Virtual non-contrast in second-generation, dual-energy computed tomography: Reliability of attenuation values

Michael Toepker, Thomas Moritz, Bernhard Krauss, Michael Weber, Gordon Euller, Thomas Mang, Florian Wolf, Christian J. Herold, Helmut Ringl

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the reliability of attenuation values in virtual non-contrast images (VNC) reconstructed from contrast-enhanced, dual-energy scans performed on a second-generation dual-energy CT scanner, compared to single-energy, non-contrast images (TNC). Materials and methods: Sixteen phantoms containing a mixture of contrast agent and water at different attenuations (0-1400 HU) were investigated on a Definition Flash-CT scanner using a single-energy scan at 120 kV and a DE-CT protocol (100 kV/SN140 kV). For clinical assessment, 86 patients who received a dual-phase CT, containing an unenhanced single-energy scan at 120 kV and a contrast enhanced (110 ml Iomeron 400 mg/ml; 4 ml/s) DE-CT (100 kV/SN140 kV) in an arterial (n = 43) or a venous phase, were retrospectively analyzed. Mean attenuation was measured within regions of interest of the phantoms and in different tissue types of the patients within the corresponding VNC and TNC images. Paired t-tests and Pearson correlation were used for statistical analysis. Results: For all phantoms, mean attenuation in VNC was 5.3 ± 18.4 HU, with respect to water. In 86 patients overall, 2637 regions were measured in TNC and VNC images, with a mean difference between TNC and VNC of -3.6 ± 8.3 HU. In 91.5% (n = 2412) of all cases, absolute differences between TNC and VNC were under 15 HU, and, in 75.3% (n = 1986), differences were under 10 HU. Conclusions: Second-generation dual-energy CT based VNC images provide attenuation values close to those of TNC. To avoid possible outliers multiple measurements are recommended especially for measurements in the spleen, the mesenteric fat, and the aorta.

Original languageEnglish (US)
JournalEuropean Journal of Radiology
Volume81
Issue number3
DOIs
StatePublished - Mar 2012
Externally publishedYes

Fingerprint

Tomography
Water
Contrast Media
Aorta
Spleen
Fats
CT protocol
VP-P protocol
iomeprol

Keywords

  • Computed tomography
  • Dual-energy
  • Image reconstruction
  • Tissue attenuation measurements
  • Virtual non-contrast

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Virtual non-contrast in second-generation, dual-energy computed tomography : Reliability of attenuation values. / Toepker, Michael; Moritz, Thomas; Krauss, Bernhard; Weber, Michael; Euller, Gordon; Mang, Thomas; Wolf, Florian; Herold, Christian J.; Ringl, Helmut.

In: European Journal of Radiology, Vol. 81, No. 3, 03.2012.

Research output: Contribution to journalArticle

Toepker, M, Moritz, T, Krauss, B, Weber, M, Euller, G, Mang, T, Wolf, F, Herold, CJ & Ringl, H 2012, 'Virtual non-contrast in second-generation, dual-energy computed tomography: Reliability of attenuation values', European Journal of Radiology, vol. 81, no. 3. https://doi.org/10.1016/j.ejrad.2011.12.011
Toepker, Michael ; Moritz, Thomas ; Krauss, Bernhard ; Weber, Michael ; Euller, Gordon ; Mang, Thomas ; Wolf, Florian ; Herold, Christian J. ; Ringl, Helmut. / Virtual non-contrast in second-generation, dual-energy computed tomography : Reliability of attenuation values. In: European Journal of Radiology. 2012 ; Vol. 81, No. 3.
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abstract = "Purpose: To evaluate the reliability of attenuation values in virtual non-contrast images (VNC) reconstructed from contrast-enhanced, dual-energy scans performed on a second-generation dual-energy CT scanner, compared to single-energy, non-contrast images (TNC). Materials and methods: Sixteen phantoms containing a mixture of contrast agent and water at different attenuations (0-1400 HU) were investigated on a Definition Flash-CT scanner using a single-energy scan at 120 kV and a DE-CT protocol (100 kV/SN140 kV). For clinical assessment, 86 patients who received a dual-phase CT, containing an unenhanced single-energy scan at 120 kV and a contrast enhanced (110 ml Iomeron 400 mg/ml; 4 ml/s) DE-CT (100 kV/SN140 kV) in an arterial (n = 43) or a venous phase, were retrospectively analyzed. Mean attenuation was measured within regions of interest of the phantoms and in different tissue types of the patients within the corresponding VNC and TNC images. Paired t-tests and Pearson correlation were used for statistical analysis. Results: For all phantoms, mean attenuation in VNC was 5.3 ± 18.4 HU, with respect to water. In 86 patients overall, 2637 regions were measured in TNC and VNC images, with a mean difference between TNC and VNC of -3.6 ± 8.3 HU. In 91.5{\%} (n = 2412) of all cases, absolute differences between TNC and VNC were under 15 HU, and, in 75.3{\%} (n = 1986), differences were under 10 HU. Conclusions: Second-generation dual-energy CT based VNC images provide attenuation values close to those of TNC. To avoid possible outliers multiple measurements are recommended especially for measurements in the spleen, the mesenteric fat, and the aorta.",
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T2 - Reliability of attenuation values

