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Can virtual monochromatic images from dual-energy CT replace low-kVp images for abdominal contrast-enhanced CT in small- and medium-sized patients?

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

Abstract

Objective

To investigate the image quality and radiation dose of dual-energy computed tomography (DECT) with automatic spectral imaging protocol selection (ASIS) compared with those of low-kVp CT in abdominal multiphase CT.

Methods

Four groups of 60 patients each underwent abdominal scans with low-kVp CT (A, 80 kVp/300 mg I/kg, body mass index [BMI] ≤ 23.9 kg/m2; C, 100 kVp/400 mg I/kg, BMI ranging from 24 to 28.9 kg/m2) or DECT with ASIS, and the 40- to 60-keV virtual monochromatic images (VMIs) generated (B and D) were matched by age, gender, BMI, cross-sectional area, and contrast agent dose; 9 patients were excluded due to technical failures. The CT number, image noise, contrast-to-noise ratio, and subjective image quality were compared between the matched protocols (A and B or C and D) on 1.25-mm reconstructed images.

Results

VMIs at approximately 55 keV and 62 keV had CT numbers and contrast similar to those of 80-kVp and 100-kVp CT images, respectively. Compared to matched low-kVp images, VMIs at 50 keV provided a higher CT number and image noise and a similar or higher contrast and overall image quality. The radiation dose for DECT was higher than that of 80-kVp CT (increased by 10%), but was similar to that of 100-kVp CT.

Conclusion

Compared to matched low-kVp CT, VMIs at 50 keV in DECT with ASIS provided similar or higher overall image quality, with no or minimal dose penalty in small- and medium-sized patients.

Key Points

• Virtual monochromatic images at approximately 55 keV and 62 keV have CT numbers and contrast similar to those of 80-kVp and 100-kVp CT images, respectively, with a given noise index.

• The radiation dose in dual-energy CT with automatic spectral imaging protocol selection was slightly higher than that of 80-kVp CT (increased by 10%) but was similar to that of 100-kVp CT.

• Dual-energy CT may be able to replace l00-kVp CT for routine clinical abdominal contrast-enhanced CT scans.

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Abbreviations

AP:

Arterial phase

ASIR:

Adaptive statistical iterative reconstruction

ASIS:

Automatic spectral imaging protocol selection

CNR:

Contrast-to-noise ratio

CTDIvol:

Volume computed tomography dose index

IC:

Iodine concentration

keV:

Kiloelectron volt

kVp:

Peak kilovoltage

PVP:

Portal venous phase

VMI:

Virtual monochromatic images

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Funding

This study has received funding by National Natural Science Fund of China (Grant No. 81301220 to P. J. L.) and Overseas Research Project of Science and Technology Talent of Henan Health and Family Planning Commission (Grant No. 2018134 to P. J. L.)

Author information

Authors and Affiliations

  1. The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou, 450052, Henan Province, China

    Peijie Lv, Zhigang Zhou, Jie Liu, Yaru Chai, Huiping Zhao, Hua Guo & Jianbo Gao

  2. The Department of Radiology, Duke University Medical Center, Erwin Rd, Box 3808, Durham, NC, 27710, USA

    Daniele Marin

Authors
  1. Peijie Lv
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  2. Zhigang Zhou
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  3. Jie Liu
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  4. Yaru Chai
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  5. Huiping Zhao
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  6. Hua Guo
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  7. Daniele Marin
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  8. Jianbo Gao
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Corresponding author

Correspondence to Jianbo Gao.

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Guarantor

The scientific guarantor of this publication is Jianbo Gao.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• observational

• performed at one institution

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Lv, P., Zhou, Z., Liu, J. et al. Can virtual monochromatic images from dual-energy CT replace low-kVp images for abdominal contrast-enhanced CT in small- and medium-sized patients?. Eur Radiol 29, 2878–2889 (2019). https://doi.org/10.1007/s00330-018-5850-z

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  • DOI: https://doi.org/10.1007/s00330-018-5850-z

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