Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität Zu Berlin, Freie Universität Berlin, Charitéplatz 1, Berlin, 10117, Germany.
Canon Medical Systems, Europe BV, Zoetermeer, The Netherlands.
Eur Radiol Exp. 2024 Jun 12;8(1):69. doi: 10.1186/s41747-024-00466-w.
Dual-energy computed tomography (DECT) is useful for detecting gouty tophi. While iodinated contrast media (ICM) might enhance the detection of monosodium urate crystals (MSU), higher iodine concentrations hamper their detection. Calculating virtual noncontrast (VNC) images might improve the detection of enhancing tophi. The aim of this study was to evaluate MSU detection with VNC images from DECT acquisitions in phantoms, compared against the results with standard DECT reconstructions.
A grid-like and a biophantom with 25 suspensions containing different concentrations of ICM (0 to 2%) and MSU (0 to 50%) were scanned with sequential single-source DECT using an ascending order of tube current time product at 80 kVp (16.5-220 mAs) and 135 kVp (2.75-19.25 mAs). VNC images were equivalently reconstructed at 80 and 135 kVp. Two-material decomposition analysis for MSU detection was applied for the VNC and conventional CT images. MSU detection and attenuation values were compared in both modalities.
For 0, 0.25, 0.5, 1, and 2% ICM, the average detection indices (DIs) for all MSU concentrations (35-50%) with VNC postprocessing were respectively 25.2, 36.6, 30.9, 38.9, and 45.8% for the grid phantom scans and 11.7, 9.4, 5.5, 24.0, and 25.0% for the porcine phantom scans. In the conventional CT image group, the average DIs were respectively 35.4, 54.3, 45.4, 1.0, and 0.0% for the grid phantom and 19.4, 17.9, 3.0, 0.0, and 0.0% for the porcine phantom scans.
VNC effectively reduces the suppression of information caused by high concentrations of ICM, thereby improving the detection of MSU.
Contrast-enhanced DECT alone may suffice for diagnosing gout without a native acquisition.
• Highly concentrated contrast media hinders monosodium urate crystal detection in CT imaging • Virtual noncontrast imaging redetects monosodium urate crystals in high-iodinated contrast media concentrations. • Contrast-enhanced DECT alone may suffice for diagnosing gout without a native acquisition.
双能计算机断层扫描（DECT）可用于检测痛风性痛风石。虽然含碘对比剂（ICM）可能会增强单钠尿酸盐晶体（MSU）的检测，但较高的碘浓度会阻碍其检测。计算虚拟非对比（VNC）图像可能会提高增强痛风石的检测效果。本研究旨在评估 DECT 采集的 VNC 图像与标准 DECT 重建结果相比，在检测 MSU 方面的效果。
使用顺序单源 DECT 对具有 25 个悬浮液的网格状和生物仿体进行扫描，悬浮液中含有不同浓度的 ICM（0 至 2%）和 MSU（0 至 50%），管电流时间乘积在 80 kVp（16.5-220 mAs）和 135 kVp（2.75-19.25 mAs）下依次升高。在 80 和 135 kVp 下等效重建 VNC 图像。对 VNC 和常规 CT 图像进行 MSU 检测的双材料分解分析。比较两种模态下 MSU 的检测和衰减值。
对于 0、0.25、0.5、1 和 2%的 ICM，VNC 后处理的所有 MSU 浓度（35-50%）在网格状扫描中的平均检测指数（DI）分别为 25.2、36.6、30.9、38.9 和 45.8%，在猪体扫描中的平均 DI 分别为 11.7、9.4、5.5、24.0 和 25.0%。在常规 CT 图像组中，网格状扫描的平均 DI 分别为 35.4、54.3、45.4、1.0 和 0.0%，猪体扫描的平均 DI 分别为 19.4、17.9、3.0、0.0 和 0.0%。
VNC 可有效降低高浓度 ICM 引起的信息抑制，从而提高 MSU 的检测效果。
单独使用对比增强 DECT 可能足以诊断痛风，而无需进行原始采集。
高浓度对比剂会阻碍 CT 成像中单钠尿酸盐晶体的检测。
虚拟非对比成像可在高碘浓度对比剂浓度下重新检测单钠尿酸盐晶体。
单独使用对比增强 DECT 可能足以诊断痛风，而无需进行原始采集。
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