Renal Lesion Characterization with Spectral CT: Determining the Optimal Energy for Virtual Monoenergetic Reconstruction

Radiology
Christoph SchabelDaniele Marin

Abstract

Purpose To investigate the relationship between energy level of virtual monoenergetic (VM) imaging and sensitivity in the detection of minimally enhancing renal lesions. Materials and Methods Phantoms simulating unenhanced and contrast material-enhanced renal parenchyma were equipped with inserts containing different concentrations of iodine (range, 0-1.15 mg iodine per milliliter). A total of 180 patients (117 men; mean age, 65.2 years ± 13.0 [standard deviation]) with 194 (62 solid, 132 cystic) renal lesions larger than 10 mm in diameter underwent unenhanced single-energy CT and contrast-enhanced dual-energy CT. VM imaging data sets were created for 70, 80, 90, and 100 keV. Renal lesions were measured, and enhancement was calculated. Area under the receiver operating characteristic curve (AUC) for renal lesion characterization was determined by using the DeLong method. Results The AUC was highest at 70 keV and decreased as energy increased toward 100 keV. AUC in the phantom decreased from 98% (95% confidence interval [CI]: 95, 100) at 70 keV to 88% (95% CI: 79, 96) at 100 keV (P = .004). AUC in patients decreased from 96% (95% CI: 94, 98) at 70 keV to 79% (95% CI: 71, 86) at 100 keV (P = .001). In patients with an enhancement...Continue Reading

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Citations

Mar 6, 2019·AJR. American Journal of Roentgenology·Davide BelliniAchille Mileto
Jun 3, 2020·Emergency Radiology·Aaron D SodicksonJennifer W Uyeda
Oct 4, 2020·Journal of Magnetic Resonance Imaging : JMRI·Satheesh KrishnaMatthew S Davenport
Jan 8, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Anushri ParakhAvinash R Kambadakone
Dec 9, 2020·Technology and Health Care : Official Journal of the European Society for Engineering and Medicine·Yi-Chuan MaAi-Qi Chen
Nov 20, 2020·European Radiology·Shanigarn ThiravitAchille Mileto

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