Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 6/2021

01-06-2021 | Thyroid Cancer | Original Article

Could both intrinsic and extrinsic iodine be successfully suppressed on virtual non-contrast CT images for detecting thyroid calcification?

Authors: Arim Park, Young Hen Lee, Hyung Suk Seo

Published in: Japanese Journal of Radiology | Issue 6/2021

Login to get access

Abstract

Purpose

Although virtual non-contrast (VNC) successfully removes iodinated contrast, uncertainty exists regarding the feasibility of VNC to suppress iodine for detecting thyroid calcification. Therefore, we evaluated whether both intrinsic and extrinsic iodine attenuation were suppressed on VNC images.

Material and methods

We enrolled 128 patients (male: female 17:111; age 48.0 ± 10.4 years) who underwent dual-layer dual-energy CT (DL-DECT) examination before their thyroid cancer surgeries. Two additional sets of VNC (VNCu, VNCc) images were retrospectively generated from their true unenhanced (TUE) and true contrast-enhanced (TCE) series. We compared CT attenuation values measured on the VNCu and VNCc images by drawing identical regions of interest encompassing thyroid parenchyma, then subjectively determined the concordance of calcification.

Results

Although CT attenuation discrepancies between the VNCu and VNCc were significant (2.0 ± 5.7HU, p < 0.001),61.7%, 89.1%, and 100.0% of all measurements were < 5HU, < 10HU, and < 15HU. Based on Bland–Altman analysis, the limits of agreement were − 9.2HU and 13.2HU, whereas the proportional differences were small for VNC images generated from both TUE and TCE images. There was no discordance between two VNC image sets in detecting thyroid calcification.

