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Published in: European Radiology 4/2011

01-04-2011 | Computed Tomography

Dual-energy-CT of hypervascular liver lesions in patients with HCC: investigation of image quality and sensitivity

Authors: Jens Altenbernd, Till A. Heusner, Adrian Ringelstein, Susanne C. Ladd, Michael Forsting, Gerald Antoch

Published in: European Radiology | Issue 4/2011

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Abstract

Objective

To investigate dual-energy CT of hypervascular liver lesions in patients with HCC.

Methods

Forty patients with hepatocellular carcinomas were investigated with abdominal dual-energy CT. In each patient unenhanced and contrast-enhanced imaging with arterial und portovenous delay were performed. Hypervascular lesions were documented on arterial phase 80-kVp images, 140-kVp images, and the averaged arterial images by two radiologists. Subjective image quality (5-point scale, from 5 [excellent] to 1 [not interpretable]) was rated on all images.

Results

The mean number of hypervascular HCC lesions detected was 3.37 ± 1.28 on 80-kVp images (p < 0.05), 1.43 ± 1.13 on 140-kVp images (p < 0.05), and 2.57 ± 1.2 on averaged images. The image quality was 0.3 ± 0.5 for 80-kVp (p < 0.05), 1.6 ± 0.5 for 140-kVp (p < 0.05) and 3.2 ± 0.4 for the averaged images.

