ABSTRACT
RATIONALE AND OBJECTIVES: Accurate assessment of air density used to quantitatively characterize amount and distribution of emphysema in chronic obstructive pulmonary disease (COPD) subjects has remained challenging. Hounsfield units (HU) within tracheal air can be considerably less negative than -1000 HU. This study has sought to characterize the effects of improved scatter correction used in dual-source pulmonary computed tomography (CT). MATERIALS AND METHODS: Dual-source dual-energy (DSDE) and single-source (SS) scans taken at multiple energy levels and scan settings were acquired for quantitative comparison using anesthetized ovine (n = 6), swine (n = 13), and a lung phantom. Data were evaluated for the lung, inferior vena cava, and tracheal segments. To minimize the effect of cross-scatter, the phantom scans in the DSDE mode were obtained by reducing the current of one of the tubes to near zero. RESULTS: A significant shift in mean HU values in the tracheal regions of animals and the phantom is observed, with values consistently closer to -1000 HU in DSDE mode. HU values associated with SS mode demonstrated a positive shift of up to 32 HU. In vivo tracheal air measurements demonstrated considerable variability with SS scanning, whereas these values were more consistent with DSDE imaging. Scatter effects in the lung parenchyma differed from adjacent tracheal measures. CONCLUSION: Data suggest that the scatter correction introduced into the dual-energy mode of imaging has served to provide more accurate CT lung density measures sought to quantitatively assess the presence and distribution of emphysema in COPD subjects. Data further suggest that CT images, acquired without adequate scatter correction, cannot be corrected by linear algorithms given the variability in tracheal air HU values and the independent scatter effects on lung parenchyma.