Initial experience with single-source dual-energy CT abdominal angiography and comparison with single-energy CT angiography: image quality, enhancement, diagnosis and radiation dose.
OBJECTIVE
To assess image quality of virtual monochromatic spectral (VMS) images, compared to single-energy (SE) CT, and to evaluate the feasibility of material density imaging in abdominal aortic disease.


METHODS
In this retrospective study, single-source (ss) dual-energy (DE) CT of the aorto-iliac system in 35 patients (32 male, mean age 76.5 years) was compared to SE-CT. By post-processing the data from ssDECT, VMS images at different energies and material density water (WD) images were generated. The image quality parameters were rated on 5-point scales. The aorto-iliac attenuation and contrast-to-noise ratio (CNR) were recorded. Quality of WD images was compared to true unenhanced (TNE) images. Radiation dose was recorded and statistical analysis was performed.


RESULTS
Image quality and noise were better at 70 keV (P < 0.01). Renal artery branch visualisation was better at 50 keV (P < 0.005). Attenuation and CNR were higher at 50 and 70 keV (P < 0.0001). The WD images had diagnostic quality but higher noise than TNE images (P < 0.0001). Radiation dose was lower using single-phase ssDECT compared to dual-phase SE-CT (P < 0.0001).


CONCLUSIONS
70-keV images from ssDECT provide higher contrast enhancement and improved image quality for aorto-iliac CT when compared to SE-CT at 120 kVp. WD images are an effective substitute for TNE images with a potential for dose reduction.
Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA. daniffcpinho@gmail.com
Daniella F
DF
Pinho
Naveen M
NM
Kulkarni
Arun
A
Krishnaraj
Sanjeeva P
SP
Kalva
Dushyant V
DV
Sahani
D034841:Abdominal Cavity / Q000000981:diagnostic imaging*; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D016477:Artifacts; D015331:Cohort Studies; D003287:Contrast Media; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media