Virtual noncontrast images reveal gouty tophi in contrast-enhanced dual-energy CT: a phantom study.

IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Experimental Pub Date : 2024-06-12 DOI:10.1186/s41747-024-00466-w

Karim Khayata, Torsten Diekhoff, Jürgen Mews, Sydney Schmolke, Maximilian Kotlyarov

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Abstract

Background: Dual-energy computed tomography (DECT) is useful for detecting gouty tophi. While iodinated contrast media (ICM) might enhance the detection of monosodium urate crystals (MSU), higher iodine concentrations hamper their detection. Calculating virtual noncontrast (VNC) images might improve the detection of enhancing tophi. The aim of this study was to evaluate MSU detection with VNC images from DECT acquisitions in phantoms, compared against the results with standard DECT reconstructions.

Methods: A grid-like and a biophantom with 25 suspensions containing different concentrations of ICM (0 to 2%) and MSU (0 to 50%) were scanned with sequential single-source DECT using an ascending order of tube current time product at 80 kVp (16.5-220 mAs) and 135 kVp (2.75-19.25 mAs). VNC images were equivalently reconstructed at 80 and 135 kVp. Two-material decomposition analysis for MSU detection was applied for the VNC and conventional CT images. MSU detection and attenuation values were compared in both modalities.

Results: For 0, 0.25, 0.5, 1, and 2% ICM, the average detection indices (DIs) for all MSU concentrations (35-50%) with VNC postprocessing were respectively 25.2, 36.6, 30.9, 38.9, and 45.8% for the grid phantom scans and 11.7, 9.4, 5.5, 24.0, and 25.0% for the porcine phantom scans. In the conventional CT image group, the average DIs were respectively 35.4, 54.3, 45.4, 1.0, and 0.0% for the grid phantom and 19.4, 17.9, 3.0, 0.0, and 0.0% for the porcine phantom scans.

Conclusions: VNC effectively reduces the suppression of information caused by high concentrations of ICM, thereby improving the detection of MSU.

Relevance statement: Contrast-enhanced DECT alone may suffice for diagnosing gout without a native acquisition.

Key points: • Highly concentrated contrast media hinders monosodium urate crystal detection in CT imaging • Virtual noncontrast imaging redetects monosodium urate crystals in high-iodinated contrast media concentrations. • Contrast-enhanced DECT alone may suffice for diagnosing gout without a native acquisition.

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虚拟非对比图像在对比增强双能 CT 中显示痛风性骨赘：一项模型研究。

背景：双能计算机断层扫描（DECT）有助于检测痛风性结石。虽然碘化造影剂（ICM）可增强对单钠尿酸盐结晶（MSU）的检测，但较高的碘浓度会妨碍对其检测。计算虚拟非对比度（VNC）图像可提高对增强型鹅口疮的检测。本研究的目的是评估利用模型中 DECT 采集的 VNC 图像检测 MSU 的效果，并与标准 DECT 重建的结果进行比较：方法：在 80 kVp（16.5-220 mAs）和 135 kVp（2.75-19.25 mAs）电压下，使用升序管电流时间积对一个网格状和一个含有 25 个不同浓度 ICM（0-2%）和 MSU（0-50%）悬浮液的生物模型进行连续单源 DECT 扫描。VNC 图像在 80 和 135 kVp 下进行了等效重建。对 VNC 和传统 CT 图像进行了用于 MSU 检测的双材料分解分析。对两种模式的 MSU 检测和衰减值进行了比较：对于 0%、0.25%、0.5%、1% 和 2% 的 ICM，使用 VNC 后处理的所有 MSU 浓度（35%-50%）的平均检测指数（DIs）分别为：网格模型扫描为 25.2%、36.6%、30.9%、38.9% 和 45.8%；猪模型扫描为 11.7%、9.4%、5.5%、24.0% 和 25.0%。在传统 CT 图像组中，网格模型扫描的平均 DI 分别为 35.4%、54.3%、45.4%、1.0% 和 0.0%，猪模型扫描的平均 DI 分别为 19.4%、17.9%、3.0%、0.0% 和 0.0%：结论：VNC 能有效减少高浓度 ICM 对信息的抑制，从而改善 MSU 的检测：对比度增强 DECT 可用于诊断痛风，而无需进行原始采集：- 高浓度造影剂阻碍了 CT 成像对单钠尿酸盐晶体的检测--虚拟非对比造影可重新检测出高浓度碘化造影剂中的单钠尿酸盐晶体。- 仅对比度增强 DECT 就足以诊断痛风，而无需原始采集。

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