title: Dual-Energy Computed Tomography Virtual Monoenergetic Imaging of Lung Cancer: Assessment of Optimal Energy Levels.
abstract: OBJECTIVE
  The aim of the study was to evaluate objective and subjective image qualities of virtual monoenergetic imaging (VMI) in dual-source dual-energy computed tomography (DECT) and optimal kiloelectron-volt (keV) levels for lung cancer.
  
  
  METHODS
  Fifty-nine lung cancer patients underwent chest DECT. Images were reconstructed as VMI series at energy levels of 40, 60, 80, and 100 keV and standard linear blending (M_0.3) for comparison. Objective and subjective image qualities were assessed.
  
  
  RESULTS
  Lesion contrast peaked in 40-keV VMI reconstructions (2.5 ± 2.9) and 60 keV (1.9 ± 3.0), which was superior to M_0.3 (0.5 ± 2.7) for both comparisons (P < 0.001). Compared with M_0.3, subjective ratings were highest for 60-keV VMI series regarding general image quality (4.48 vs 4.52; P = 0.74) and increased for lesion demarcation (4.07 vs 4.84; P < 0.001), superior to all other VMI series (P < 0.001). Image sharpness was similar between both series. Image noise was rated superior in the 80-keV and M_0.3 series, followed by 60 keV.
  
  
  CONCLUSIONS
  Virtual monoenergetic imaging reconstructions at 60-keV provided the best combination of subjective and objective image qualities in DECT of lung cancer.
authors.affiliation: From the Departments of *Diagnostic and Interventional Radiology and †Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Kaup
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Scholtz
authors.forename: Alexander
authors.initials: A
authors.lastname: Engler
authors.forename: Moritz H
authors.initials: MH
authors.lastname: Albrecht
authors.forename: Ralf W
authors.initials: RW
authors.lastname: Bauer
authors.forename: J Matthias
authors.initials: JM
authors.lastname: Kerl
authors.forename: Martin
authors.initials: M
authors.lastname: Beeres
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehnert
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D007479:Iopamidol / Q000031:analogs & derivatives; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; 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; D059629:Signal-To-Noise Ratio; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol