Jae Seok Bae, Jeong Hee Yoon, Jae Hyun Kim, Seungchul Han, Sungeun Park, Se Woo Kim
{"title":"利用双层光谱计算机断层扫描获得的虚拟单能图像评估结直肠肝转移瘤。","authors":"Jae Seok Bae, Jeong Hee Yoon, Jae Hyun Kim, Seungchul Han, Sungeun Park, Se Woo Kim","doi":"10.1007/s00261-024-04635-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the potential of virtual monoenergetic images in assessing colorectal liver metastasis (CRLM) compared with conventional CT images.</p><p><strong>Methods: </strong>This single-center, retrospective study included 173 consecutive patients (mean age, 65.5 ± 10.6 years; 106 men) who underwent dual-layer spectral CT (DLSCT) between November 2016 and April 2021. Portal venous phase images were reconstructed using hybrid iterative reconstruction (iDose) and virtual monoenergetic imaging at 50 keV. Four radiologists independently and randomly reviewed the de-identified iDose and 50 keV images. Lesion detection, CRLM conspicuity, and CRLM diagnosis were compared between these images using a generalized estimating equation analysis. The reference standards used were histopathology and follow-up imaging findings.</p><p><strong>Results: </strong>The study included 797 focal liver lesions, including 463 CRLMs (median size, 18.1 mm [interquartile range, 10.9-37.7 mm]). Lesion detection was better with 50 keV images than with iDose images (45.0% [95% confidence interval [CI]: 39-50] vs 40.0% [95% CI: 34-46], P = 0.003). CRLM conspicuity was higher in the 50 keV images than in the iDose images (3.27 [95% CI: 3.09-3.46] vs 3.09 [95% CI: 2.90-3.28], P < 0.001). However, the specificity for diagnosing CRLM was lower with 50 keV images than with iDose images (94.5% [95% CI: 91.6-96.4] vs 96.0% [95% CI: 93.2-98.1], P = 0.022), whereas sensitivity did not differ significantly (77.6% [95% CI: 70.3-83.5] vs 76.9% [95% CI: 70.0-82.7], P = 0.736). Indeterminate lesions were more frequently noted in 50 keV images than in iDose images (13% [445/3188] vs 9% [313/3188], P = 0.005), and 56% (247/445) of the indeterminate lesions at 50 keV were not CRLMs.</p><p><strong>Conclusion: </strong>The 50 keV images obtained from DLSCT were better than the iDose images in terms of CRLM conspicuity and lesion detection. However, 50 keV images did not improve CRLM diagnosis but slightly increased the reporting of indeterminate focal liver lesions associated with CRLMs.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of colorectal liver metastases using virtual monoenergetic images obtained from dual-layer spectral computed tomography.\",\"authors\":\"Jae Seok Bae, Jeong Hee Yoon, Jae Hyun Kim, Seungchul Han, Sungeun Park, Se Woo Kim\",\"doi\":\"10.1007/s00261-024-04635-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess the potential of virtual monoenergetic images in assessing colorectal liver metastasis (CRLM) compared with conventional CT images.</p><p><strong>Methods: </strong>This single-center, retrospective study included 173 consecutive patients (mean age, 65.5 ± 10.6 years; 106 men) who underwent dual-layer spectral CT (DLSCT) between November 2016 and April 2021. Portal venous phase images were reconstructed using hybrid iterative reconstruction (iDose) and virtual monoenergetic imaging at 50 keV. Four radiologists independently and randomly reviewed the de-identified iDose and 50 keV images. Lesion detection, CRLM conspicuity, and CRLM diagnosis were compared between these images using a generalized estimating equation analysis. The reference standards used were histopathology and follow-up imaging findings.