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  3. Role of spectral-detector CT in reduction of artifacts from contrast media in axillary and subclavian veins: single institution study in 50 patients.

Role of spectral-detector CT in reduction of artifacts from contrast media in axillary and subclavian veins: single institution study in 50 patients.

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DOI
10.7892/boris.132687
Publisher DOI
10.1177/0284185119868904
PubMed ID
31423809
Abstract
Background: In CT imaging, a high concentration of iodinated contrast media in axillary and subclavian veins after brachialapplication can cause perivenous artifacts impairing diagnostic assessment of local vascular structures and soft tissue.
Purpose:To investigate reduction of perivenous hypo- and hyperattenuating artifacts of the axillary and subclavian veinsusing virtual monoenergetic images (VMI) in comparison to conventional CT images (CI), acquired on spectral-detector CT.
Material and Methods:50 spectral-detector CT datasets of patients with perivenous artifacts from contrast mediawere included in this retrospective, institutional review board-approved study. CT images and virtual monoenergeticimages (range 40–200 keV, 10-keV increments) were reconstructed from the same scans. Quantitative analysis wasperformed by region of interest-based assessment of mean attenuation (HU) and standard deviation in most pro-nounced hypo- and hyperdense artifacts and artifact-impaired arteries as well as muscle. Visually, artifact reduction,assessment of vessels, and surrounding soft tissue were rated on 5-point Likert-scales by two radiologists.
Results:In comparison to CT images, virtual monoenergetic images of ≥90 keV showed a significant reduction of hypo- and hyperattenuating artifacts (hypodense: CI -220.0±171.2 HU; VMI130keV -13.4±49.1 HU; hyperdense: CI 274.6±184.4 HU; VMI130keV 24.2±84.9 HU; P<0.001). Subjective analysis confirmed that virtual-monoenergetic images of ≥100 keV significantly reduced artifacts (hypodense: CI 2[1–3]; VMI130keV 5[4–5], hyperdense: CI 2[1–4]; VMI130keV 5[5–5], P<0.001) and improved diagnostic assessment. Best results for diagnostic assessment were noted for virtual monoenergetic images at 130 keV. Overcorrection of artifacts was observed at higher keV values. Interrater agreement was excellent for each evaluation and keV value (intraclass correlation coefficient 0.89).
Conclusion:Higher keV virtual monoenergetic images yielded significant reduction of contrast media artifacts and ledto improved assessment of vessels and surrounding soft tissue. Recommended keV values for best diagnostic assessmentare in the range of 100–160 keV.
Date Issued
2020-04
Publication Type
Article
Subject(s)
600 Technology > 610 Medicine & health
Subjects
X-ray computed tomography artifacts contrast media neoplasm staging
•
spectral-detector CT
Language(s)
en
Author(s)
Laukamp, Kai Roman
Gupta, Amit
Große Hokamp, Nils
Obmann, Verena Carola  
Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie  
Graner, Frank Philipp
Ho, Vivian
Ros, Pablo
Ramaiya, Nikhil
Gilkeson, Robert
Additional Credits
Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie  
Journal
Acta radiologica
Publisher
Sage
ISSN
0284-1851
Access(Rights)
restricted
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