The value of quantitative dual-energy CT parameters in predicting delayed haemorrhage after thrombectomy in acute ischaemic stroke.

OBJECTIVE: This study investigates the predictive value of dual-energy CT Rho/Z quantitative parameters for delayed hemorrhage post-thrombectomy in patients with acute ischemic stroke MATERIALS AND METHODS: A retrospective analysis was conducted on 80 patients who underwent dual-energy CT after thrombectomy for acute ischemic stroke. Patients were divided into delayed hemorrhage/no delayed hemorrhage, symptomatic intracranial hemorrhage/asymptomatic intracranial hemorrhage and cerebral parenchymal hematoma/no cerebral parenchymal hematoma groups RESULTS: The quantitative parameters significantly associated with delayed hemorrhage are DEI and Zeff (p < 0.001), with the optimal cutoff values for DEI and Zeff being 0.045 and 9.355, respectively. The quantitative parameters significantly associated with symptomatic intracranial hemorrhage are DEI and Zeff (p < 0.001), with the optimal cutoff values being 0.064 and 9.422, respectively. The parameters significantly associated with cerebral parenchymal hematoma are DEI and Zeff (p < 0.001), with the optimal cutoff values for DEI and Zeff being 0.058 and 9.09, respectively CONCLUSION: The DEI and Zeff parameters derived from dual-energy CT Rho/Z analysis are valuable in predicting delayed hemorrhage, symptomatic intracranial hemorrhage, and cerebral parenchymal hematoma in patients with acute ischemic stroke following thrombectomy.

Research on accuracy of material identification based on photon counting spectral CT.

BACKGROUND: Photon counting spectral CT is a significant direction in the development of CT technology and material identification is an important application of spectral CT. However, spectrum estimation in photon counting spectral CT is highly complex and may affect quantification accuracy of material identification. OBJECTIVE: To address the problem of energy spectrum estimation in photon-counting spectral CT, this study investigates empirical material decomposition algorithms to achieve accurate quantitative decomposition of the effective atomic number. METHODS: The spectrum is first calibrated using the empirical dual-energy calibration (EDEC) method and the effective atomic number is then quantitatively estimated based on the EDEC method. The accuracy of estimating the effective atomic number of materials under different calibration conditions is investigated by designing different calibration phantoms, and accurate quantitation is achieved using suitable calibration settings. Last, the validity of this method is verified through simulations and experimental studies. RESULTS: The results demonstrate that the error in estimating the effective atomic number is reduced to within 4% for low and medium Z materials, thereby enabling accurate material identification. CONCLUSION: The empirical dual-energy correction method can solve the problem of energy spectrum estimation in photon counting spectral CT. Accurate effective atomic number estimation can be achieved with suitable calibration.

Quantitative evaluation of disease severity in connective tissue disease-associated interstitial lung disease by dual-energy computed tomography.

BACKGROUND: High-resolution computed tomography (HRCT) is recommended diagnosing and monitoring connective tissue disease-associated interstitial lung disease (CTD-ILD). Quantitative computed tomography has the potential to precisely assess the radiological severity of CTD-ILD, but has still been under study. OBJECTIVE: To investigate whether dual-energy computed tomography (DECT), a novel quantitative technique, can be used for quantitative severity assessment in CTD-ILD. METHODS: This cross sectional study recruited adult CTD-ILD patients who underwent DECT scans from the ICE study between October 2019 and November 2021. DECT parameters, including effective atomic number (Zeff), lung (lobe) volume, and monochromatic CT number (MCTN) of each lung lobe, were evaluated. CTD-ILD was classified into extensive CTD-ILD and limited CTD-ILD by staging algorithm using combined forced vital capacity (FVC)%predicted and total extent of ILD (TEI) on CT. Dyspnea, cough, and life quality were scored by Borg dyspnea score, Leicester cough questionnaire (LCQ), and short-form 36 health survey questionnaire (SF-36), respectively. RESULTS: There was a total of 147 patients with DECT scans enrolled. Higher Zeff value (3.104 vs 2.256, p < 0.001), higher MCTN (- 722.87 HU vs - 802.20 HU, p < 0.001), and lower lung volume (2309.51cm3 vs 3475.21cm3, p < 0.001) were found in extensive CTD-ILD compared with limited CTD-ILD. DECT parameters had significant moderate correlations with FVC%predicted (|r|= 0.542-0.667, p < 0.01), DLCO%predicted (|r|= 0.371-0.427, p < 0.01), and TEI (|r|= 0.485-0.742, p < 0.01). Receiver operating characteristic (ROC) analysis indicated MCTN averaged over the whole lung had the best performance for extensive CTD-ILD discrimination (AUC = 0.901, cut-off: - 762.30 HU, p < 0.001), with a sensitivity of 82.1% and a specificity of 85.4%. The Zeff value was the independent risk factor for dyspnea (OR = 3.644, 95% CI: 1.846-7.192, p < 0.001) and cough (OR = 3.101, 95% CI: 1.528-6.294, p = 0.002), and lung volume significantly contributed to the mental component summary (MCS) in SF-36 (standardized ß = 0.198, p < 0.05). CONCLUSIONS: DECT can be applied to evaluate the severity of CTD-ILD.

