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Noise-optimized virtual monoenergetic dual-energy computed tomography: optimization of kiloelectron volt settings in patients with gastrointestinal stromal tumors

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Abstract

Purpose

The aim of this study was to evaluate the impact of a noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique on quantitative and qualitative image analysis in patients with gastrointestinal stromal tumors (GISTs) at dual-energy computed tomography (DECT) of the abdomen.

Methods

Forty-five DECT datasets of 21 patients (14 men; 63.7 ± 9.2 years) with GISTs were reconstructed with the standard linearly blended (M_0.6) and VMI+ and traditional virtual monoenergetic (VMI) algorithm in 10-keV increments from 40 to 100 keV. Attenuation measurements were performed in GIST lesions and abdominal metastases to calculate objective signal-to-noise (SNR) and contrast-to-noise ratios (CNR). Five-point scales were used to evaluate overall image quality, lesion delineation, image sharpness, and image noise.

Results

Quantitative image parameters peaked at 40-keV VMI+ series (SNR 27.8 ± 13.0; CNR 26.3 ± 12.7), significantly superior to linearly blended (SNR 16.8 ± 7.3; CNR 13.6 ± 6.9) and all VMI series (all P < 0.001). Qualitative image parameters were highest for 60-keV VMI+ reconstructions regarding overall image quality and image sharpness (median 5, respectively; P ≤ 0.023). Qualitative assessment of lesion delineation peaked in 40 and 50-keV VMI+ series (median 5, respectively). Image noise was superior in 90 and 100-keV VMI and VMI+ reconstructions (all medians 5).

Conclusions

Low-keV VMI+ reconstructions significantly increase SNR and CNR of GISTs and improve quantitative and qualitative image quality of abdominal DECT datasets compared to traditional VMI and standard linearly blended image series.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Simon S. Martin, Sophia Pfeifer, Julian L. Wichmann, Moritz H. Albrecht, Doris Leithner, Lukas Lenga, Jan-Erik Scholtz, Thomas J. Vogl & Boris Bodelle

  2. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA

    Moritz H. Albrecht

  3. Cardiac MR PET CT Program, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Jan-Erik Scholtz

Authors
  1. Simon S. Martin
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  2. Sophia Pfeifer
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  3. Julian L. Wichmann
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  9. Boris Bodelle
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Corresponding author

Correspondence to Julian L. Wichmann.

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Funding

No funding was received for this study.

Conflicts of interest

Julian L. Wichmann received speakers’ fees from GE Healthcare and Siemens Healthcare. All other authors have no conflict of interest.

Ethical approval

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. This article does not contain any studies with animals performed by any of the authors. The study was approved by our institutional review board. As images were analyzed retrospectively in this single-center study, the requirement for informed consent was waived. For this type of study, formal consent is not required.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Martin, S.S., Pfeifer, S., Wichmann, J.L. et al. Noise-optimized virtual monoenergetic dual-energy computed tomography: optimization of kiloelectron volt settings in patients with gastrointestinal stromal tumors. Abdom Radiol 42, 718–726 (2017). https://doi.org/10.1007/s00261-016-1011-5

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  • DOI: https://doi.org/10.1007/s00261-016-1011-5

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