Conclusion

Low-kVp images of dual-energy datasets are more sensitive in detecting hypervascular liver lesions. However, this increase in sensitivity goes along with a decrease in the subjective image quality of low-kVp images.
Literature
1.
go back to reference Flohr TG, Mccollough CH, Bruder H et al (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef Flohr TG, Mccollough CH, Bruder H et al (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef
2.
go back to reference Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef
3.
go back to reference Scheffel H, Stolzmann P, Frauenfelder T et al (2007) Dual-energy contrast-enhanced computed tomography for the detection of urinary stone disease. Invest Radiol 42:823–829PubMedCrossRef Scheffel H, Stolzmann P, Frauenfelder T et al (2007) Dual-energy contrast-enhanced computed tomography for the detection of urinary stone disease. Invest Radiol 42:823–829PubMedCrossRef
4.
go back to reference Graser A, Johnson TR, Chandarana H et al (2009) Dual energy CT: preliminary observations and potential clinical applications in the abdomen. Eur Radiol 19:13–23PubMedCrossRef Graser A, Johnson TR, Chandarana H et al (2009) Dual energy CT: preliminary observations and potential clinical applications in the abdomen. Eur Radiol 19:13–23PubMedCrossRef
5.
go back to reference Baron RL, Oliver JH 3rd, Dodd GD 3rd et al (1996) Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology 199:505–511PubMed Baron RL, Oliver JH 3rd, Dodd GD 3rd et al (1996) Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology 199:505–511PubMed
6.
go back to reference Oliver JH 3rd, Baron RL (1996) Helical biphasic contrast-enhanced CT of the liver: technique, indications, interpretation, and pitfalls. Radiology 201:1–14PubMed Oliver JH 3rd, Baron RL (1996) Helical biphasic contrast-enhanced CT of the liver: technique, indications, interpretation, and pitfalls. Radiology 201:1–14PubMed
7.
go back to reference Oliver JH 3rd, Baron RL, Federle MP et al (1996) Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both used in conjunction with conventional portal venous phase contrast-enhanced CT imaging. AJR Am J Roentgenol 167:71–77PubMed Oliver JH 3rd, Baron RL, Federle MP et al (1996) Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both used in conjunction with conventional portal venous phase contrast-enhanced CT imaging. AJR Am J Roentgenol 167:71–77PubMed
8.
go back to reference Ohashi I, Hanafusa K, Yoshida T (1993) Small hepatocellular carcinomas: two-phase dynamic incremental CT in detection and evaluation. Radiology 189:851–855PubMed Ohashi I, Hanafusa K, Yoshida T (1993) Small hepatocellular carcinomas: two-phase dynamic incremental CT in detection and evaluation. Radiology 189:851–855PubMed
9.
go back to reference Hollett MD, Jeffrey RB Jr, Nino-Murcia M et al (1995) Dual-phase helical CT of the liver: value of arterial phase scans in the detection of small (< or = 1.5 cm) malignant hepatic neoplasms. AJR Am J Roentgenol 164:879–884PubMed Hollett MD, Jeffrey RB Jr, Nino-Murcia M et al (1995) Dual-phase helical CT of the liver: value of arterial phase scans in the detection of small (< or = 1.5 cm) malignant hepatic neoplasms. AJR Am J Roentgenol 164:879–884PubMed
10.
go back to reference Oliver JH 3rd, Baron RL, Federle MP et al (1997) Hypervascular liver metastases: do unenhanced and hepatic arterial phase CT images affect tumor detection? Radiology 205:709–715PubMed Oliver JH 3rd, Baron RL, Federle MP et al (1997) Hypervascular liver metastases: do unenhanced and hepatic arterial phase CT images affect tumor detection? Radiology 205:709–715PubMed
11.
go back to reference Paulson EK, Mcdermott VG, Keogan MT et al (1998) Carcinoid metastases to the liver: role of triple-phase helical CT. Radiology 206:143–150PubMed Paulson EK, Mcdermott VG, Keogan MT et al (1998) Carcinoid metastases to the liver: role of triple-phase helical CT. Radiology 206:143–150PubMed
12.
13.
go back to reference Kalva SP, Sahani DV, Hahn PF et al (2006) Using the K-edge to improve contrast conspicuity and to lower radiation dose with a 16-MDCT: a phantom and human study. J Comput Assist Tomogr 30:391–397PubMedCrossRef Kalva SP, Sahani DV, Hahn PF et al (2006) Using the K-edge to improve contrast conspicuity and to lower radiation dose with a 16-MDCT: a phantom and human study. J Comput Assist Tomogr 30:391–397PubMedCrossRef
14.
go back to reference Sahani DV, Kalva SP, Hahn PF et al (2007) 16-MDCT angiography in living kidney donors at various tube potentials: impact on image quality and radiation dose. AJR Am J Roentgenol 188:115–120PubMedCrossRef Sahani DV, Kalva SP, Hahn PF et al (2007) 16-MDCT angiography in living kidney donors at various tube potentials: impact on image quality and radiation dose. AJR Am J Roentgenol 188:115–120PubMedCrossRef
15.
go back to reference Schueller-Weidekamm C, Schaefer-Prokop CM, Weber M et al (2006) CT angiography of pulmonary arteries to detect pulmonary embolism: improvement of vascular enhancement with low kilovoltage settings. Radiology 241:899–907PubMedCrossRef Schueller-Weidekamm C, Schaefer-Prokop CM, Weber M et al (2006) CT angiography of pulmonary arteries to detect pulmonary embolism: improvement of vascular enhancement with low kilovoltage settings. Radiology 241:899–907PubMedCrossRef
16.
go back to reference Heyer CM, Mohr PS, Lemburg SP et al (2007) Image quality and radiation exposure at pulmonary CT angiography with 100- or 120-kVp protocol: prospective randomized study. Radiology 245:577–583PubMedCrossRef Heyer CM, Mohr PS, Lemburg SP et al (2007) Image quality and radiation exposure at pulmonary CT angiography with 100- or 120-kVp protocol: prospective randomized study. Radiology 245:577–583PubMedCrossRef
