[Anemia Assessment Using Aortic Attenuation on Dual-energy CT].

Abstract

Purpose: This study aimed to evaluate the relationship between computed tomography (CT) attenuation values obtained from virtual monochromatic images (VMI) and virtual non-contrast (VNC) images generated by dual-energy CT (DECT) and hemoglobin concentration (Hb), and to investigate the feasibility of anemia assessment using DECT.

Methods: A total of 400 patients (200 males and 200 females) who underwent abdominal contrast-enhanced CT with dual-energy mode were included. Non-contrast VMIs at 70 keV (diaphragmatic dome and celiac artery levels) and equilibrium-phase VNC images (celiac artery level) were generated, and CT attenuation values were measured in the aortic lumen. Correlations between CT values and Hb levels, as well as receiver operating characteristic (ROC) analyses, were performed.

Results: For non-contrast VMI, correlation coefficients at the diaphragmatic dome were 0.582 in males and 0.562 in females, and at the celiac artery level were 0.829 in males and 0.860 in females. For VNC images, the coefficients were 0.628 in males and 0.545 in females. ROC analysis of non-contrast VMI at the celiac artery level showed the highest diagnostic performance, with area under the curve values of 0.914 in males and 0.920 in females.

Conclusion: CT attenuation values on non-contrast VMI at the celiac artery level demonstrated strong correlations with Hb and support the clinical utility of DECT for noninvasive anemia assessment.