Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2025-06-04 DOI:10.3390/tomography11060066

Jae En Kim, Yewon Lim, Jin Sil Kim, Hyo Jeong Lee, Jeong Kyong Lee, Hye Ah Lee

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引用次数: 0

Abstract

Background: This study aimed to evaluate whether low-concentration iodine contrast-enhanced multiphase low-monoenergetic computed tomography (LCLM CT; 270 mg I/mL, 40 keV) is non-inferior to standard-dose computed tomography (SDCT; 350 mg I/mL) in image quality and lesion detectability for chronic liver disease patients.

Methods: Sixty-seven patients underwent both protocols. Image quality was assessed using a 5-point scale with a non-inferiority margin of -0.5. Quantitative metrics included signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Lesion detectability was evaluated using jackknife free-response receiver operating characteristic (JAFROC) analysis with a -0.1 margin.

Results: LCLM CT reduced iodine dose per kilogram by 21.9%. Despite higher image noise, it achieved higher CNR for the aorta and hepatic lesions, as well as superior hepatic artery clarity. Image quality was non-inferior (difference: -0.119; 95% CI: -0.192 to -0.047), and lesion detectability (FOM: 0.744 vs. 0.721; difference: 0.023; 95% CI: -0.170 to 0.218) also showed non-inferiority.

Conclusions: LCLM CT maintains diagnostic performance and improves vascular contrast while reducing iodine burden, supporting its clinical utility in longitudinal HCC surveillance.

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低单能成像的图像质量和病变检出率：慢性肝病肝脏多期CT低浓度碘造影剂的研究

背景：本研究旨在评估低浓度碘增强多相低单能计算机断层扫描(LCLM CT；270 mg I/mL, 40 keV)不低于标准剂量计算机断层扫描(SDCT；350mg I/mL)对慢性肝病患者图像质量和病变检出率的影响。方法：67例患者接受了两种方案。使用5分制评估图像质量，非劣效裕度为-0.5。定量指标包括信噪比（SNR）和噪声对比比（CNR）。病变可检出性评估采用折刀自由反应受者工作特征（JAFROC）分析，裕度为-0.1。结果：LCLM CT每公斤碘剂量降低21.9%。尽管图像噪声较高，但它对主动脉和肝脏病变的CNR较高，肝动脉清晰度也较高。图像质量不差(差异：-0.119；95% CI: -0.192 ~ -0.047)，病变检出率(FOM: 0.744 vs. 0.721；区别:0.023;95% CI: -0.170 ~ 0.218)也显示非劣效性。结论：LCLM CT维持诊断性能，改善血管造影，同时减少碘负担，支持其在HCC纵向监测中的临床应用。

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

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.