Conclusions

VNC technique could be a feasible method to suppress both intrinsic and extrinsically administered iodine for detecting thyroid calcification
Literature
1.
McCollough CH, Leng S, Yu L, Fletcher JG. Dual- and multi-energy CT: principles, technical approaches, and clinical applications. Radiology. 2015;276(3):637–53.CrossRef
2.
Krauss B. Dual-energy computed tomography: technology and challenges. Radiol Clin N Am. 2018;56(4):497–506.CrossRef
3.
Wolman DN, Patel BP, Wintermark M, Heit JJ. Dual-energy computed tomography applications in neurointervention. J Comput Assist Tomogr. 2018;42(6):831–9.CrossRef
4.
Megibow AJ, Kambadakone A, Ananthakrishnan L. Dual-Energy computed tomography: image acquisition, processing, and workflow. Radiol Clin N Am. 2018;56(4):507–20.CrossRef
5.
Ozguner O, Dhanantwari A, Halliburton S, Wen G, Utrup S, Jordan D. Objective image characterization of a spectral CT scanner with dual-layer detector. Phys Med Biol. 2018;63(2):025027.CrossRef
6.
Grosse Hokamp N, Maintz D, Shapira N, Chang H, Noel PB. Technical background of a novel detector-based approach to dual-energy computed tomography. Diagn Interv Radiol (Ank Turk). 2020;26(1):68–71.CrossRef
7.
Hua CH, Shapira N, Merchant TE, Klahr P, Yagil Y. Accuracy of electron density, effective atomic number, and iodine concentration determination with a dual-layer dual-energy computed tomography system. Med Phys. 2018;45(6):2486–97.CrossRef
8.
Durieux P, Gevenois PA, Muylem AV, Howarth N, Keyzer C. Abdominal attenuation values on virtual and true unenhanced images obtained with third-generation dual-source dual-energy CT. AJR Am J Roentgenol. 2018;210(5):1042–58.CrossRef
9.
Chai Y, Xing J, Gao J, Lv P, Liang P, Liu J, Guo Y. Feasibility of virtual nonenhanced images derived from single-source fast kVp-switching dual-energy CT in evaluating gastric tumors. Eur J Radiol. 2016;85(2):366–72.CrossRef
10.
Sun H, Hou XY, Xue HD, Li XG, Jin ZY, Qian JM, Yu JC, Zhu HD. Dual-source dual-energy CT angiography with virtual non-enhanced images and iodine map for active gastrointestinal bleeding: image quality, radiation dose and diagnostic performance. Eur J Radiol. 2015;84(5):884–91.CrossRef
11.
Connolly MJ, McInnes MDF, El-Khodary M, McGrath TA, Schieda N. Diagnostic accuracy of virtual non-contrast enhanced dual-energy CT for diagnosis of adrenal adenoma: a systematic review and meta-analysis. Eur Radiol. 2017;27(10):4324–35.CrossRef
12.
Walter SS, Schneeweiss S, Maurer M, Kraus MS, Wichmann JL, Bongers MN, Lescan M, Bamberg F, Othman AE. Virtual non-enhanced dual-energy CT reconstruction may replace true non-enhanced CT scans in the setting of suspected active hemorrhage. Eur J Radiol. 2018;109:218–22.CrossRef
13.
Bae JS, Lee DH, Joo I, Jeon SK, Han JK. Utilization of virtual non-contrast images derived from dual-energy CT in evaluation of biliary stone disease: virtual non-contrast image can replace true non-contrast image regarding biliary stone detection. Eur J Radiol. 2019;116:34–40.CrossRef
14.
Lee HA, Lee YH, Yoon KH, Bang DH, Park DE. Comparison of virtual unenhanced images derived from dual-energy CT with true unenhanced images in evaluation of gallstone disease. AJR Am J Roentgenol. 2016;206(1):74–80.CrossRef
15.
Song I, Yi JG, Park JH, Kim SM, Lee KS, Chung MJ. Virtual non-contrast CT using dual-energy spectral CT: feasibility of coronary artery calcium scoring. Korean J Radiol. 2016;17(3):321–9.CrossRef
16.
Yoo SY, Kim Y, Cho HH, Choi MJ, Shim SS, Lee JK, Baek SY. Dual-energy CT in the assessment of mediastinal lymph nodes: comparative study of virtual non-contrast and true non-contrast images. Korean J Radiol. 2013;14(3):532–9.CrossRef
17.
Khoo ML, Asa SL, Witterick IJ, Freeman JL. Thyroid calcification and its association with thyroid carcinoma. Head Neck. 2002;24(7):651–5.CrossRef
18.
Kim BK, Choi YS, Kwon HJ, Lee JS, Heo JJ, Han YJ, Park YH, Kim JH. Relationship between patterns of calcification in thyroid nodules and histopathologic findings. Endocr J. 2013;60(2):155–60.CrossRef
19.
Wu CW, Dionigi G, Lee KW, Hsiao PJ, Paul Shin MC, Tsai KB, Chiang FY. Calcifications in thyroid nodules identified on preoperative computed tomography: patterns and clinical significance. Surgery. 2012;151(3):464–70.CrossRef
20.
Yoon DY, Chang SK, Choi CS, Yun EJ, Seo YL, Nam ES, Cho SJ, Rho YS, Ahn HY. The prevalence and significance of incidental thyroid nodules identified on computed tomography. J Comput Assist Tomogr. 2008;32(5):810–5.CrossRef
21.
Ahad F, Ganie SA. Iodine, Iodine metabolism and Iodine deficiency disorders revisited. Indian J Endocrinol Metab. 2010;14(1):13–7.PubMedPubMedCentral
22.
Bin Saeedan M, Aljohani IM, Khushaim AO, Bukhari SQ, Elnaas ST. Thyroid computed tomography imaging: pictorial review of variable pathologies. Insights Imaging. 2016;7(4):601–17.CrossRef
23.
Iida Y, Konishi J, Harioka T, Misaki T, Endo K, Torizuka K. Thyroid CT number and its relationship to iodine concentration. Radiology. 1983;147(3):793–5.CrossRef
24.
Cooper DS, Ladenson PW. Chapter 7. The thyroid gland. In: Gardner DG, Shoback D, editors. New York Greenspan’s basic & clinical endocrinology, 9edn. New York: The McGraw-Hill Companies; 2011.
