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Inter-scan and inter-scanner variation of quantitative dual-energy CT: evaluation with three different scanner types

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate inter-scan and inter-scanner variation of iodine concentration (IC) and attenuation in virtual monoenergetic images at 65 keV (HU65keV) in patients with repeated abdominal examinations on dual-source (dsDECT), rapid kV switching (rsDECT), and dual-layer detector DECT (dlDECT).

Methods

We retrospectively included 131 patients who underwent two abdominal DECT examinations on the same scanner (dsDECT: n = 46, rsDECT: n = 45, dlDECT: n = 40). IC and HU65keV were measured by placing regions of interest in the liver, spleen, kidneys, aorta, portal vein, and inferior vena cava. Overall IC and HU65keV for each scanner, their inter-scan differences and proportional variation were calculated and compared between scanner types.

Results

The three scanner-specific cohorts showed similar weight, body diameter, age, sex, and contrast media injection parameters as well as inter-scan differences hereof (p range: 0.23–0.99). Absolute inter-scan differences of HU65keV and IC were comparable between scanners (p range: 0.08–1.0). Overall inter-scan variation was significantly higher in IC than HU65keV (p < 0.05). For the liver, rsDECT showed significantly lower inter-scan variation of IC compared to dsDECT/dlDECT (p = 0.005/0.01), while for the spleen, this difference was only significant compared to dsDECT (p = 0.015). Normalizing IC of the liver to the portal vein and of the spleen to the aorta did not significantly reduce inter-scan variation (p = 0.97 and 0.50).

Conclusions

Iodine measurements across different DECT scanners show inter-scan variation which is higher compared to variation of attenuation values. Inter-scanner differences in longitudinal variation and overall iodine concentration depend on the scanner pairs and organs assessed and should be acknowledged in clinical and scientific DECT applications.

Key Points

• All scanner types showed comparable inter-scan variation of attenuation, while for iodine, the rapid kV switching DECT showed lower variability in the liver and spleen.

• Iodine concentration showed higher inter-scan variation than attenuation measurements; normalization to vessels did not significantly improve inter-scan reproducibility of iodine concentration in parenchymal organs.

• Differences between the three scanner types regarding overall iodine concentration and attenuation obtained from both timepoints were within the range of average intra-patient, inter-scan differences for most assessed organs and vessels.

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Abbreviations

DECT:

Dual-energy CT

dlDECT:

Dual-layer detector dual-energy CT

dsDECT:

Dual-source dual-energy CT

IC:

Iodine concentration

IVC:

Inferior vena cava

keV:

Kiloelectron volt

kV:

Kilovolt

mGy:

Milligray

ROI:

Region of interest

rsDECT:

Rapid kV switching dual-energy CT

SSDE:

Size-specific dose estimate

VMI:

Virtual monoenergetic images

VNC:

Virtual non-contrast images

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Funding

This study was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—LE 4401/1-1 to Simon Lennartz (project number 426969820).

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Simon Lennartz, Anushri Parakh, Jinjin Cao & Avinash Kambadakone

  2. Institute for Diagnostic and Interventional Radiology, University Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    Simon Lennartz, David Zopfs & Nils Große Hokamp

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  1. Simon Lennartz
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  2. Anushri Parakh
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Corresponding author

Correspondence to Avinash Kambadakone.

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Guarantor

The scientific guarantor of this publication is Avinash Kambadakone.

Conflict of interest

Avinash Kambadakone: research grants (GE and Philips Healthcare). Simon Lennartz, Nils Große Hokamp, David Zopfs: research support (Philips Healthcare). Nils Große Hokamp: speaker’s bureau (Philips Healthcare).

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No complex statistical methods were necessary for this paper.

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Written informed consent was waived by the Institutional Review Board.

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Lennartz, S., Parakh, A., Cao, J. et al. Inter-scan and inter-scanner variation of quantitative dual-energy CT: evaluation with three different scanner types. Eur Radiol 31, 4438–4451 (2021). https://doi.org/10.1007/s00330-020-07611-0

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  • DOI: https://doi.org/10.1007/s00330-020-07611-0

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