TY  - JOUR
A1  - Martin, Simon
A1  - Kolaneci, Jetlir
A1  - Czwikla, Rouben
A1  - Booz, Christian
A1  - Grünewald, Leon David
A1  - Albrecht, Moritz Hans Ernst
A1  - Thompson, Zachary M.
A1  - Lenga, Lukas
A1  - Yel, Ibrahim
A1  - Vogl, Thomas J.
A1  - Wichmann, Julian
A1  - Koch, Vitali
T1  - Dual-energy CT for the detection of portal vein thrombosis: improved diagnostic performance using virtual monoenergetic reconstructions
T2  - Diagnostics
N2  - Purpose: To investigate the diagnostic performance of noise-optimized virtual monoenergetic images (VMI+) in dual-energy CT (DECT) of portal vein thrombosis (PVT) compared to standard reconstructions. Method: This retrospective, single-center study included 107 patients (68 men; mean age, 60.1 ± 10.7 years) with malignant or cirrhotic liver disease and suspected PVT who had undergone contrast-enhanced portal-phase DECT of the abdomen. Linearly blended (M_0.6) and virtual monoenergetic images were calculated using both standard VMI and noise-optimized VMI+ algorithms in 20 keV increments from 40 to 100 keV. Quantitative measurements were performed in the portal vein for objective contrast-to-noise ratio (CNR) calculation. The image series showing the greatest CNR were further assessed for subjective image quality and diagnostic accuracy of PVT detection by two blinded radiologists. Results: PVT was present in 38 subjects. VMI+ reconstructions at 40 keV revealed the best objective image quality (CNR, 9.6 ± 4.3) compared to all other image reconstructions (p < 0.01). In the standard VMI series, CNR peaked at 60 keV (CNR, 4.7 ± 2.1). Qualitative image parameters showed the highest image quality rating scores for the 60 keV VMI+ series (median, 4) (p ≤ 0.03). The greatest diagnostic accuracy for the diagnosis of PVT was found for the 40 keV VMI+ series (sensitivity, 96%; specificity, 96%) compared to M_0.6 images (sensitivity, 87%; specificity, 92%), 60 keV VMI (sensitivity, 87%; specificity, 97%), and 60 keV VMI+ reconstructions (sensitivity, 92%; specificity, 97%) (p ≤ 0.01). Conclusions: Low-keV VMI+ reconstructions resulted in significantly improved diagnostic performance for the detection of PVT compared to other DECT reconstruction algorithms.
KW  - diagnostic imaging
KW  - liver
KW  - multidetector computed tomography
KW  - portal vein
KW  - thrombosis
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69247
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-692477
SN  - 2075-4418
VL  - 12
IS  - 7, art. 1682
SP  - 1
EP  - 12
PB  - MDPI
CY  - Basel
ER  -