Universität zu Köln

Reimer, R. P., Grosse Hokamp, N., Fehrmann Efferoth, A., Krauskopf, A., Zopfs, D., Kroeger, J. R., Persigehl, T., Maintz, D. and Bunck, A. C. . Virtual monoenergetic images from spectral detector computed tomography facilitate washout assessment in arterially hyper-enhancing liver lesions. Eur. Radiol.. NEW YORK: SPRINGER. ISSN 1432-1084

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Abstract

Objectives To investigate whether the increased soft tissue contrast of virtual monoenergetic images (VMIs) obtained from a spectral detector computed tomography (SDCT) system improves washout assessment of arterially hyper-enhancing liver lesions. Methods Fifty-nine arterially hyper-enhancing lesions in 31 patients (age 65 +/- 9 years, M/W 20/11) were included in this IRB-approved study. All patients underwent multi-phase SDCT for HCC screening. MRI, CEUS or biopsy within 3 months served as standard of reference to classify lesions as LiRADS 3 or 4/5. VMIs and conventional images (CIs) were reconstructed. Visual analysis was performed on 40, 60, and 80 kiloelectronvolt (keV) and CIs by 3 radiologists. Presence and visibility of washout were assessed; image quality and confidence of washout evaluation were evaluated on 5-point Likert scales. Signal-to-noise ratio (SNR), lesion-to-liver contrast-to-noise ratio (CNR) (|HUlesion-HUliver|/SDliver) and washout (|HUlesion-HUliver|) were calculated. Statistical assessment was performed using ANOVA and Wilcoxon test. Results On subjective lesion analysis, the highest level of diagnostic confidence and highest sensitivity for the detection of lesion washout were found for 40-keV VMIs (40 keV vs. CI, 81.3 vs. 71.3%). Image quality parameters were significantly better in low-kiloelectronvolt VMIs than in CIs (p < 0.05; e.g. SNRliver: 40 keV vs. CIs, 12.5 +/- 4.1 vs. 5.6 +/- 1.6). In LiRADS 4/5 lesions, CNR and quantitative washout values were significantly higher in 40-keV VMIs compared to CIs (p < 0.05; e.g. CNR and washout in 40 keV vs. CIs, 2.3 +/- 1.6 vs. 0.8 +/- 0.5 and 29.0 +/- 19.1 vs. 12.9 +/- 6.9 HU, respectively). Conclusion By increasing lesion contrast, low-kiloelectronvolt VMIs obtained from SDCT improve washout assessment of hyper-enhancing liver lesions with respect to washout visibility and diagnostic confidence.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reimer, R. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Grosse Hokamp, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fehrmann Efferoth, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krauskopf, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, J. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-311566
DOI:	10.1007/s00330-020-07379-3
Journal or Publication Title:	Eur. Radiol.
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEPATOCELLULAR-CARCINOMA; INITIAL-EXPERIENCE; CT; RECONSTRUCTIONS Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31156