nach oben

Erschienen in:

01.06.2015 | Computed Tomography

Noise-optimized virtual monoenergetic images and iodine maps for the detection of venous thrombosis in second-generation dual-energy CT (DECT): an ex vivo phantom study

verfasst von: Malte N. Bongers, Christoph Schabel, Bernhard Krauss, Ilias Tsiflikas, Dominik Ketelsen, Stefanie Mangold, Claus D. Claussen, Konstantin Nikolaou, Christoph Thomas

Erschienen in: European Radiology | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Aims and objectives

Deep venous thrombosis (DVT) can be difficult to detect using CT due to poor and heterogeneous contrast. Dual-energy CT (DECT) allows iodine contrast optimization using noise-optimized monoenergetic extrapolations (MEIs) and iodine maps (IMs). Our aim was to assess whether MEI and IM could improve the delineation of thrombotic material within iodine-enhanced blood compared to single-energy CT (SECT).

Materials and methods

Six vessel phantoms, including human thrombus and contrast media-enhanced blood and one phantom without contrast, were placed in an attenuation phantom and scanned with DECT 100/140 kV and SECT 120 kV. IM, virtual non-contrast images (VNC), mixed images, and MEI were calculated. Attenuation of thrombi and blood were measured. Contrast and contrast-to-noise-ratios (CNRs) were calculated and compared among IM, VNC, mixed images, MEI, and SECT using paired t tests.

Results

MEI40keV and IM showed significantly higher contrast and CNR than SE120kV from high to intermediate iodine concentrations (contrast:pMEI40keV < 0.002,pIM < 0.005;CNR:pMEI40keV < 0.002,pIM < 0.004). At low iodine concentrations, MEI190keV and VNC images showed significantly higher contrast and CNR than SE120kV with inverted contrasts (contrast:pMEI190keV < 0.008,pVNC < 0.002;CNR:pMEI190keV < 0.003,pVNC < 0.002).

Conclusions

Noise-optimized MEI and IM provide significantly higher contrast and CNR in the delineation of thrombosis compared to SECT, which may facilitate the detection of DVT in difficult cases.

Key points

• Poor contrast makes it difficult to detect thrombosis in CT.

• Dual-energy-CT allows contrast optimization using monoenergetic extrapolations (MEI) and iodine maps (IM).

• Noise-optimized-MEI and IM are significantly superior to single-energy-CT in delineation of thrombosis.

• Noise-optimized-MEI and IM may facilitate the detection of deep vein thrombosis.

Nur mit Berechtigung zugänglich

Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ 3rd (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 158:585–593CrossRefPubMed

Spencer FA, Emery C, Lessard D et al (2006) The Worcester Venous Thromboembolism study: a population-based study of the clinical epidemiology of venous thromboembolism. J Gen Intern Med 21:722–727CrossRefPubMedCentralPubMed

Spencer FA, Emery C, Joffe SW et al (2009) Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study. J Thromb Thrombolysis 28:401–409CrossRefPubMedCentralPubMed

Cushman M, Tsai AW, White RH et al (2004) Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. Am J Med 117:19–25CrossRefPubMed

Goldhaber SZ (1992) Pulmonary embolism thrombolysis: a clarion call for international collaboration. J Am Coll Cardiol 19:246–247CrossRefPubMed

Tagalakis V, Patenaude V, Kahn SR, Suissa S (2013) Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE Study Cohort. Am J Med 126(832):e813–e821

Kearon C, Julian JA, Newman TE, Ginsberg JS (1998) Noninvasive diagnosis of deep venous thrombosis. McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann Intern Med 128:663–677CrossRefPubMed

Zhang LJ, Peng J, Wu SY et al (2010) Liver virtual non-enhanced CT with dual-source, dual-energy CT: a preliminary study. Eur Radiol 20:2257–2264CrossRefPubMed

Yu L, Primak AN, Liu X, McCollough CH (2009) Image quality optimization and evaluation of linearly mixed images in dual-source, dual-energy CT. Med Phys 36:1019–1024CrossRefPubMedCentralPubMed

10.

Liu X, Yu L, Primak AN, McCollough CH (2009) Quantitative imaging of element composition and mass fraction using dual-energy CT: three-material decomposition. Med Phys 36:1602–1609CrossRefPubMedCentralPubMed

11.

