Spectral parametric segmentation of contrast-enhanced dual-energy CT to detect bone metastasis: feasibility sensitivity study using whole-body bone scintigraphy.
BACKGROUND
Dual-energy computed tomography (DECT) images may be underutilized for the evaluation of skeletal metastasis. Spectral parametric segmentation of DECT can produce bone-iodine separated images, which have the potential to detect bone metastases.


OBJECTIVE
To evaluate the potential of bone-iodine separation in the detection of bone metastasis with spectral parametric segmentation of DECT images which are acquired at clinical follow-up for patients with prior malignancy.


METHODS
The institutional review board approved the protocol of this retrospective review. Chest DECT scans using fast kV-switching between 80 and 140 kVp were included in this study. Bone-iodine separated reformatted images were produced by spectral parametric segmentation of synthesized monochromatic images. All chest CT images of 702 metastatic lesions from 54 patients were retrospectively evaluated in terms of visualization of metastatic lesions compared with (99m)Tc-MDP (methylene diphosphonate) whole-body bone scintigraphy (WBBS) as reference standard of diagnosis.


RESULTS
Spectral parametric segmentation images of DECT visualized metastatic lesions in 92.3% (n = 648/702). Osteoblastic metastases were delineated as subtle enhancing lesions on DECT in comparison to WBBS.


CONCLUSIONS
Spectral parametric segmentation of iodine from cortical and medullary bone allowed visualization of bone metastasis. DECT might be utilized for the screening or detection of bone metastases.
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Young Han
YH
Lee
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sungjun
S
Kim
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Daekeon
D
Lim
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Jin-Suck
JS
Suh
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea hotsong@yuhs.ac.
Ho-Taek
HT
Song
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods*
D003287:Contrast Media; D019275:Radiopharmaceuticals; D007479:Iopamidol; D013669:Technetium Tc 99m Medronate
Dual-energy CT; bone metastases; bone scintigraphy; computed tomography (CT)