25.
Kim E, Park JS, Son KR, Kim JH, Jeon SJ, Na DG. Preoperative diagnosis of cervical metastatic lymph nodes in papillary thyroid carcinoma: comparison of ultrasound, computed tomography, and combined ultrasound with computed tomography. Thyroid. 2008;18(4):411–8.CrossRef
26.
Lee Y, Kim JH, Baek JH, Jung SL, Park SW, Kim J, Yun TJ, Ha EJ, Lee KE, Kwon SY, et al. Value of CT added to ultrasonography for the diagnosis of lymph node metastasis in patients with thyroid cancer. Head Neck. 2018;40(10):2137–48.CrossRef
27.
Lee YH, Seo HS, Suh SI, Ryoo I, You SH, Son KR, Kwon SY, Son GS, Yang KS. Feasibility study of a contrast-enhanced multi-detector CT (64 channels) protocol for papillary thyroid carcinoma: the influence of different scan delays on tumor conspicuity. Thyroid. 2016;26(5):726–33.CrossRef
28.
Lee KH, Kim DW, Baek JW, Lee YJ, Choo HJ, Cho YJ, Lee SJ, Park YM, Jung SJ, Baek HJ. Comparison of computed tomography features between follicular neoplasm and nodular hyperplasia. Cancer Imaging. 2016;16(1):31.CrossRef
29.
Jamali S, Michoux N, Coche E, Dragean CA. Virtual unenhanced phase with spectral dual-energy CT: Is it an alternative to conventional true unenhanced phase for abdominal tissues? Diagn Interv Imaging. 2019;100(9):503–11.CrossRef
30.
Laukamp KR, Ho V, Obmann VC, Herrmann K, Gupta A, Borggrefe J, Lennartz S, Grosse Hokamp N, Ramaiya N. Virtual non-contrast for evaluation of liver parenchyma and vessels: results from 25 patients using multi-phase spectral-detector CT. Acta Radiol. 2020;61(8):1143–52.CrossRef
31.
Ananthakrishnan L, Rajiah P, Ahn R, Rassouli N, Xi Y, Soesbe TC, Lewis MA, Lenkinski RE, Leyendecker JR, Abbara S. Spectral detector CT-derived virtual non-contrast images: comparison of attenuation values with unenhanced CT. Abdom Radiol (N Y). 2017;42(3):702–9.CrossRef
32.
Sauter AP, Muenzel D, Dangelmaier J, Braren R, Pfeiffer F, Rummeny EJ, Noel PB, Fingerle AA. Dual-layer spectral computed tomography: virtual non-contrast in comparison to true non-contrast images. Eur J Radiol. 2018;104:108–14.CrossRef
33.
Graser A, Johnson TR, Hecht EM, Becker CR, Leidecker C, Staehler M, Stief CG, Hildebrandt H, Godoy MC, Finn ME, et al. Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images? Radiology. 2009;252(2):433–40.CrossRef
34.
Sahni VA, Shinagare AB, Silverman SG. Virtual unenhanced CT images acquired from dual-energy CT urography: accuracy of attenuation values and variation with contrast material phase. Clin Radiol. 2013;68(3):264–71.CrossRef
35.
Borhani AA, Kulzer M, Iranpour N, Ghodadra A, Sparrow M, Furlan A, Tublin ME. Comparison of true unenhanced and virtual unenhanced (VUE) attenuation values in abdominopelvic single-source rapid kilovoltage-switching spectral CT. Abdom Radiol (N Y). 2017;42(3):710–7.CrossRef
36.
Camlidag I. Compatibility of true and virtual unenhanced attenuation in rapid kV-switching dual energy CT. Diagn Interv Radiol (Ank Turk). 2020;26(2):95–100.CrossRef
37.
De Cecco CN, Buffa V, Fedeli S, Luzietti M, Vallone A, Ruopoli R, Miele V, Rengo M, Paolantonio P, Maurizi Enrici M, et al. Dual energy CT (DECT) of the liver: conventional versus virtual unenhanced images. Eur Radiol. 2010;20(12):2870–5.CrossRef
38.
Sellerer T, Noel PB, Patino M, Parakh A, Ehn S, Zeiter S, Holz JA, Hammel J, Fingerle AA, Pfeiffer F, et al. Dual-energy CT: a phantom comparison of different platforms for abdominal imaging. Eur Radiol. 2018;28(7):2745–55.CrossRef
39.
Kalisz K, Rassouli N, Dhanantwari A, Jordan D, Rajiah P. Noise characteristics of virtual monoenergetic images from a novel detector-based spectral CT scanner. Eur J Radiol. 2018;98:118–25.CrossRef
40.
Ananthakrishnan L, Duan X, Rajiah P, Soesbe TC, Lewis MA, Xi Y, Fielding JR, Lenkinski RE, Leyendecker JR, Abbara S. Phantom validation of spectral detector computed tomography-derived virtual monoenergetic, virtual noncontrast, and iodine quantification images. J Comput Assist Tomogr. 2018;42(6):959–64.CrossRef
Metadata
Title
Could both intrinsic and extrinsic iodine be successfully suppressed on virtual non-contrast CT images for detecting thyroid calcification?
Authors
Arim Park
Young Hen Lee
Hyung Suk Seo
Publication date
01-06-2021
Publisher
Springer Singapore
Published in
Japanese Journal of Radiology / Issue 6/2021
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-021-01095-8

Other articles of this Issue 6/2021

Japanese Journal of Radiology 6/2021 Go to the issue

Editorial

The future of cardiac disease assessment using 18F-FDG PET/CT

Review

MR imaging findings of unusual leiomyoma and malignant uterine myometrial tumors: what the radiologist should know

Original Article

Deep learning image reconstruction for improvement of image quality of abdominal computed tomography: comparison with hybrid iterative reconstruction

Review

Series of myocardial FDG uptake requiring considerations of myocardial abnormalities in FDG-PET/CT

Original Article

3D fat-suppressed T1-weighted volume isotropic turbo spin-echo acquisition (VISTA) imaging for the evaluation of the ectopic posterior pituitary gland

Invited Review

Artificial intelligence: a critical review of current applications in pancreatic imaging