title: Can dual-energy computed tomography improve visualization of hypoenhancing liver lesions in portal venous phase? Assessment of advanced image-based virtual monoenergetic images.
abstract: OBJECTIVE
  The purpose was to assess image quality of portal-venous phase dual-energy computed tomography (DECT) for liver lesions.
  
  
  METHODS
  We performed 120-kVp-equivalent linear-blended (LB) and monoenergetic reconstructions from 40 to 190 keV by standard (VMI) and advanced virtual monoenergetic (VMI+) methods. Diagnostic performance, and quantitative and qualitative image analyses were assessed and compared.
  
  
  RESULTS
  Liver contrast to noise ratio peaked at 40 keV_VMI+, while image quality and reader preference peaked at 50 keV_VMI+. 50 keV_VMI+ scored overall higher diagnostic performance: lesion sensitivity 95.4% vs. 83.3% for both 75 keV_VMI and LB.
  
  
  CONCLUSIONS
  DECT improves assessment of hypoenhancing liver lesions on portal venous phase. 50 keV_VMI+ demonstrated the highest image quality and diagnostic performance over VMI and LB.
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Department of Radiological Sciences, Oncological and Pathological Sciences University of Rome "Sapienza", via Franco Faggiana 1668, 04100 Latina, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Caruso
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.affiliation: Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Schaefer
authors.affiliation: Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
authors.forename: Parker W
authors.initials: PW
authors.lastname: Leland
authors.affiliation: Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425.
authors.forename: Dustin
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Department of Radiological Sciences, Oncological and Pathological Sciences University of Rome "Sapienza", via Franco Faggiana 1668, 04100 Latina, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Laghi
authors.affiliation: Division of Abdominal Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: andrewdhardie@gmail.com.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hardie
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Dual-energy CT; Liver lesion; Monoenergetic; Portal venous phase