Assessment of arterially hyper-enhancing liver lesions using virtual monoenergetic images from spectral detector CT: phantom and patient experience
Assessment of arterially hyper-enhancing liver lesions using virtual monoenergetic images from spectral detector CT: phantom and patient experience
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DOI：
10.1007/s00261-017-1411-1
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发表时间：
2018-08-01
影响因子：
2.4
通讯作者：
Haneder, S.
中科院分区：
文献类型：
--
作者：
Hokamp, N. Grosse;Hoeink, A. J.;Haneder, S.
目的 研究虚拟单能重建 (VMI) 用于评估体模和患者动脉过度强化肝脏病变的益处，并比较传统图像（CI-IR 和 CI-SR）的混合迭代和光谱图像重建。所有成像均在 SDCT（Philips Healthcare，Best，荷兰）上进行。对带有模拟病变插入物（含有碘水溶液）的非拟人体模的图像以及来自对比增强患者检查的动脉期图像进行了评估。使用不同强度的图像去噪重建 VMI（40-200 keV，10 keV 增量）、CI-IR 和 CI-SR。 ROI 放置在病变、肝脏/基质、肌肉中；计算信噪比、对比噪声比以及病变与肝脏比（SNR、CNR 和 LLR）。两名放射科医生对 40、70 和 110 keV 和 CI 图像进行定性评估，采用五点李克特量表评估整体图像质量、病变评估和噪声。在体模中，与 CI-IR/SR 相比，VMI40keV 的 SNR 增加了三倍（5.8 +/- 1.1 与 18.8 +/- 2.2，p ae 0.001），而介于 CI-IR 和 CI-SR 之间 (p = 1)。去噪能够降低 40% 的噪音。总共对 20 名表现出 51 个肝脏病变的患者进行了评估。 VMI40keV 中的衰减最高，而图像噪声与 CI-IR 相当，导致 CNR/LLR 增加三倍（CI-IR 1.3 +/- 0.8/4.4 +/- 2.0，VMI40keV：3.8 +/- 2.7/14.2 +/- 7.5，p ae 0.001）。 VMI40keV 图像中的主观病灶勾画效果最好（p ae 0.01），它还提供了最低的可感知噪声和最佳的整体图像质量。VMI 改善了对动脉过度增强肝脏病灶的评估，因为它们增加了病灶对比度，同时在整个 keV 频谱中保持了低图像噪声。这些数据表明，在动脉过度强化肝脏病变后应考虑进行 VMI 筛查。
To investigate a benefit from virtual monoenergetic reconstructions (VMIs) for assessment of arterially hyper-enhancing liver lesions in phantom and patients and to compare hybrid-iterative and spectral image reconstructions of conventional images (CI-IR and CI-SR).All imaging was performed on a SDCT (Philips Healthcare, Best, The Netherlands). Images of a non-anthropomorphic phantom with a lesion-mimicking insert (containing iodine in water solution) and arterial-phase images from contrast-enhanced patient examinations were evaluated. VMIs (40-200 keV, 10 keV increment), CI-IR, and CI-SR were reconstructed using different strengths of image denoising. ROIs were placed in lesions, liver/matrix, muscle; signal-to-noise, contrast-to-noise, and lesion-to-liver ratios (SNR, CNR, and LLR) were calculated. Qualitatively, 40, 70, and 110 keV and CI images were assessed by two radiologists on five-point Likert scales regarding overall image quality, lesion assessment, and noise.In phantoms, SNR was increased threefold by VMI40keV compared with CI-IR/SR (5.8 +/- 1.1 vs. 18.8 +/- 2.2, p ae 0.001), while no difference was found between CI-IR and CI-SR (p = 1). Denoising was capable of noise reduction by 40%. In total, 20 patients exhibiting 51 liver lesions were assessed. Attenuation was the highest in VMI40keV, while image noise was comparable to CI-IR resulting in a threefold increase of CNR/LLR (CI-IR 1.3 +/- 0.8/4.4 +/- 2.0, VMI40keV: 3.8 +/- 2.7/14.2 +/- 7.5, p ae 0.001). Subjective lesion delineation was the best in VMI40keV image (p ae 0.01), which also provided the lowest perceptible noise and the best overall image quality.VMIs improve assessment of arterially hyper-enhancing liver lesions since they increase lesion contrast while maintaining low image noise throughout the entire keV spectrum. These data suggest that to consider VMI screening after arterially hyper-enhancing liver lesions.