17.
go back to reference Sigal-Cinqualbre AB, Hennequin R, Abada HT et al (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174PubMedCrossRef Sigal-Cinqualbre AB, Hennequin R, Abada HT et al (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174PubMedCrossRef
18.
go back to reference Waaijer A, Prokop M, Velthuis BK et al (2007) Circle of Willis at CT angiography: dose reduction and image quality–reducing tube voltage and increasing tube current settings. Radiology 242:832–839PubMedCrossRef Waaijer A, Prokop M, Velthuis BK et al (2007) Circle of Willis at CT angiography: dose reduction and image quality–reducing tube voltage and increasing tube current settings. Radiology 242:832–839PubMedCrossRef
19.
go back to reference Graser A, Wintersperger BJ, Suess C et al (2006) Dose reduction and image quality in MDCT colonography using tube current modulation. AJR Am J Roentgenol 187:695–701PubMedCrossRef Graser A, Wintersperger BJ, Suess C et al (2006) Dose reduction and image quality in MDCT colonography using tube current modulation. AJR Am J Roentgenol 187:695–701PubMedCrossRef
20.
go back to reference Bongartz G, Golding SJ, Jurik AG, European, Computed Gfm, Tomography et al (2004) European guidelines for multislice computed tomography. European Commission, Brussels Bongartz G, Golding SJ, Jurik AG, European, Computed Gfm, Tomography et al (2004) European guidelines for multislice computed tomography. European Commission, Brussels
21.
go back to reference Chandarana H, Godoy MC, Vlahos I et al (2008) Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms—initial observations. Radiology 249:692–700PubMedCrossRef Chandarana H, Godoy MC, Vlahos I et al (2008) Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms—initial observations. Radiology 249:692–700PubMedCrossRef
22.
go back to reference Stolzmann P, Frauenfelder T, Pfammatter T et al (2008) Endoleaks after endovascular abdominal aortic aneurysm repair: detection with dual-energy dual-source CT. Radiology 249:682–691PubMedCrossRef Stolzmann P, Frauenfelder T, Pfammatter T et al (2008) Endoleaks after endovascular abdominal aortic aneurysm repair: detection with dual-energy dual-source CT. Radiology 249:682–691PubMedCrossRef
23.
go back to reference Nakayama Y, Awai K, Funama Y et al (2005) Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology 237:945–951PubMedCrossRef Nakayama Y, Awai K, Funama Y et al (2005) Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology 237:945–951PubMedCrossRef
24.
go back to reference Brenner D, Elliston C, Hall E et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176:289–296PubMed Brenner D, Elliston C, Hall E et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176:289–296PubMed
25.
go back to reference Avrin DE, Macovski A, Zatz LE (1978) Clinical application of Compton and photo-electric reconstruction in computed tomography: preliminary results. Invest Radiol 13:217–222PubMedCrossRef Avrin DE, Macovski A, Zatz LE (1978) Clinical application of Compton and photo-electric reconstruction in computed tomography: preliminary results. Invest Radiol 13:217–222PubMedCrossRef
26.
go back to reference Graser A, Johnson TR, Hecht EM et al (2009) Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images? Radiology Graser A, Johnson TR, Hecht EM et al (2009) Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images? Radiology
27.
go back to reference Chae EJ, Song JW, Seo JB et al (2008) Clinical utility of dual-energy CT in the evaluation of solitary pulmonary nodules: initial experience. Radiology 249:671–681PubMedCrossRef Chae EJ, Song JW, Seo JB et al (2008) Clinical utility of dual-energy CT in the evaluation of solitary pulmonary nodules: initial experience. Radiology 249:671–681PubMedCrossRef
28.
go back to reference Kalra MK, Maher MM, Blake MA et al (2004) Detection and characterization of lesions on low-radiation-dose abdominal CT images postprocessed with noise reduction filters. Radiology 232:791–797PubMedCrossRef Kalra MK, Maher MM, Blake MA et al (2004) Detection and characterization of lesions on low-radiation-dose abdominal CT images postprocessed with noise reduction filters. Radiology 232:791–797PubMedCrossRef
29.
go back to reference Kalra MK, Maher MM, Sahani DV et al (2003) Low-dose CT of the abdomen: evaluation of image improvement with use of noise reduction filters pilot study. Radiology 228:251–256PubMedCrossRef Kalra MK, Maher MM, Sahani DV et al (2003) Low-dose CT of the abdomen: evaluation of image improvement with use of noise reduction filters pilot study. Radiology 228:251–256PubMedCrossRef
30.
go back to reference Kalra MK, Wittram C, Maher MM et al (2003) Can noise reduction filters improve low-radiation-dose chest CT images? Pilot study. Radiology 228:257–264PubMedCrossRef Kalra MK, Wittram C, Maher MM et al (2003) Can noise reduction filters improve low-radiation-dose chest CT images? Pilot study. Radiology 228:257–264PubMedCrossRef
Metadata
Title
Dual-energy-CT of hypervascular liver lesions in patients with HCC: investigation of image quality and sensitivity
Authors
Jens Altenbernd
Till A. Heusner
Adrian Ringelstein
Susanne C. Ladd
Michael Forsting
Gerald Antoch
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 4/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1964-7

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