</p><p><strong>Results: </strong>The study included 797 focal liver lesions, including 463 CRLMs (median size, 18.1 mm [interquartile range, 10.9-37.7 mm]). Lesion detection was better with 50 keV images than with iDose images (45.0% [95% confidence interval [CI]: 39-50] vs 40.0% [95% CI: 34-46], P = 0.003). CRLM conspicuity was higher in the 50 keV images than in the iDose images (3.27 [95% CI: 3.09-3.46] vs 3.09 [95% CI: 2.90-3.28], P < 0.001). However, the specificity for diagnosing CRLM was lower with 50 keV images than with iDose images (94.5% [95% CI: 91.6-96.4] vs 96.0% [95% CI: 93.2-98.1], P = 0.022), whereas sensitivity did not differ significantly (77.6% [95% CI: 70.3-83.5] vs 76.9% [95% CI: 70.0-82.7], P = 0.736). Indeterminate lesions were more frequently noted in 50 keV images than in iDose images (13% [445/3188] vs 9% [313/3188], P = 0.005), and 56% (247/445) of the indeterminate lesions at 50 keV were not CRLMs.</p><p><strong>Conclusion: </strong>The 50 keV images obtained from DLSCT were better than the iDose images in terms of CRLM conspicuity and lesion detection. However, 50 keV images did not improve CRLM diagnosis but slightly increased the reporting of indeterminate focal liver lesions associated with CRLMs.</p>\",\"PeriodicalId\":7126,\"journal\":{\"name\":\"Abdominal Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Abdominal Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00261-024-04635-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Abdominal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00261-024-04635-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Evaluation of colorectal liver metastases using virtual monoenergetic images obtained from dual-layer spectral computed tomography.
Purpose: To assess the potential of virtual monoenergetic images in assessing colorectal liver metastasis (CRLM) compared with conventional CT images.
Methods: This single-center, retrospective study included 173 consecutive patients (mean age, 65.5 ± 10.6 years; 106 men) who underwent dual-layer spectral CT (DLSCT) between November 2016 and April 2021. Portal venous phase images were reconstructed using hybrid iterative reconstruction (iDose) and virtual monoenergetic imaging at 50 keV. Four radiologists independently and randomly reviewed the de-identified iDose and 50 keV images. Lesion detection, CRLM conspicuity, and CRLM diagnosis were compared between these images using a generalized estimating equation analysis. The reference standards used were histopathology and follow-up imaging findings.
Results: The study included 797 focal liver lesions, including 463 CRLMs (median size, 18.1 mm [interquartile range, 10.9-37.7 mm]). Lesion detection was better with 50 keV images than with iDose images (45.0% [95% confidence interval [CI]: 39-50] vs 40.0% [95% CI: 34-46], P = 0.003). CRLM conspicuity was higher in the 50 keV images than in the iDose images (3.27 [95% CI: 3.09-3.46] vs 3.09 [95% CI: 2.90-3.28], P < 0.001). However, the specificity for diagnosing CRLM was lower with 50 keV images than with iDose images (94.5% [95% CI: 91.6-96.4] vs 96.0% [95% CI: 93.2-98.1], P = 0.022), whereas sensitivity did not differ significantly (77.6% [95% CI: 70.3-83.5] vs 76.9% [95% CI: 70.0-82.7], P = 0.736). Indeterminate lesions were more frequently noted in 50 keV images than in iDose images (13% [445/3188] vs 9% [313/3188], P = 0.005), and 56% (247/445) of the indeterminate lesions at 50 keV were not CRLMs.
Conclusion: The 50 keV images obtained from DLSCT were better than the iDose images in terms of CRLM conspicuity and lesion detection. However, 50 keV images did not improve CRLM diagnosis but slightly increased the reporting of indeterminate focal liver lesions associated with CRLMs.
期刊介绍：
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
Reasons to Publish Your Article in Abdominal Radiology:
· Official journal of the Society of Abdominal Radiology (SAR)
· Published in Cooperation with:
European Society of Gastrointestinal and Abdominal Radiology (ESGAR)
European Society of Urogenital Radiology (ESUR)
Asian Society of Abdominal Radiology (ASAR)
· Efficient handling and Expeditious review
· Author feedback is provided in a mentoring style
· Global readership
· Readers can earn CME credits
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