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Value of the virtual monoenergetic image from dual-layer dual-energy computed tomography enterography in the preoperative assessment of the internal penetrating complication of Crohn’s disease

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Abstract

Background

To determine the utility of virtual-monoenergetic imaging (VMI) at low energy levels from contrast-enhanced dual-layer dual-energy (DLDE) computed tomography enterography (CTE) in the preoperative assessment of internal penetrating lesions of Crohn’s disease (CD).

Materials and methods

Thirty-eight patients with penetrating lesions of CD by surgery undergoing contrast-enhanced DLDE CTE were retrospectively included. Polyenergetic imaging (PEI) and VMIs at low energy levels [40–70 kiloelectron volts (keV)] with 10 keV intervals were reconstructed. The objective parameters of image quality [noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)] and the subjective parameter of image quality [diagnostic performance of lesions (DPL), overall image quality(OIQ)] of PEI and all VMIs at the low energy level were compared to determine the VMI on the optimal energy level. The lesion detection capability between PEI and the optimal VMI was compared.

Results

VMI40 was determined to be the optimal VMI among all VMIs at the low energy level for owning the best image quality. No significant difference was found in the detecting capability in penetrating lesions between VMI40 and PEI (p = 1.0), whereas a significant difference was found in the detecting capability in the bowel origin of the penetrating lesions (p = 0.004), the involved organ or structure by the fistula (p = 0.016) and the orifice of the fistula connected to the involved organ or structure ( p = 0.031) between them.

Conclusions

Compared to conventional PEI, VMI40 improves the detection capability in anatomical details of penetrating lesions of CD, helping colorectal surgeons rationalizing preoperative plans of internal penetrating lesions of CD.

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Data availability

All relevant data are within the manuscript.

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Funding

This research was supported by the China Crohn’s & Colitis Foundation (CCCF) under Grant No. CCF-QF-2022C41-20.

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Authors and Affiliations

  1. Department of Radiology, Chongqing General Hospital, 118 Xingguang Street, Yubei District, Chongqing, 400000, ChongQing Province, China

    Meilin Gong, Lili Liu, Peipei He, Xiong Ran, Yu Xu, Ya Zou & Kang Li

  2. Department of Health Management Center, Chongqing General Hospital, 5 Xingguang Road, Xingguang Street, Yubei District, Chongqing, 400000, ChongQing Province, China

    Zhengying Zhang

  3. Department of Radiology, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing, China

    Huanhuan Ren

  4. Department of General Surgery, Chongqing General Hospital, Chongqing, China

    Jingsong Wu

  5. Department of Pathology, Chongqing General Hospital, Chongqing, China

    Zan Li

  6. Department of Gastroenterology, Chongqing General Hospital, Chongqing, China

    Wei Tan

Authors
  1. Meilin Gong
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  2. Lili Liu
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  3. Huanhuan Ren
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  4. Peipei He
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  7. Ya Zou
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  9. Zan Li
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  10. Wei Tan
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  11. Zhengying Zhang
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  12. Kang Li
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Contributions

KL, ZZ and MG designed and conceived the study. LL, HR, PH, and XR analyzed CT images. MG performed statistical analysis. YX, YZ, JW, ZL and WT collected data. MG wrote the first draft of the manuscript. All authors contributed to the final version of the manuscript.

Corresponding authors

Correspondence to Zhengying Zhang or Kang Li.

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Competing interests

The author(s) declared no potential competing interests with respect to the research, authorship, and publication of this manuscript.

Ethical approval

This retrospective single-center cohort study received institutional ethics review board approval of Chongqing general hospital.

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Written informed consent was waived by the institutional review board for this was a retrospective study.

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Gong, M., Liu, L., Ren, H. et al. Value of the virtual monoenergetic image from dual-layer dual-energy computed tomography enterography in the preoperative assessment of the internal penetrating complication of Crohn’s disease. Abdom Radiol 49, 814–822 (2024). https://doi.org/10.1007/s00261-023-04148-w

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  • DOI: https://doi.org/10.1007/s00261-023-04148-w

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