Optimisation of virtual monoenergetic reconstructions for the diagnosis of pulmonary embolism using photon-counting detector computed tomography angiography.

Autor:	Chamberlin JH; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Toth A; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Hinen S; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., O'Doherty J; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States.; Siemens Medical Solutions, Malvern, PA, United States., Baruah D; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Maisuria D; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., McGuire A; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Knight H; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Schoepf UJ; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Munden RF; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States., Kabakus IM; Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, United States.
Jazyk:	angličtina
Zdroj:	Polish journal of radiology [Pol J Radiol] 2024 Jan 31; Vol. 89, pp. e63-e69. Date of Electronic Publication: 2024 Jan 31 (Print Publication: 2024).
DOI:	10.5114/pjr.2024.134905
Abstrakt:	Purpose: Computed tomography (CT) pulmonary angiography is considered the gold standard for pulmonary embolism (PE) diagnosis, relying on the discrimination between contrast and embolus. Photon-counting detector CT (PCD-CT) generates monoenergetic reconstructions through energy-resolved detection. Virtual monoenergetic images (VMI) at low keV can be used to improve pulmonary artery opacification. While studies have assessed VMI for PE diagnosis on dual-energy CT (DECT), there is a lack of literature on optimal settings for PCD-CT-PE reconstructions, warranting further investigation. Material and Methods: Twenty-five sequential patients who underwent PCD-CT pulmonary angiography for suspicion of acute PE were retrospectively included in this study. Quantitative metrics including signal-to-noise ratio (SNR) and contrast-to-noise (CNR) ratio were calculated for 4 VMI values (40, 60, 80, and 100 keV). Qualitative measures of diagnostic quality were obtained for proximal to distal pulmonary artery branches by 2 cardiothoracic radiologists using a 5-point modified Likert scale. Results: SNR and CNR were highest for the 40 keV VMI (49.3 ± 22.2 and 48.2 ± 22.1, respectively) and were inversely related to monoenergetic keV. Qualitatively, 40 and 60 keV both exhibited excellent diagnostic quality (mean main pulmonary artery: 5.0 ± 0 and 5.0 ± 0; subsegmental pulmonary arteries 4.9 ± 0.1 and 4.9 ± 0.1, respectively) while distal segments at high (80-100) keVs had worse quality. Conclusions: 40 keV was the best individual VMI for the detection of pulmonary embolism by quantitative metrics. Qualitatively, 40-60 keV reconstructions may be used without a significant decrease in subjective quality. VMIs at higher keV lead to reduced opacification of the distal pulmonary arteries, resulting in decreased image quality. Competing Interests: The authors report no conflicts of interest. (© Pol J Radiol 2024.)
Databáze:	MEDLINE
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