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Evaluation of virtual monoenergetic imaging algorithms for dual-energy carotid and intracerebral CT angiography: Effects on image quality, artefacts and diagnostic performance for the detection of stenosis.

Abstract：

PURPOSE:To investigate the impact of traditional (VMI) and noise-optimized virtual monoenergetic imaging (VMI+) algorithms on quantitative and qualitative image quality, and the assessment of stenosis in carotid and intracranial dual-energy CTA (DE-CTA). MATERIALS AND METHODS:DE-CTA studies of 40 patients performed on a third-generation 192-slice dual-source CT scanner were included in this retrospective study. 120-kVp image-equivalent linearly-blended, VMI and VMI+ series were reconstructed. Quantitative analysis included evaluation of contrast-to-noise ratios (CNR) of the aorta, common carotid artery, internal carotid artery, middle cerebral artery, and basilar artery. VMI and VMI+ with highest CNR, and linearly-blended series were rated qualitatively. Three radiologists assessed artefacts and suitability for evaluation at shoulder height, carotid bifurcation, siphon, and intracranial using 5-point Likert scales. Detection and grading of stenosis were performed at carotid bifurcation and siphon. RESULTS:Highest CNR values were observed for 40-keV VMI+ compared to 65-keV VMI and linearly-blended images (P < 0.001). Artefacts were low in all qualitatively assessed series with excellent suitability for supraaortic artery evaluation at shoulder and bifurcation height. Suitability was significantly higher in VMI+ and VMI compared to linearly-blended images for intracranial and ICA assessment (P < 0.002). VMI and VMI+ showed excellent accordance for detection and grading of stenosis at carotid bifurcation and siphon with no differences in diagnostic performance. CONCLUSION:40-keV VMI+ showed improved quantitative image quality compared to 65-keV VMI and linearly-blended series in supraaortic DE-CTA. VMI and VMI+ provided increased suitability for carotid and intracranial artery evaluation with excellent assessment of stenosis, but did not translate into increased diagnostic performance.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Leithner D,Mahmoudi S,Wichmann JL,Martin SS,Lenga L,Albrecht MH,Booz C,Arendt CT,Beeres M,D'Angelo T,Bodelle B,Vogl TJ,Scholtz JE

doi

10.1016/j.ejrad.2017.12.024

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

111-117

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(17)30546-6

journal_volume

pub_type

杂志文章

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Evaluation of virtual monoenergetic imaging algorithms for dual-energy carotid and intracerebral CT angiography: Effects on image quality, artefacts and diagnostic performance for the detection of stenosis.