higher image quality and image preference compared with low kVp CT.

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Data availability

We declared that materials described in the manuscript, including all relevant raw data, will be freely available to any scientist wishing to use them for non-commercial purposes, without breaching participant confidentiality.

Code availability

All softwares used during the study appear in the submitted article; No code was generated or used during the study.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, Seoul, Korea

    Jeongin Yoo, Jeong Min Lee, Jeong Hee Yoon, Ijin Joo & Sun Kyung Jeon

  2. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Jeong Min Lee

  3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Jeong Min Lee, Jeong Hee Yoon & Ijin Joo

  4. Department of Radiology, Chung-Ang University Hospital, Seoul, Korea

    Eun Sun Lee

  5. Department of Radiology, Seoul National University Boramae Hospital, Seoul, Korea

    Siwon Jang

  6. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Korea

    Jeong Min Lee

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Contributions

Study conception and design: JML; Acquisition of data: JY; Data Analysis: ESL, SKJ, SJ; Data interpretation: JY; Drafting of manuscript: JY; Critical revision of manuscript: JHY, IJ, JML.

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Correspondence to Jeong Min Lee.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by Institutional Review Board of Seoul National University Hospital and in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent was waived by Institutional Review Board of Seoul National University Hospital due to retrospective design of the study.

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Yoo, J., Lee, J.M., Yoon, J.H. et al. Comparison of low kVp CT and dual-energy CT for the evaluation of hypervascular hepatocellular carcinoma. Abdom Radiol 46, 3217–3226 (2021). https://doi.org/10.1007/s00261-020-02888-7

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  • DOI: https://doi.org/10.1007/s00261-020-02888-7

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