Dual-Energy CT Material Density Iodine Quantification for Distinguishing Vascular From Nonvascular Renal Lesions: Normalization Reduces Intermanufacturer Threshold Variability
| Autor: | Mathias Meyer, Nicholas Rudnick, Rendon C. Nelson, Daniele Marin, Michael D. Rosenberg, Juan Carlos Ramirez-Giraldo, Alfredo E. Farjat, Scott Harring, Federica Vernuccio, Bhavik N. Patel, Benjamin Godwin |
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| Přispěvatelé: | Bhavik N. Patel, Federica Vernuccio, Mathias Meyer, Benjamin Godwin, Michael Rosenberg, Nicholas Rudnick, Scott Harring, Rendon Nelson, Juan Carlos Ramirez-Giraldo, Alfredo Farjat, Daniele Marin |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Normalization (statistics) chemistry.chemical_element Iodine dual-energy CT rapid-kilovoltage switching 030218 nuclear medicine & medical imaging Diagnosis Differential Radiography Dual-Energy Scanned Projection Young Adult 03 medical and health sciences 0302 clinical medicine Humans Medicine Dual source Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over variability business.industry General Medicine Material density Middle Aged renal lesion Kidney Neoplasms chemistry 030220 oncology & carcinogenesis dual source Female Dual energy ct Tomography X-Ray Computed business Nuclear medicine |
| Zdroj: | American Journal of Roentgenology. 212:366-376 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.18.20115 |
| Popis: | OBJECTIVE. The purpose of this study was to determine whether a single, uniform normalized iodine threshold reduces variability and enables reliable differentiation between vascular and nonvascular renal lesions independent of the dual-energy CT (DECT) platform used. MATERIALS AND METHODS. In this retrospective, HIPAA-compliant, institutional review board-approved study, 247 patients (156 men, 91 women; mean age ± SD, 67 ± 12 years old) with 263 renal lesions (193 nonvascular, 70 vascular) underwent unenhanced single- energy and contrast-enhanced DECT scans. One hundred and six nonvascular and 38 vascular lesions were scanned on two dual-source DECT (dsDECT) scanners, and 87 nonvascular and 32 vascular lesions were scanned on two rapid-kilovoltage-switching single-source DECT (rsDECT) scanners. Optimal absolute and normalized (to aorta) lesion iodine thresholds were determined for each platform type and for the entire cohort combined. RESULTS. Mean optimal absolute discriminant thresholds were 1.3 mg I/mL (95% CI, 1.2-1.9 mg I/mL), 1.6 mg I/mL (95% CI, 0.9-1.5 mg I/mL), and 1.5 mg I/mL (95% CI, 1.4- 1.7 mg I/mL) for dsDECT, rsDECT, and combined cohorts, respectively. Optimal normalized discriminant thresholds were 0.3 mg I/mL (95% CI, 0.2-0.4 mg I/mL) for both the dsDECT and rsDECT cohorts, and 0.3 mg I/mL (0.3-0.4 mg I/mL) for the combined cohort. The AUC, sensitivity, and specificity for the combined optimal normalized discriminant threshold of 0.3 mg I/mL was 0.96 (95% CI, 0.92-1.00), 0.93 (0.84-0.97), and 0.95 (0.91-0.98), respectively. Normalization resulted in decreased variability and better lesion separation (effect size, 1.77 vs 1.69, p < 0.0001). CONCLUSION. The optimal absolute discriminant threshold for evaluating renal lesions varies depending on the type of DECT platform, though this difference is not statistically significant. Variation can be reduced with a better separation of vascular and nonvascular lesions by normalizing iodine quantification to the aorta. |
| Databáze: | OpenAIRE |
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