title: Optimization of window settings for standard and advanced virtual monoenergetic imaging in abdominal dual-energy CT angiography.
abstract: To determine the optimal window setting for displaying virtual monoenergetic reconstructions of third generation dual-source, dual-energy CT (DECT) angiography of the abdomen.
  
  
  
  Forty-five patients were evaluated with DECT angiography (90/150 kV, 180/90 ref. mAs). Three datasets were reconstructed: standard linear blending (M_0.6), 70 keV traditional virtual monoenergetic (M70), and 40 keV advanced noise-optimized virtual monoenergetic (M40+). The best window setting (width and level, W/L) was assessed by two blinded observers and was correlated with aortic attenuation to obtain the Optimized W/L setting (O-W/L). Subjective image quality was assessed, and vessel diameters were measured to determine any possible influences between different W/L settings. Repeated measures of variance were used to evaluate comparison of W/L values, image quality, and vessel sizing between M_0.6, M70, and M40+.
  
  
  
  The Best W/L (B-W/L) for M70 and M40+ was 880/280 and 1410/450, respectively. Results from regression analysis inferred an O-W/L of 850/270 for M70 and 1350/430 for M40+. Significant differences for W and L were found between the Best and the Optimized W/L for M40+, and between M70 and M40+ for both the Best and Optimized W/L. No significant differences for vessel measurements were found using the O-W/L for M40+ compared to the standard M_0.6 (p ≥ 0.16), and significant differences were observed when using the B-W/L with M40+ compared to M_0.6 (p ≤ 0.04).
  
  
  
  In order to optimize virtual monoenergetic imaging with both traditional M70 and advanced M40+, adjusting the W/L settings is necessary. Our results suggest a W/L setting of 850/270 for M70 and 1350/430 for M40+.
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.|Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome "Sapienza", 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, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Parinella
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA. schoepf@musc.edu.|Division of Cardiology, Department of MedicineMedical, University of South Carolina, Charleston, SC, USA. schoepf@musc.edu.
authors.forename: U Joseph
authors.identifier: 0000-0002-6164-5641
authors.initials: UJ
authors.lastname: Schoepf
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.
authors.forename: Maxwell H
authors.initials: MH
authors.lastname: Stroebel
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.|Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Mangold
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.|Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.
authors.forename: Akos
authors.initials: A
authors.lastname: Varga-Szemes
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.
authors.forename: B Devon
authors.initials: BD
authors.lastname: Ball
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.|Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome "Sapienza", Latina, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Santis
authors.affiliation: Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome "Sapienza", Latina, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Laghi
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
mesh_terms: D000368:Aged; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D011860:Radiography, Abdominal / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: CT angiography; Dual-energy CT; Virtual monoenergetic; W/L; Window settings