Evaluation of colorectal liver metastases using virtual monoenergetic images obtained from dual-layer spectral computed tomography.

IF 2.3 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2024-10-15 DOI:10.1007/s00261-024-04635-8

Jae Seok Bae, Jeong Hee Yoon, Jae Hyun Kim, Seungchul Han, Sungeun Park, Se Woo Kim

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引用次数: 0

Abstract

Purpose: To assess the potential of virtual monoenergetic images in assessing colorectal liver metastasis (CRLM) compared with conventional CT images.

Methods: This single-center, retrospective study included 173 consecutive patients (mean age, 65.5 ± 10.6 years; 106 men) who underwent dual-layer spectral CT (DLSCT) between November 2016 and April 2021. Portal venous phase images were reconstructed using hybrid iterative reconstruction (iDose) and virtual monoenergetic imaging at 50 keV. Four radiologists independently and randomly reviewed the de-identified iDose and 50 keV images. Lesion detection, CRLM conspicuity, and CRLM diagnosis were compared between these images using a generalized estimating equation analysis. The reference standards used were histopathology and follow-up imaging findings.

Results: The study included 797 focal liver lesions, including 463 CRLMs (median size, 18.1 mm [interquartile range, 10.9-37.7 mm]). Lesion detection was better with 50 keV images than with iDose images (45.0% [95% confidence interval [CI]: 39-50] vs 40.0% [95% CI: 34-46], P = 0.003). CRLM conspicuity was higher in the 50 keV images than in the iDose images (3.27 [95% CI: 3.09-3.46] vs 3.09 [95% CI: 2.90-3.28], P < 0.001). However, the specificity for diagnosing CRLM was lower with 50 keV images than with iDose images (94.5% [95% CI: 91.6-96.4] vs 96.0% [95% CI: 93.2-98.1], P = 0.022), whereas sensitivity did not differ significantly (77.6% [95% CI: 70.3-83.5] vs 76.9% [95% CI: 70.0-82.7], P = 0.736). Indeterminate lesions were more frequently noted in 50 keV images than in iDose images (13% [445/3188] vs 9% [313/3188], P = 0.005), and 56% (247/445) of the indeterminate lesions at 50 keV were not CRLMs.

Conclusion: The 50 keV images obtained from DLSCT were better than the iDose images in terms of CRLM conspicuity and lesion detection. However, 50 keV images did not improve CRLM diagnosis but slightly increased the reporting of indeterminate focal liver lesions associated with CRLMs.

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利用双层光谱计算机断层扫描获得的虚拟单能图像评估结直肠肝转移瘤。

目的：与传统 CT 图像相比，评估虚拟单能图像在评估结直肠肝转移（CRLM）方面的潜力：这项单中心回顾性研究纳入了 2016 年 11 月至 2021 年 4 月间接受双层频谱 CT（DLSCT）检查的 173 名连续患者（平均年龄 65.5 ± 10.6 岁；106 名男性）。门静脉相位图像采用混合迭代重建（iDose）和 50 keV 的虚拟单能成像进行重建。四名放射科医生独立随机审查了去标识化的 iDose 和 50 keV 图像。使用广义估计方程分析法对这些图像的病变检测、CRLM 清晰度和 CRLM 诊断进行比较。使用的参考标准是组织病理学和后续成像结果：研究包括 797 个肝脏局灶性病变，其中包括 463 个 CRLM（中位数大小为 18.1 毫米[四分位间范围为 10.9-37.7 毫米]）。50 keV 图像的病灶检测率高于 iDose 图像（45.0% [95% 置信区间 [CI]：39-50] vs 40.0% [95% CI: 34-46]，P = 0.003）。50 keV 图像的 CRLM 清晰度高于 iDose 图像（3.27 [95% CI：3.09-3.46] vs 3.09 [95% CI：2.90-3.28]，P=0.003）：在CRLM的清晰度和病灶检测方面，DLSCT获得的50 keV图像优于iDose图像。然而，50 keV图像并不能提高CRLM的诊断率，但却略微增加了与CRLM相关的不确定局灶性肝脏病变的报告率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits