{"title":"Photon-counting detector CT (PCD-CT) generated iodine maps to characterize parenchymal lung disease: A feasibility study","authors":"","doi":"10.1016/j.ejrad.2024.111689","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>With photon-counting CT, spectral imaging is always available, and iodine maps with high spatial and spectral resolution can be generated.</p></div><div><h3>Objectives</h3><p>The aim of this study was to investigate whether iodine uptake in different parenchymal patterns can be used to characterise parenchymal disease with increased lung attenuation.</p></div><div><h3>Methods</h3><p>325 patients were scanned with a photon-counting CT using four scan protocols, all with lung parenchymal contrast. Lesions were classified into three basic patterns: consolidation, ground-glass opacities (GGO), and reticular pattern. Lesion classification was performed by 2 of 3 radiologists who were blinded to the diagnosis. Classification was performed twice using a 5-point Likert scale (with and without iodine maps). In case of disagreement, a third reader was consulted, and the decision was made by consensus.</p></div><div><h3>Results</h3><p>206 lesions were found with a confirmed diagnosis (83 consolidations, 72 GGO, and 51 reticular). Diagnostic confidence improved when iodine maps were included in the evaluation. The mean Likert score increased significantly for all three basic patterns (consolidations: 3.3 vs. 3.9, GGO: 3.4 vs. 4.1, and reticular: 3.6 vs. 4.4, p < 0.001). However, the score for GGO and reticular pattern was downgraded in three and one cases, respectively. The downgrading occurred for morphologically uncertain GGO findings (3) and atelectasis (1) with inhomogeneous iodine uptake. In 29 lesions, the classification was changed when the iodine maps were included in the evaluation.</p></div><div><h3>Conclusion</h3><p>Including iodine maps adds contrast uptake information and improves the diagnostic confidence of radiologists in the characterization of parenchymal pathologies.</p></div><div><h3>Clinical Impact</h3><p>Iodine maps have the potential to provide complementary information for the interpretation of lung opacities with overlapping morphology.</p></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X24004054","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background
With photon-counting CT, spectral imaging is always available, and iodine maps with high spatial and spectral resolution can be generated.
Objectives
The aim of this study was to investigate whether iodine uptake in different parenchymal patterns can be used to characterise parenchymal disease with increased lung attenuation.
Methods
325 patients were scanned with a photon-counting CT using four scan protocols, all with lung parenchymal contrast. Lesions were classified into three basic patterns: consolidation, ground-glass opacities (GGO), and reticular pattern. Lesion classification was performed by 2 of 3 radiologists who were blinded to the diagnosis. Classification was performed twice using a 5-point Likert scale (with and without iodine maps). In case of disagreement, a third reader was consulted, and the decision was made by consensus.
Results
206 lesions were found with a confirmed diagnosis (83 consolidations, 72 GGO, and 51 reticular). Diagnostic confidence improved when iodine maps were included in the evaluation. The mean Likert score increased significantly for all three basic patterns (consolidations: 3.3 vs. 3.9, GGO: 3.4 vs. 4.1, and reticular: 3.6 vs. 4.4, p < 0.001). However, the score for GGO and reticular pattern was downgraded in three and one cases, respectively. The downgrading occurred for morphologically uncertain GGO findings (3) and atelectasis (1) with inhomogeneous iodine uptake. In 29 lesions, the classification was changed when the iodine maps were included in the evaluation.
Conclusion
Including iodine maps adds contrast uptake information and improves the diagnostic confidence of radiologists in the characterization of parenchymal pathologies.
Clinical Impact
Iodine maps have the potential to provide complementary information for the interpretation of lung opacities with overlapping morphology.
期刊介绍:
European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field.
Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.