Universität zu Köln

Lennartz, Simon, Le Blanc, Markus, Zopfs, David ORCID: 0000-0001-9978-7453, Hokamp, Nils Grosse, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Laukamp, Kai Roman, Haneder, Stefan, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Maintz, David and Persigehl, Thorsten (2019). Dual-Energy CT-derived Iodine Maps: Use in Assessing Pleural Carcinomatosis. Radiology, 290 (3). S. 796 - 805. OAK BROOK: RADIOLOGICAL SOC NORTH AMERICA. ISSN 0033-8419

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Abstract

Purpose: To evaluate the use of spectral CT for differentiation between noncalcified benign pleural lesions and pleural carcinomatosis. Materials and Methods: In this retrospective study, patients who underwent contrast agent-enhanced late venous phase spectral CT of the chest between June 1, 2016, and July 1, 2018 with histopathologic and/or imaging confirmation of noncalcified pleural lesions were evaluated. Conventional images, iodine overlay (IO) images, and virtual monoenergetic images at 40 keV (hereafter, VMI40keV) were reconstructed from contrast-enhanced spectral chest CT. Four blinded radiologists determined lesion presence and indicated lesion conspicuity and diagnostic certainty. Hounsfield unit attenuation from conventional images and iodine concentration (IC) (in milligrams per milliliter) from IO images were determined. Area under the receiver operating characteristics curve determined thresholds for quantitative lesion differentiation and cutoff values were validated in an independent data set. Results: Eighty-four patients were included (mean age, 66.2 years; 54 men and 30 women; 44 patients with cancer with confirmed pleural carcinomatosis and 40 patients with benign pleural lesions). The area under the receiver operating characteristics curve for IC was greater than that of conventional Hounsfield units (0.96 vs 0.91; P <= .05, respectively). The optimal IC threshold was 1.3 mg/mL, with comparable sensitivity and specificity when applied to the test data set. The sensitivities to depict pleural carcinomatosis with spectral reconstructions versus conventional CT were 96% (199 of 208) and 83% (172 of 208), respectively, with specificities of 84% (161 of 192) and 63% (120 of 192), respectively (P <= .001 each). Conclusion: Compared with conventional images, spectral CT with iodine maps improved both quantitative and qualitative determination of pleural carcinomatosis versus noncalcified benign pleural lesions. (C) RSNA, 2019

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Le Blanc, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED orcid.org/0000-0001-9978-7453 UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Laukamp, Kai Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Haneder, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-155926
DOI:	10.1148/radiol.2018181567
Journal or Publication Title:	Radiology
Volume:	290
Number:	3
Page Range:	S. 796 - 805
Date:	2019
Publisher:	RADIOLOGICAL SOC NORTH AMERICA
Place of Publication:	OAK BROOK
ISSN:	0033-8419
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPUTED-TOMOGRAPHY; DIFFERENTIAL-DIAGNOSIS; IMAGE QUALITY; DETECTOR CT; QUANTIFICATION; DISEASE; ACCURACY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15592