Zegadło Arkadiusz, Żabicka Magdalena, Różyk Aleksandra, Więsik-Szewczyk Ewa
Department of Radiology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland.
Department of Internal Medicine, Pulmonology, Allergy and Clinical Immunology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland.
J Clin Med. 2021 Apr 26;10(9):1870. doi: 10.3390/jcm10091870.
For some time, dual energy computed tomography (DECT) has been an established method used in a vast array of clinical applications, including lung nodule assessment. The aim of this study was to analyze (using monochromatic DECT images) how the X-ray absorption of solitary pulmonary nodules (SPNs) depends on the iodine contrast agent and when X-ray absorption is no longer dependent on the accumulated contrast agent. Sixty-six patients with diagnosed solid lung tumors underwent DECT scans in the late arterial phase (AP) and venous phase (VP) between January 2017 and June 2018. Statistically significant correlations ( ≤ 0.001) of the iodine contrast concentration were found in the energy range of 40-90 keV in the AP phase and in the range of 40-80 keV in the VP phase. The strongest correlation was found between the concentrations of the contrast agent and the scanning energy of 40 keV. At the higher scanning energy, no significant correlations were found. We concluded that it is most useful to evaluate lung lesions in DECT virtual monochromatic images (VMIs) in the energy range of 40-80 keV. We recommend assessing SPNs in only one phase of contrast enhancement to reduce the absorbed radiation dose.
一段时间以来，双能计算机断层扫描（DECT）一直是一种既定的方法，用于包括肺结节评估在内的大量临床应用。本研究的目的是（使用单色DECT图像）分析孤立性肺结节（SPN）的X射线吸收如何依赖于碘造影剂，以及X射线吸收何时不再依赖于累积的造影剂。2017年1月至2018年6月期间，66例诊断为实性肺肿瘤的患者在动脉晚期（AP）和静脉期（VP）接受了DECT扫描。在AP期40-90keV能量范围内以及VP期40-80keV能量范围内发现碘造影剂浓度具有统计学显著相关性（≤0.001）。在造影剂浓度与40keV扫描能量之间发现最强的相关性。在较高的扫描能量下，未发现显著相关性。我们得出结论，在40-80keV能量范围内的DECT虚拟单色图像（VMI）中评估肺部病变最为有用。我们建议仅在一个对比增强阶段评估SPN，以减少吸收的辐射剂量。
