title: Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction.
abstract: OBJECTIVE
  To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms.
  
  
  METHODS
  Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared.
  
  
  RESULTS
  Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p=0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p=0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p<0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p=0.22).
  
  
  CONCLUSIONS
  DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.
authors.affiliation: Department of Radiology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA. syamamoto@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.forename: J
authors.initials: J
authors.lastname: McWilliams
authors.forename: C
authors.initials: C
authors.lastname: Arellano
authors.forename: W
authors.initials: W
authors.lastname: Marfori
authors.forename: W
authors.initials: W
authors.lastname: Cheng
authors.forename: T
authors.initials: T
authors.lastname: Mcnamara
authors.forename: W J
authors.initials: WJ
authors.lastname: Quinones-Baldrich
authors.forename: S G
authors.initials: SG
authors.lastname: Ruehm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000792:Angiography / Q000379:methods; D015901:Angiography, Digital Subtraction / Q000379:methods*; D050281:Bones of Lower Extremity / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*