Kulkarni NM, Sahani DV, Desai GS, Kalva SP (2012) Indirect computed tomography venography of the lower extremities using single-source dual-energy computed tomography: advantage of low-kiloelectron volt monochromatic images. J Vasc Interv Radiol 23:879–886CrossRefPubMed

12.

Zhao LQ, He W, Li JY, Chen JH, Wang KY, Tan L (2012) Improving image quality in portal venography with spectral CT imaging. Eur J Radiol 81:1677–1681CrossRefPubMed

13.

Grant KL, Flohr TG, Krauss B, Sedlmair M, Thomas C, Schmidt B (2014) Assessment of an advanced image-based technique to calculate virtual monoenergetic computed tomographic images from a dual-energy examination to improve contrast-to-noise ratio in examinations using iodinated contrast media. Invest Radiol 49:586–592CrossRefPubMed

14.

Schabel C, Bongers M, Sedlmair M et al (2014) Assessment of the hepatic veins in poor contrast conditions using dual energy CT: evaluation of a novel monoenergetic extrapolation software algorithm. Röfo 186:591–597PubMed

15.

Mori H, Hayashi K, Uetani M, Matsuoka Y, Iwao M, Maeda H (1987) High-attenuation recent thrombus of the portal vein: CT demonstration and clinical significance. Radiology 163:353–356CrossRefPubMed

16.

Bittencourt MS, Achenbach S, Marwan M et al (2012) Left ventricular thrombus attenuation characterization in cardiac computed tomography angiography. J Cardiovasc Comput Tomogr 6:121–126CrossRefPubMed

17.

Fobbe F, Ruhnke-Trautmann M, von Gemmeren D, Hartmann CA, Kania U, Wolf KJ (1991) Age determination of venous thrombi by ultrasound. Röfo 155:344–348PubMed

18.

Geier B, Barbera L, Muth-Werthmann D et al (2005) Ultrasound elastography for the age determination of venous thrombi. Evaluation in an animal model of venous thrombosis. Thromb Haemost 93:368–374PubMed

19.

De Luca F, Modolon C, Buia F et al (2012) Densitometric CT evaluation of acute and chronic thromboembolic filling defects of the pulmonary arteries before and after contrast injection. Radiol Med 117:979–991CrossRefPubMed

20.

Puig J, Pedraza S, Demchuk A et al (2012) Quantification of thrombus Hounsfield units on noncontrast CT predicts stroke subtype and early recanalization after intravenous recombinant tissue plasminogen activator. AJNR Am J Neuroradiol 33:90–96CrossRefPubMed

21.

Apfaltrer P, Sudarski S, Schneider D et al (2014) Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CT pulmonary angiography. Eur J Radiol 83:322–328CrossRefPubMed

22.

Yu L, Christner JA, Leng S, Wang J, Fletcher JG, McCollough CH (2011) Virtual monochromatic imaging in dual-source dual-energy CT: radiation dose and image quality. Med Phys 38:6371–6379CrossRefPubMedCentralPubMed

23.

Baumgartner HR (1984) Blood flow and thrombogenesis. Correlation of blood platelets, blood coagulation factors and the vascular wall. Internist (Berl) 25:75–81

24.

Stiegler H, Arbogast H, Nees S, Halder A, Grau A, Riess H (1989) Thrombectomy, lysis, or heparin treatment: concurrent therapies of deep vein thrombosis: therapy and experimental studies. Semin Thromb Hemost 15:250–258CrossRefPubMed

25.

Kistner RL, Sparkuhl MD (1979) Surgery in acute and chronic venous disease. Surgery 85:31–43PubMed

Titel: Noise-optimized virtual monoenergetic images and iodine maps for the detection of venous thrombosis in second-generation dual-energy CT (DECT): an ex vivo phantom study
verfasst von: Malte N. Bongers
Christoph Schabel
Bernhard Krauss
Ilias Tsiflikas
Dominik Ketelsen
Stefanie Mangold
Claus D. Claussen
Konstantin Nikolaou
Christoph Thomas
Publikationsdatum: 01.06.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 6/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3544-8

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Noise-optimized virtual monoenergetic images and iodine maps for the detection of venous thrombosis in second-generation dual-energy CT (DECT): an ex vivo phantom study