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Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the image quality and lesion conspicuity of virtual-monochromatic-imaging (VMI) with dual-layer DECT (DL-DECT) for reduced-iodine-load multiphasic-hepatic CT.

Methods

Forty-five adults with renal dysfunction who had undergone hepatic DL-DECT with 300-mgI/kg were included. VMI (40–70-keV, DL-DECT-VMI) was generated at each enhancement phase. As controls, 45 matched patients undergoing standard 120-kVp protocol (120-kVp, 600-mgI/kg, and iterative reconstruction) were included. We compared the size-specific dose estimate (SSDE), image noise, CT attenuation, and contrast-to-noise ratio (CNR) between protocols. Two radiologists scored the image quality and lesion conspicuity.

Results

SSDE was significantly lower in DL-DECT group (p < 0.01). Image noise of DL-DECT-VMI was almost constant at each keV (differences of ≤15%) and equivalent to or lower than of 120-kVp. As the energy decreased, CT attenuation and CNR gradually increased; the values of 55-60 keV images were almost equivalent to those of standard 120-kVp. The highest scores for overall quality and lesion conspicuity were assigned at 40-keV followed by 45 to 55-keV, all of which were similar to or better than of 120-kVp.

Conclusions

For multiphasic-hepatic CT with 50% iodine-load, DL-DECT-VMI at 40- to 55-keV provides equivalent or better image quality and lesion conspicuity without increasing radiation dose compared with standard 120-kVp protocol.

Key Points

• 40-55-keV yields optimal image quality for half-iodine-load multiphasic-hepatic CT with DL-DECT.

• DL-DECT protocol decreases radiation exposure compared with 120-kVp scans with iterative reconstruction.

• 40-keV images maximise conspicuity of hepatocellular carcinoma especially at hepatic-arterial phase.

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Abbreviations

CM:

Contrast medium

CNR:

Contrast-to-noise ratio

CTDIvol :

volume CT dose index

DECT:

Dual-energy CT

DL-DECT:

Dual-layer dual-energy CT

eGFR:

Estimated glomerular filtration rate

EP:

Equilibrium phase

HAP:

Hepatic arterial phase

HCC:

Hepatocellular carcinoma

IR:

Iterative reconstruction

PVP:

Portal venous phase

ROI:

Region of interest

SSDE:

Size-specific dose estimate

TLC:

Tumour-to-liver contrast

TL-CNR:

Tumour-to liver contrast-to-noise ratio

VMI:

Virtual monochromatic imaging

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Yasunori Nagayama, Takeshi Nakaura, Seitaro Oda, Daisuke Utsunomiya, Yuji Iyama, Narumi Taguchi, Tomohiro Namimoto, Hideaki Yuki, Masafumi Kidoh, Kenichiro Hirata, Masataka Nakagawa & Yasuyuki Yamashita

  2. Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan

    Yoshinori Funama

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  1. Yasunori Nagayama
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Correspondence to Yasunori Nagayama.

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The scientific guarantor of this publication is Yasuyuki Yamashita.

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The authors of this manuscript declare no relationships with any companies.

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Nagayama, Y., Nakaura, T., Oda, S. et al. Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol. Eur Radiol 28, 1719–1730 (2018). https://doi.org/10.1007/s00330-017-5114-3

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  • DOI: https://doi.org/10.1007/s00330-017-5114-3

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