Albrecht Moritz H, Scholtz Jan-Erik, Kraft Johannes, Bauer Ralf W, Kaup Moritz, Dewes Patricia, Bucher Andreas M, Burck Iris, Wagenblast Jens, Lehnert Thomas, Kerl J Matthias, Vogl Thomas J, Wichmann Julian L
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany,
Eur Radiol. 2015 Aug;25(8):2493-501. doi: 10.1007/s00330-015-3627-1. Epub 2015 Feb 14.
To define optimal keV settings for advanced monoenergetic (Mono+) dual-energy computed tomography (DECT) in patients with head and neck squamous cell carcinoma (SCC).
DECT data of 44 patients (34 men, mean age 55.5 ± 16.0 years) with histopathologically confirmed SCC were reconstructed as 40, 55, 70 keV Mono + and M_0.3 (30 % 80 kV) linearly blended series. Attenuation of tumour, sternocleidomastoid muscle, internal jugular vein, submandibular gland, and noise were measured. Three radiologists with >3 years of experience subjectively assessed image quality, lesion delineation, image sharpness, and noise.
The highest lesion attenuation was shown for 40 keV series (248.1 ± 94.1 HU), followed by 55 keV (150.2 ± 55.5 HU; P = 0.001). Contrast-to-noise ratio (CNR) at 40 keV (19.09 ± 13.84) was significantly superior to all other reconstructions (55 keV, 10.25 ± 9.11; 70 keV, 7.68 ± 6.31; M_0.3, 5.49 ± 3.28; all P < 0.005). Subjective image quality was highest for 55 keV images (4.53; κ = 0.38, P = 0.003), followed by 40 keV (4.14; κ = 0.43, P < 0.001) and 70 keV reconstructions (4.06; κ = 0.32, P = 0.005), all superior (P < 0.004) to linear blending M_0.3 (3.81; κ = 0.280, P = 0.056).
Mono + DECT at low keV levels significantly improves CNR and subjective image quality in patients with head and neck SCC, as tumour CNR peaks at 40 keV, and 55 keV images are preferred by observers.
• Mono + DECT combines increased contrast with reduced image noise, unlike linearly blended images. • Mono + DECT imaging allows for superior CNR and subjective image quality. • Head and neck tumour contrast-to-noise ratio peaks at 40 keV. • 55 keV images are preferred over all other series by observers.
确定头颈部鳞状细胞癌（SCC）患者进行高级单能量（Mono+）双能量计算机断层扫描（DECT）的最佳keV设置。
对44例经组织病理学确诊为SCC的患者（34例男性，平均年龄55.5±16.0岁）的DECT数据进行重建，生成40、55、70 keV的Mono+和M_0.3（30% 80 kV）线性混合序列。测量肿瘤、胸锁乳突肌、颈内静脉及下颌下腺的衰减值和噪声。3名经验超过3年的放射科医生对图像质量、病变轮廓、图像清晰度和噪声进行主观评估。
40 keV序列的病变衰减值最高（248.1±94.1 HU），其次是55 keV（150.2±55.5 HU；P = 0.001）。40 keV时的对比噪声比（CNR）（19.09±13.84）显著优于所有其他重建序列（55 keV，10.25±9.11；70 keV，7.68±6.31；M_0.3，5.49±3.28；所有P < 0.005）。主观图像质量在55 keV图像时最高（4.53；κ = 0.38，P = 0.003），其次是40 keV（4.14；κ = 0.43，P < 0.001）和70 keV重建序列（4.06；κ = 0.32，P = 0.005），均优于线性混合M_0.3（3.81；κ = 0.280，P = 0.056）（P < 0.004）。
对于头颈部SCC患者，低keV水平的Mono+ DECT可显著提高CNR和主观图像质量，因为肿瘤CNR在40 keV时达到峰值，且观察者更倾向于55 keV的图像。
• 与线性混合图像不同，Mono+ DECT在提高对比度的同时降低了图像噪声。• Mono+ DECT成像可实现更高的CNR和主观图像质量。• 头颈部肿瘤的对比噪声比在40 keV时达到峰值。• 观察者对55 keV图像的偏好高于所有其他序列。
