Virtual monochromatic spectral attenuation curve analysis for evaluation of incidentally detected small renal lesions using rapid kilovoltage-switching dual-energy computed tomography
Issued Date
2022-11-01
Resource Type
ISSN
2366004X
eISSN
23660058
Scopus ID
2-s2.0-85135612313
Pubmed ID
35945346
Journal Title
Abdominal Radiology
Volume
47
Issue
11
Start Page
3817
End Page
3827
Rights Holder(s)
SCOPUS
Bibliographic Citation
Abdominal Radiology Vol.47 No.11 (2022) , 3817-3827
Suggested Citation
Moleesaide A., Maneegarn A., Kaewlai R., Thiravit S. Virtual monochromatic spectral attenuation curve analysis for evaluation of incidentally detected small renal lesions using rapid kilovoltage-switching dual-energy computed tomography. Abdominal Radiology Vol.47 No.11 (2022) , 3817-3827. 3827. doi:10.1007/s00261-022-03634-x Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85429
Title
Virtual monochromatic spectral attenuation curve analysis for evaluation of incidentally detected small renal lesions using rapid kilovoltage-switching dual-energy computed tomography
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Purpose: To determine whether the spectral attenuation curve on a rapid kilovoltage-switching dual-energy computed tomography (DECT) scan can distinguish enhancing from nonenhancing incidental small (1–4 cm) renal lesions compared with conventional single-energy attenuation changes. Methods: This retrospective study enrolled 46 patients with 78 renal lesions (24 enhancing; 54 nonenhancing) who underwent DECT with DE mode performed during the portovenous or nephrographic phase. Final diagnosis of enhancing and nonenhancing masses was confirmed by pathology or imaging following the established criteria. Virtual monochromatic images (VMI) were reconstructed, and the slopes between the VMI dataset at 40–70 keV (Slope HU40–70), 40–100 keV (Slope HU40–100), and 40–140 keV (Slope HU40–140) were measured. Visual assessment of the curve pattern was recorded. Diagnostic accuracies were calculated with a cross-validated Mann–Whitney U test, and correlations of quantitative spectral parameters and intraclass correlation coefficient (ICC) were calculated using Spearman’s rho correlation. Results: All quantitative and qualitative spectral analysis parameters significantly differentiated the enhancing and nonenhancing lesions (P < 0.001). The optimal slope thresholds calculated by cross-validation for Slope HU40–70, Slope HU40–100, and Slope HU40–140 were 3.0, 1.8 and 1.2, respectively for reader 1 and 3.0, 1.9 and 1.15, respectively for reader 2. Using a slope threshold at all datasets yielded a high diagnostic accuracy of 96 for reader 1 and 95 for reader 2. Using a ∆HU threshold of 20 HU yielded an accuracy of 100. Visual analysis of the curve pattern also yielded high accuracy of 94. Conclusions: The spectral attenuation curve on rapid kilovoltage-switching DECT gives excellent diagnostic accuracy differentiating between incidental enhancing and nonenhancing renal lesions. This benefit of DECT will be most helpful when the true unenhanced phase is not performed.