Objective and subjective comparison of virtual monoenergetic vs. polychromatic images in patients with pancreatic ductal adenocarcinoma.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 30888484.
- Also identified by DOI 10.1007/s00330-019-06116-9 and PMC identifier 6554239.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
The aim of this study was to assess the objective and subjective image characteristics of monoenergetic images (MEI[+]), using a noise-optimized algorithm at different kiloelectron volts (keV) compared to polyenergetic images (PEI), in patients with pancreatic ductal adenocarcinoma (PDAC). This retrospective, institutional review board-approved study included 45 patients (18 male, 27 female; mean age 66 years; range, 42-96 years) with PDAC who had undergone a dual-energy CT (DECT) of the abdomen for staging. One standard polyenergetic image (PEI) and five MEI(+) images in 10-keV intervals, ranging from 40 to 80 keV, were reconstructed. Line-density profile analysis, as well as the contrast-to-noise ratio (CNR) of the tumor, the signal-to-noise ratio (SNR) of the regular pancreas parenchyma and the tumor, and the CNR of the three main peripancreatic vessels, was calculated. For subjective quality assessment, two readers independently assessed the images using a 5-point Likert scale. Reader reliability was evaluated using an intraclass correlation coefficient. Line-density profile analysis revealed the largest gradient in attenuation between PDAC and regular tissue in MEI(+) at 40 keV. Low-keV MEI(+)reconstructions at 40 and 50 keV increased CNR and SNR compared to PEI (40 keV: CNR 46.8 vs. 7.5; SNR<sub>Pankreas</sub> 32.5 vs. 15.7; SNR<sub>Lesion</sub> 13.5 vs. 8.6; p < 0.001). MEI(+) at 40 keV and 50 keV were consistently preferred by the observers (p < 0.05), showing a high intra-observer 0.937 (0.92-0.95) and inter-observer 0.911 (0.89-0.93) agreement. MEI(+) reconstructions at 40 keV and 50 keV provide better objective and subjective image quality compared to conventional PEI of DECT in patients with PDAC. • Low-keV MEI(+) reconstructions at 40 and 50 keV increase tumor-to-pancreas contrast compared to PEI. • Low-keV MEI(+) reconstructions improve objective and subjective image quality parameters compared to PEI. • Dual-energy post-processing might be a valuable tool in the diagnostic workup of patients with PDAC.
Medical subject headings
- Algorithms
- Carcinoma, Pancreatic Ductal
- Image Processing, Computer-Assisted
- Pancreas
- Pancreatic Neoplasms
- Radiography, Dual-Energy Scanned Projection
- Virtual Reality