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Virtual monoenergetic dual-layer dual-energy CT images in colorectal cancer: CT diagnosis could be improved?

  • Abdominal Radiology
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La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

To compare conventional CT images and virtual monoenergetic images (VMI) at dual-layer dual-energy CT (dlDECT) in patients with colorectal cancer (CRC) through quantitative analysis and to investigate the added value of VMI.

Material and Methods

Sixty-six consecutive patients with histologically documented CRC and available VMI reconstructions were retrospectively investigated. Subsequently, forty-two patients, without any colonic disease at colonoscopy, were selected as control group. Conventional CT images and VMI reconstructions at energy levels ranging from 40 (VMI40) to 100 keV (VMI100) in 10 keV increments, were obtained from the late arterial phase. First, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were obtained to select the best VMI reconstruction. Finally, the diagnostic accuracy of conventional CT and VMI40 in late arterial phase was evaluated.

Results

On quantitative analysis, SNR and CNR were higher for VMI40 (19.5 ± 7.7 and 11.8 ± 6.2, respectively) with statistically significant differences compared to conventional CT (P < 0.05) and all the other VMI reconstructions (P < 0.05), except for VMI50 (P > 0.05). The addition of VMI40 to conventional CT images significantly improved the area under the curve (AUC) for the diagnosis of CRC, increasing it from 0.875 to 0.943 for reader 1 (P < 0.05) and from 0.916 to 0.954 for reader 2 (P < 0.05). The improvement was greater in the less experienced radiologist (0.068) compared to the more experienced one (0.037).

Conclusion

VMI40 has showed the highest quantitative image parameters. Furthermore, the use of VMI40 can lead to a significant improvement in the diagnostic performance for detecting CRC.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy

    Francesco Marcello Arico’, Renato Trimarchi, Antonio Portaluri, Claudia Barilla’, Nicola Migliaccio, Giuseppe Mauro Bucolo, Giuseppe Cicero, Carmelo Sofia, Maria Adele Marino, Tommaso D’Angelo, Silvio Mazziotti & Giorgio Ascenti

  2. Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Christian Booz & Thomas J. Vogl

  3. Postgraduate School of Radiodiagnostics, Policlinico Universitario, University of Milan, Milan, Italy

    Velio Ascenti

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  1. Francesco Marcello Arico’
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  3. Antonio Portaluri
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Contributions

All authors contributed to the study conception and design.

Corresponding author

Correspondence to Renato Trimarchi.

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

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This retrospective study was approved by the Review Board of our institution (Policlinico Universitario G. Martino, University of Messina, Italy) and the requirement for informed consent was waived.

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Arico’, F.M., Trimarchi, R., Portaluri, A. et al. Virtual monoenergetic dual-layer dual-energy CT images in colorectal cancer: CT diagnosis could be improved?. Radiol med 128, 891–899 (2023). https://doi.org/10.1007/s11547-023-01663-0

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