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Skeletal radiology
Apr, 2021;50 (4): 693-703.

Dual-energy CT arthrography: a feasibility study.

Rashpal Sandhu, Mercan Aslan, Nancy Obuchowski, Andrew Primak, Wadih Karim, Naveen Subhas
Author Information
  1. Rashpal Sandhu: Imaging Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
  2. Mercan Aslan: Imaging Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
  3. Nancy Obuchowski: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, 44195, USA.
  4. Andrew Primak: Siemens Medical Solutions USA, Inc., Malvern, PA, 19355, USA.
  5. Wadih Karim: Imaging Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
  6. Naveen Subhas: Imaging Institute, Cleveland Clinic, Cleveland, OH, 44195, USA. subhasn@ccf.org. ORCID
PMID: 32948903 DOI: 10.1007/s00256-020-03603-9

Abstract

OBJECTIVE: To evaluate the feasibility of producing 2-dimensional (2D) virtual noncontrast images and 3-dimensional (3D) bone models from dual-energy computed tomography (DECT) arthrograms and to determine whether this is best accomplished using 190 keV virtual monoenergetic images (VMI) or virtual unenhanced (VUE) images.
MATERIALS AND METHODS: VMI and VUE images were retrospectively reconstructed from patients with internal derangement of the shoulder or knee joint who underwent DECT arthrography between September 2017 and August 2019. A region of interest was placed in the area of brightest contrast, and the mean attenuation (in Hounsfield units [HUs]) was recorded. Two blinded musculoskeletal radiologists qualitatively graded the 2D images and 3D models using scores ranging from 0 to 3 (0 considered optimal).
RESULTS: Twenty-six patients (mean age ± SD, 57.5 ± 16.8 years; 6 women) were included in the study. The contrast attenuation on VUE images (overall mean ± SD, 10.5 ± 16.4 HU; knee, 19.3 ± 10.7 HU; shoulder, 5.0 ± 17.2 HU) was significantly lower (p < 0.001 for all comparisons) than on VMI (overall mean ± SD, 107.7 ± 43.8 HU; knee, 104.6 ± 31.1 HU; shoulder, 109.6 ± 51.0 HU). The proportion of cases with optimal scores (0 or 1) was significantly higher with VUE than with VMI for both 2D and 3D images (p < 0.001).
CONCLUSIONS: DECT arthrography can be used to produce 2D virtual noncontrast images and to generate 3D bone models. The VUE technique is superior to VMI in producing virtual noncontrast images.

Keywords

CT arthrography CT technique Dual-energy CT Virtual monoenergetic Virtual noncontrast

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MeSH Term

Arthrography
Feasibility Studies
Female
Humans
Radiographic Image Interpretation, Computer-Assisted
Radiography, Dual-Energy Scanned Projection
Retrospective Studies
Signal-To-Noise Ratio
Tomography, X-Ray Computed
Journal Article

Word Cloud

Created with Highcharts 10.0.0imagesvirtualVMIVUE2Dnoncontrast3DCTmodelsDECTshoulderkneearthrography0feasibilityproducingboneusingmonoenergeticpatientscontrastmeanattenuationscoresoptimal5 ± 16studyoverallmean ± SDsignificantlyp < 0001techniqueDual-energyVirtualOBJECTIVE:evaluate2-dimensional3-dimensionaldual-energycomputedtomographyarthrogramsdeterminewhetherbestaccomplished190 keVunenhancedMATERIALSANDMETHODS:retrospectivelyreconstructedinternalderangementjointunderwentSeptember2017August2019regioninterestplacedareabrightestHounsfieldunits[HUs]recordedTwoblindedmusculoskeletalradiologistsqualitativelygradedranging3consideredRESULTS:Twenty-sixage ± SD578 years6womenincluded104 HU193 ± 107 HU50 ± 172 HUlowercomparisons1077 ± 438 HU1046 ± 311 HU1096 ± 510 HUproportioncases1higherCONCLUSIONS:canusedproducegeneratesuperiorarthrography:

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