Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study.
OBJECTIVE
To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT).


METHODS
70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140 kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140 kV ratio was calculated.


RESULTS
All intra- and interobserver agreements were excellent (r = 0.93-0.97; p < 0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p < 0.05; average increase, 12.5 ± 3.6 HU), while the ratios remained similar (each, p > 0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p < 0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p < 0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p < 0.05).


CONCLUSIONS
DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80 kV and 140 kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.
Karlo
Christoph
C
Institute for Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland. christoph.karlo@usz.ch
Lauber
Arno
A
Götti
Robert Paul
RP
Baumüller
Stephan
S
Stolzmann
Paul
P
Scheffel
Hans
H
Desbiolles
Lotus
L
Schmidt
Bernhard
B
Marincek
Borut
B
Alkadhi
Hatem
H
Leschka
Sebastian
S
D001769:Blood; D001798:Blood Proteins; D003287:Contrast Media; D005374:Filtration / Q000379:methods*; D006801:Humans; D007455:Iodine; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014001:Tin; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods
D001798:Blood Proteins; D003287:Contrast Media; D014001:Tin; D007455:Iodine