Masha Gliner-Ron, Jacob Sosna, Isaac Leichter, S. N. Goldberg, Dorit Shaham, Dotan Cohen, Yehuda Malul, Zimam Romman, N. Lev-Cohain
{"title":"Evaluation of the Pulmonary Arteries on CTPA With Dual Energy CT: Objective Analysis and Subjective Preferences in a Multireader Study.","authors":"Masha Gliner-Ron, Jacob Sosna, Isaac Leichter, S. N. Goldberg, Dorit Shaham, Dotan Cohen, Yehuda Malul, Zimam Romman, N. Lev-Cohain","doi":"10.1097/RTI.0000000000000782","DOIUrl":null,"url":null,"abstract":"PURPOSE\nTo perform qualitative and quantitative evaluation of low-monoenergetic images (50 KeV) compared with conventional images (120 kVp) in pulmonary embolism (PE) studies and to determine the extent and clinical relevance of these differences as well as radiologists' preferences.\n\n\nMATERIALS AND METHODS\nOne hundred fifty CT examinations for PE detection conducted on a single-source dual-energy CT were retrospectively evaluated. Attenuation, contrast-to-noise-ratio, and signal-to-noise-ratio were obtained in a total of 8 individual pulmonary arteries on each exam-including both central (450/1200=37.5%) and peripheral (750/1200=62.5%) locations. Results were compared between the conventional and low-monoenergetic images. For quality assessment, 41 images containing PE were presented side-by-side as pairs of slices in both conventional and monoenergetic modes and evaluated for ease in embolus detection by 9 radiologists: cardiothoracic specialists (3), noncardiothoracic specialists (3), and residents (3). Paired samples t tests, a-parametric Wilcoxon test, McNemar test, and kappa statistics were performed.\n\n\nRESULTS\nMonoenergetic images had an overall statistically significant increased average ratio of 2.09 to 2.26 (P<0.05) for each measured vessel attenuation, with an increase in signal-to-noise ratio (23.82±9.29 vs. 11.39±3.2) and contrast-to-noise ratio (17.17±6.7 vs 7.27±2.52) (P<0.05). Moreover, 10/150 (6%) of central pulmonary artery measurements considered suboptimal on conventional mode were considered diagnostic on the monoenergetic images (181±14.6 vs. 387.7±72.4 HU respectively, P<0.05). In the subjective evaluation, noncardiothoracic radiologists showed a preference towards low-monoenergetic images, whereas cardiothoracic radiologists did not (74.4% vs. 57.7%, respectively, P<0.05).\n\n\nCONCLUSIONS\nThe SNR and CNR increase on monoenergetic images may have clinical significance particularly in the setting of sub-optimal PE studies. Noncardiothoracic radiologists and residents prefer low monoenergetic images.","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Thoracic Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RTI.0000000000000782","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
PURPOSE
To perform qualitative and quantitative evaluation of low-monoenergetic images (50 KeV) compared with conventional images (120 kVp) in pulmonary embolism (PE) studies and to determine the extent and clinical relevance of these differences as well as radiologists' preferences.
MATERIALS AND METHODS
One hundred fifty CT examinations for PE detection conducted on a single-source dual-energy CT were retrospectively evaluated. Attenuation, contrast-to-noise-ratio, and signal-to-noise-ratio were obtained in a total of 8 individual pulmonary arteries on each exam-including both central (450/1200=37.5%) and peripheral (750/1200=62.5%) locations. Results were compared between the conventional and low-monoenergetic images. For quality assessment, 41 images containing PE were presented side-by-side as pairs of slices in both conventional and monoenergetic modes and evaluated for ease in embolus detection by 9 radiologists: cardiothoracic specialists (3), noncardiothoracic specialists (3), and residents (3). Paired samples t tests, a-parametric Wilcoxon test, McNemar test, and kappa statistics were performed.
RESULTS
Monoenergetic images had an overall statistically significant increased average ratio of 2.09 to 2.26 (P<0.05) for each measured vessel attenuation, with an increase in signal-to-noise ratio (23.82±9.29 vs. 11.39±3.2) and contrast-to-noise ratio (17.17±6.7 vs 7.27±2.52) (P<0.05). Moreover, 10/150 (6%) of central pulmonary artery measurements considered suboptimal on conventional mode were considered diagnostic on the monoenergetic images (181±14.6 vs. 387.7±72.4 HU respectively, P<0.05). In the subjective evaluation, noncardiothoracic radiologists showed a preference towards low-monoenergetic images, whereas cardiothoracic radiologists did not (74.4% vs. 57.7%, respectively, P<0.05).
CONCLUSIONS
The SNR and CNR increase on monoenergetic images may have clinical significance particularly in the setting of sub-optimal PE studies. Noncardiothoracic radiologists and residents prefer low monoenergetic images.
期刊介绍:
Journal of Thoracic Imaging (JTI) provides authoritative information on all aspects of the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Original articles and analytical reviews published in this timely journal provide the very latest thinking of leading experts concerning the use of chest radiography, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and all other promising imaging techniques in cardiopulmonary radiology.
Official Journal of the Society of Thoracic Radiology:
Japanese Society of Thoracic Radiology
Korean Society of Thoracic Radiology
European Society of Thoracic Imaging.