Imaging Pearls ❯ Dual Energy ❯ Oncology
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- “Dual-energy CT is an innovative imaging technique that enhances the capabilities of CT in evaluating oncology patients.”
Oncologic applications of dual-energy CT in the abdomen.
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612. - “ Dual-energy computed tomographic (DECT) technology offers enhanced capabilities that may benefit oncologic imaging in the abdomen. By using two different energies, dual-energy CT allows material decomposition on the basis of energy-dependent attenuation profiles of specific materials. Although image acquisition with dual-energy CT is similar to that with single-energy CT, comprehensive postprocessing is able to generate not only images that are similar to single-energy CT (SECT) images, but a variety of other images, such as virtual unenhanced (VUE), virtual monochromatic (VMC), and material-specific iodine images.”
Oncologic applications of dual-energy CT in the abdomen.
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612. - “ Dual-energy computed tomographic (DECT) technology offers enhanced capabilities that may benefit oncologic imaging in the abdomen. By using two different energies, dual-energy CT allows material decomposition on the basis of energy-dependent attenuation profiles of specific materials. Although image acquisition with dual-energy CT is similar to that with single-energy CT, comprehensive postprocessing is able to generate not only images that are similar to single-energy CT (SECT) images, but a variety of other images, such as virtual unenhanced (VUE), virtual monochromatic (VMC), and material-specific iodine images.”
Oncologic applications of dual-energy CT in the abdomen.
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612. - “ An increase in the conspicuity of iodine on low-energy VMC images and material-specific iodine images may aid detection and characterization of tumors. Use of VMC images of a desired energy level (40-140 keV) improves lesion-to-background contrast and the quality of vascular imaging for preoperative planning. Material-specific iodine images enable differentiation of hypoattenuating tumors from hypo- or hyperattenuating cysts and facilitate detection of isoattenuating tumors, such as pancreatic masses and peritoneal disease, thereby defining tumor targets for imaging-guided therapy. Moreover, quantitative iodine mapping may serve as a surrogate biomarker for monitoring effects of the treatment.”
Oncologic applications of dual-energy CT in the abdomen.
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612. - “ By interrogating the unique characteristics of different materials at different x-ray energies, dual-energy CT can be used to provide quantitative information about tissue composition, overcoming the limitations of attenuation-based conventional single-energy CT imaging. In the past few years, intensive research efforts have been devoted to exploiting the unique and powerful opportunities of dual-energy CT for a variety of clinical applications. This has led to CT protocol modifications for radiation dose reduction, improved diagnostic performance for detection and characterization of diseases, as well as image quality optimization.”
State of the art: dual-energy CT of the abdomen
Marin D et al.
Radiology. 2014 May;271(2):327-42 - “ Iodine concentration thresholds of 16.66 and 17.78 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between ampullary adenocarcinomas and pancreatic adenocarcinomas in the portal venous phase and delayed phase.”
Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region
Wei W et al.
Abdom Imaging (2014) 39;702-710 - “ The use of monchromatic X-ray beam eliminates the beam-hardening artifacts and averaging attenuation effects. For medical diagnostic imaging, water and iodine are often selected as the basis for material decomposition (MD) image analysis because their atomic numbers approximate those of soft tissue and iodinated contrast material to result in MD images that are easy to interpret.”
Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region
Wei W et al.
Abdom Imaging (2014) 39;702-710 - “ According to our study presented here, there were more obvious differences in CT values between different diseases at low energy levels (40-80 keV). The higher absorption of low energy level X-rays allows for higher contrast, and enabled us to differentiate among the three origins of adenocarcinomas studied. The iodine concentration was significantly higher in enhancing common bile duct adenocarcinomas than in enhancing pancreatic adenocarcinoma and enhancing duodenal papillary adenocarcinoma during AP, PP, and DP.”
Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region
Wei W et al.
Abdom Imaging (2014) 39;702-710 - “ DESCT with multiple parameters can provide useful diagnostic information and may be used to predict the histological origin of carcinomas in the ampullary region.”
Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region
Wei W et al.
Abdom Imaging (2014) 39;702-710 - “ In summary, DESCT with triple phase scanning enables material decomposition analysis and other quantitative CT image parameters analysis that may be used to predict histological origin of ampullary region carcinomas before surgery.”
Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region
Wei W et al.
Abdom Imaging (2014) 39;702-710 - “Dual-energy computed tomographic (DECT) technology offers enhanced capabilities that may benefit oncologic imaging in the abdomen. By using two different energies, dual-energy CT allows material decomposition on the basis of energy-dependent attenuation profiles of specific materials. Although image acquisition with dual-energy CT is similar to that with single-energy CT, comprehensive postprocessing is able to generate not only images that are similar to single-energy CT (SECT) images, but a variety of other images, such as virtual unenhanced (VUE), virtual monochromatic (VMC), and material-specific iodine images. An increase in the conspicuity of iodine on low-energy VMC images and material-specific iodine images may aid detection and characterization of tumors.”
Oncologic applications of dual-energy CT in the abdomen
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612 - “Use of VMC images of a desired energy level (40-140 keV) improves lesion-to-background contrast and the quality of vascular imaging for preoperative planning. Material-specific iodine images enable differentiation of hypoattenuating tumors from hypo- or hyperattenuating cysts and facilitate detection of isoattenuating tumors, such as pancreatic masses and peritoneal disease, thereby defining tumor targets for imaging-guided therapy. Moreover, quantitative iodine mapping may serve as a surrogate biomarker for monitoring effects of the treatment.”
Oncologic applications of dual-energy CT in the abdomen
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612 - “Quantification of iodine in tissues on iodine-specific images may serve as a biomarker for tumor vascularity and viability beyond the conventional measurements of tumor burden . If appropriately applied, dual-energy CT may concurrently provide morphologic and functional information in a single imaging examination .”
Oncologic applications of dual-energy CT in the abdomen
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612 - “In conventional contrast-enhanced CT acquisitions, attenuation measurements take into account both the inherent tissue attenuation and uptake of contrast media (iodine) by the tissue. Compared with single-energy CT, dual-energy CT offers more information. Dual-energy CT allows material decomposition and provides iodine images that map the iodine content of the tissue and, thus, provide a more reliable measurement of tissue enhancement. Iodine-only images may serve as a surrogate marker for tissue contrast media uptake and are independent of inherent tissue attenuation, which contributes to CT attenuation measurements.”
Oncologic applications of dual-energy CT in the abdomen
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612 - “The use of low-energy images in oncologic CT may improve lesion detection by improving the contrast between a hypervascular lesion, a hypovascular lesion, and normally enhancing parenchyma.”
Oncologic applications of dual-energy CT in the abdomen
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612 - “Iodine-specific maps have the potential to increase the depiction and characterization of hypoattenuating malignancies by increasing the contrast between a hypoattenuating lesion and normally enhancing parenchyma on the basis of differences in tissue iodine content. Iodine-specific maps depict and quantify iodine in each voxel; thus, a small amount of enhancement in a lesion may be detected. Another potential application of iodine-specific maps is improved depiction of nodules with varying enhancement patterns in patients with a cirrhotic liver.”
Oncologic applications of dual-energy CT in the abdomen
Agrawal MD et al.
Radiographics. 2014 May-Jun;34(3):589-612 - Dual Energy in Oncology: The Possibilities
- Single energy equivalent images
- Virtual unenhanced imaging
- Virtual monochromatic imaging
- Material specific iodine images - Dual Energy in Oncology: The Possibilities
- Improved lesion detection
- Improved lesion discrimination
- Improved lesion characterization
- Improved vascular imaging
- Surrogate biomarker for monitoring effects of therapy
- “ Dual energy CT (DECT) is an innovative imaging technique that operates on the basic principle of application of two distinct energy settings that make the transition from CT attenuation based imaging to material specific or spectral imaging.”
Dual-Energy CT: Oncologic Applications
De Cecco CN et al.
AJR 2012; 199:S98-S105 - “ DECT is an innovative imaging technique that can have a considerable effect on the care of oncologic patients. The possibility of obtaining different material specific datasets in the same acquisition can improve lesion detection and characterization. This approach can also aid in evaluation of response to therapy, and detection of oncology related disorders.”
Dual-Energy CT: Oncologic Applications
De Cecco CN et al.
AJR 2012; 199:S98-S105