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Dual-energy CT arthrography: a feasibility study

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Abstract

Objective

To evaluate the feasibility of producing 2-dimensional (2D) virtual noncontrast images and 3-dimensional (3D) bone models from dual-energy computed tomography (DECT) arthrograms and to determine whether this is best accomplished using 190 keV virtual monoenergetic images (VMI) or virtual unenhanced (VUE) images.

Materials and methods

VMI and VUE images were retrospectively reconstructed from patients with internal derangement of the shoulder or knee joint who underwent DECT arthrography between September 2017 and August 2019. A region of interest was placed in the area of brightest contrast, and the mean attenuation (in Hounsfield units [HUs]) was recorded. Two blinded musculoskeletal radiologists qualitatively graded the 2D images and 3D models using scores ranging from 0 to 3 (0 considered optimal).

Results

Twenty-six patients (mean age ± SD, 57.5 ± 16.8 years; 6 women) were included in the study. The contrast attenuation on VUE images (overall mean ± SD, 10.5 ± 16.4 HU; knee, 19.3 ± 10.7 HU; shoulder, 5.0 ± 17.2 HU) was significantly lower (p < 0.001 for all comparisons) than on VMI (overall mean ± SD, 107.7 ± 43.8 HU; knee, 104.6 ± 31.1 HU; shoulder, 109.6 ± 51.0 HU). The proportion of cases with optimal scores (0 or 1) was significantly higher with VUE than with VMI for both 2D and 3D images (p < 0.001).

Conclusions

DECT arthrography can be used to produce 2D virtual noncontrast images and to generate 3D bone models. The VUE technique is superior to VMI in producing virtual noncontrast images.

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Author information

Authors and Affiliations

  1. Imaging Institute, Cleveland Clinic, Cleveland, OH, 44195, USA

    Rashpal Sandhu, Mercan Aslan, Wadih Karim & Naveen Subhas

  2. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, 44195, USA

    Nancy Obuchowski

  3. Siemens Medical Solutions USA, Inc., Malvern, PA, 19355, USA

    Andrew Primak

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  1. Rashpal Sandhu
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Correspondence to Naveen Subhas.

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Conflict of interest

Naveen Subhas, MD, MPH, has received research support from Siemens Healthcare and NIH. Andrew Primak, PhD, is an employee of Siemens Medical Solutions.

Ethical approval

This retrospective study was approved by the institutional review board with a waiver of informed consent. 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.

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Sandhu, R., Aslan, M., Obuchowski, N. et al. Dual-energy CT arthrography: a feasibility study. Skeletal Radiol 50, 693–703 (2021). https://doi.org/10.1007/s00256-020-03603-9

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  • DOI: https://doi.org/10.1007/s00256-020-03603-9

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