Virtual monoenergetic images by spectral detector computed tomography may improve image quality and diagnostic ability for ischemic lesions in acute ischemic stroke.
Acta Radiol
; 64(4): 1631-1640, 2023 Apr.
Article
in En
| MEDLINE
| ID: mdl-36255120
ABSTRACT
BACKGROUND:
Acute ischemic lesions are challenging to detect by conventional computed tomography (CT). Virtual monoenergetic images may improve detection rates by increased tissue contrast.PURPOSE:
To compare the ability to detect ischemic lesions of virtual monoenergetic with conventional images in patients with acute stroke. MATERIAL ANDMETHODS:
We included consecutive patients at our center that underwent brain CT in a spectral scanner for suspicion of acute stroke, onset <12â h, with or without (negative controls) a confirmed cortical ischemic lesion in the initial scan or a follow-up CT or magnetic resonance imaging. Attenuation was measured in predefined areas in ischemic gray (guided by follow-up exams), normal gray, and white matter in conventional images and retrieved in spectral diagrams for the same locations in monoenergetic series at 40-200â keV. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Visual assessment of diagnostic measures was performed by independent review by two neuroradiologists blinded to reconstruction details.RESULTS:
In total, 29 patients were included (January 2018 to July 2019). SNR was higher in virtual monoenergetic compared to conventional images, significantly at 60-150â keV. CNR between ischemic gray and normal white matter was higher in monoenergetic images at 40-70â keV compared to conventional images. Virtual monoenergetic images received higher scores in overall image quality. The sensitivity for diagnosing acute ischemia was 93% and 97%, respectively, for the reviewers, compared to 55% of the original report based on conventional images.CONCLUSION:
Virtual monoenergetic reconstructions of spectral CIs may improve image quality and diagnostic ability in stroke assessment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Radiography, Dual-Energy Scanned Projection
/
Stroke
/
Ischemic Stroke
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Acta Radiol
Year:
2023
Document type:
Article
Affiliation country:
Suecia