AU - Toepker, Michael

AU - Moritz, Thomas

AU - Krauss, Bernhard

AU - Weber, Michael

AU - Euller, Gordon

AU - Mang, Thomas

AU - Wolf, Florian

AU - Herold, Christian J.

AU - Ringl, Helmut

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N2 - Purpose: To evaluate the reliability of attenuation values in virtual non-contrast images (VNC) reconstructed from contrast-enhanced, dual-energy scans performed on a second-generation dual-energy CT scanner, compared to single-energy, non-contrast images (TNC). Materials and methods: Sixteen phantoms containing a mixture of contrast agent and water at different attenuations (0-1400 HU) were investigated on a Definition Flash-CT scanner using a single-energy scan at 120 kV and a DE-CT protocol (100 kV/SN140 kV). For clinical assessment, 86 patients who received a dual-phase CT, containing an unenhanced single-energy scan at 120 kV and a contrast enhanced (110 ml Iomeron 400 mg/ml; 4 ml/s) DE-CT (100 kV/SN140 kV) in an arterial (n = 43) or a venous phase, were retrospectively analyzed. Mean attenuation was measured within regions of interest of the phantoms and in different tissue types of the patients within the corresponding VNC and TNC images. Paired t-tests and Pearson correlation were used for statistical analysis. Results: For all phantoms, mean attenuation in VNC was 5.3 ± 18.4 HU, with respect to water. In 86 patients overall, 2637 regions were measured in TNC and VNC images, with a mean difference between TNC and VNC of -3.6 ± 8.3 HU. In 91.5% (n = 2412) of all cases, absolute differences between TNC and VNC were under 15 HU, and, in 75.3% (n = 1986), differences were under 10 HU. Conclusions: Second-generation dual-energy CT based VNC images provide attenuation values close to those of TNC. To avoid possible outliers multiple measurements are recommended especially for measurements in the spleen, the mesenteric fat, and the aorta.

AB - Purpose: To evaluate the reliability of attenuation values in virtual non-contrast images (VNC) reconstructed from contrast-enhanced, dual-energy scans performed on a second-generation dual-energy CT scanner, compared to single-energy, non-contrast images (TNC). Materials and methods: Sixteen phantoms containing a mixture of contrast agent and water at different attenuations (0-1400 HU) were investigated on a Definition Flash-CT scanner using a single-energy scan at 120 kV and a DE-CT protocol (100 kV/SN140 kV). For clinical assessment, 86 patients who received a dual-phase CT, containing an unenhanced single-energy scan at 120 kV and a contrast enhanced (110 ml Iomeron 400 mg/ml; 4 ml/s) DE-CT (100 kV/SN140 kV) in an arterial (n = 43) or a venous phase, were retrospectively analyzed. Mean attenuation was measured within regions of interest of the phantoms and in different tissue types of the patients within the corresponding VNC and TNC images. Paired t-tests and Pearson correlation were used for statistical analysis. Results: For all phantoms, mean attenuation in VNC was 5.3 ± 18.4 HU, with respect to water. In 86 patients overall, 2637 regions were measured in TNC and VNC images, with a mean difference between TNC and VNC of -3.6 ± 8.3 HU. In 91.5% (n = 2412) of all cases, absolute differences between TNC and VNC were under 15 HU, and, in 75.3% (n = 1986), differences were under 10 HU. Conclusions: Second-generation dual-energy CT based VNC images provide attenuation values close to those of TNC. To avoid possible outliers multiple measurements are recommended especially for measurements in the spleen, the mesenteric fat, and the aorta.

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KW - Dual-energy

KW - Image reconstruction

KW - Tissue attenuation measurements

KW - Virtual non-contrast

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