Universität zu Köln

Reimer, Robert Peter, Gertz, Roman Johannes, Pennig, Lenhard, Henze, Joern, Celik, Erkan, Lennartz, Simon, Maintz, David, Zopfs, David and Hokamp, Nils Grosse (2021). Value of spectral detector computed tomography to differentiate infected from noninfected thoracoabominal fluid collections. Eur. J. Radiol., 145. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: To investigate the diagnostic value of spectral detector CT (SDCT)-derived virtual non-contrast (VNC), virtual monoenergetic images (VMI) and iodine overlays (IO) for distinguishing infected from noninfected fluid collections (FC) in the chest or abdomen. Method: This retrospective study included 58 patients with venous phase SDCT with 77 FC. For all included FC, microbiological analysis of aspirated fluid served as reference. For quantitative analysis, wall thickness was measured, and (ROI)-based analysis performed within the fluid, the FC's wall (if any) and the aorta. Two radiologists qualitatively evaluated visibility of wall enhancement, diagnostic confidence regarding infection of fluid collection, confidence of CT-guided drainage catheter placement and visibility of anatomical landmarks in conventional images (CI) and VNC, VMI40keV, IO. Results: Wall thickness significantly differed between infected (n = 46) and noninfected (n = 31) FC (3.5 +/- 1.8 mm vs. 1.4 +/- 1.8 mm, AUC = 0.81; p < 0.05). Fluid attenuation and wall enhancement was significantly higher in infected as compared to noninfected FC in all reconstructions (p < 0.05, respectively). Highest AUC regarding A) attenuation in fluid was yielded in CI and VMI70,80keV (0.75); B) wall enhancement in CI (0.88) followed by iodine concentration (0.86). Contrast-to-noise ratio of wall vs. fluid was highest in VMI40keV (p < 0.05). All assessed qualitative parameters received significantly higher ratings when using spectral reconstructions vs. CI (p for all <0.05), except for visibility of wall enhancement. Conclusion: Spectral reconstructions improve the assessment of infected from noninfected thoracoabdominal fluid collections and depiction of wall enhancement. Diagnostic performance of the quantitative measurements in spectral reconstructions were comparable with measurements in conventional images.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reimer, Robert Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Gertz, Roman Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Henze, Joern UNSPECIFIED UNSPECIFIED UNSPECIFIED Celik, Erkan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-568625
DOI:	10.1016/j.ejrad.2021.110037
Journal or Publication Title:	Eur. J. Radiol.
Volume:	145
Date:	2021
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; VIRTUAL MONOENERGETIC IMAGES; IODINE QUANTIFICATION; ABDOMINAL ABSCESSES; LIVER-ABSCESS; DIAGNOSIS; ACCURACY; RECONSTRUCTIONS; DRAINAGE; EMPYEMA Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56862