Prognostic Utility of Parameters Derived From Pretreatment Dual-Layer Spectral-Detector CT in Patients With Metastatic Renal Cell Carcinoma.

BACKGROUND. New therapies have emerged for metastatic renal cell carcinoma (mRCC), though corresponding imaging markers are lacking. Dual-layer spectral-detector CT (DLCT) can quantify iodine concentration (IC) and effective atomic number (Zeffective), providing information beyond attenuation that may indicate mRCC prognosis. OBJECTIVE. The purpose of our study was to assess the utility of the DLCT-derived parameters IC and Zeffective for predicting mRCC treatment response and survival. METHODS. This prospective study enrolled 120 participants with mRCC from January 2018 to January 2020 who underwent DLCT, with reconstruction of IC and Zeffective maps, before treatment initiation. Final analysis included 115 participants (86 men, 29 women; median age, 65.1 years), incorporating 313 target lesions that were clinically selected using RECIST version 1.1 on arterial phase acquisitions of the chest and abdomen. Semiautomatic volumetric segmentation was performed of the target lesions. Voxels from all lesions were combined to a single histogram per patient. The median IC and Zeffective of the combined histograms were recorded. Measurements above and below the cohort median values were considered high and low, respectively. Univariable associations were explored between IC and Zeffective with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Multivariable associations were explored between IC and ORR, PFS, and OS, adjusting for treatment (tyrosine kinase inhibitor vs checkpoint immunotherapy) and significant univariable predictors (including tumor histology and International Metastatic Renal Cell Carcinoma Database Consortium [IMDC] risk factors). RESULTS. At baseline, median IC was 2.26 mg/mL, and median Zeffective was 8.49. In univariable analysis, high IC and high Zeffective were associated with better ORR (both, odds ratio [OR] = 4.35; p = .001), better PFS (both, hazard ratio [HR] = 0.51; p = .004), and better OS (both, HR = 0.38; p < .001). In multivariable models, high IC independently predicted better ORR (OR = 4.35, p = .001), better PFS (HR = 0.51, p = .004), and better OS (HR = 0.37, p < .001); neutrophilia independently predicted worse PFS (HR = 2.10, p = .004) and worse OS (HR = 2.28, p = .003). The estimated C-index for predicting OS using IMDC risk factors alone was 0.650 versus 0.687 when incorporating high attenuation and 0.692 when incorporating high IC or high Zeffective. CONCLUSION. High IC and high Zeffective are significant predictors of better treatment response and survival in mRCC. CLINICAL IMPACT. Baseline DLCT parameters may improve current mRCC prognostic models. TRIAL REGISTRATION. ClinicalTrials.gov NCT03616951.

Image synthesis of effective atomic number images using a deep convolutional neural network-based generative adversarial network.

Background: The effective atomic numbers obtained from dual-energy computed tomography (DECT) can aid in characterization of materials. In this study, an effective atomic number image reconstructed from a DECT image was synthesized using an equivalent single-energy CT image with a deep convolutional neural network (CNN)-based generative adversarial network (GAN). Materials and methods: The image synthesis framework to obtain the effective atomic number images from a single-energy CT image at 120 kVp using a CNN-based GAN was developed. The evaluation metrics were the mean absolute error (MAE), relative root mean square error (RMSE), relative mean square error (MSE), structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), and mutual information (MI). Results: The difference between the reference and synthetic effective atomic numbers was within 9.7% in all regions of interest. The averages of MAE, RMSE, MSE, SSIM, PSNR, and MI of the reference and synthesized images in the test data were 0.09, 0.045, 0.0, 0.89, 54.97, and 1.03, respectively. Conclusions: In this study, an image synthesis framework using single-energy CT images was constructed to obtain atomic number images scanned by DECT. This image synthesis framework can aid in material decomposition without extra scans in DECT.

Quantitative X-ray phase contrast computed tomography with grating interferometry : Biomedical applications of quantitative X-ray grating-based phase contrast computed tomography.

The ability of biomedical imaging data to be of quantitative nature is getting increasingly important with the ongoing developments in data science. In contrast to conventional attenuation-based X-ray imaging, grating-based phase contrast computed tomography (GBPC-CT) is a phase contrast micro-CT imaging technique that can provide high soft tissue contrast at high spatial resolution. While there is a variety of different phase contrast imaging techniques, GBPC-CT can be applied with laboratory X-ray sources and enables quantitative determination of electron density and effective atomic number. In this review article, we present quantitative GBPC-CT with the focus on biomedical applications.

Calculation of Stopping-Power Ratio from Multiple CT Numbers Using Photon-Counting CT System: Two- and Three-Parameter-Fitting Method.

The two-parameter-fitting method (PFM) is commonly used to calculate the stopping-power ratio (SPR). This study proposes a new formalism: a three-PFM, which can be used in multiple spectral computed tomography (CT). Using a photon-counting CT system, seven rod-shaped samples of aluminium, graphite, and poly(methyl methacrylate) (PMMA), and four types of biological phantom materials were placed in a water-filled sample holder. The X-ray tube voltage and current were set at 150 kV and 40 µA, respectively, and four CT images were obtained at four threshold settings. A semi-empirical correction method that corrects the difference between the CT values from the photon-counting CT images and theoretical values in each spectral region was also introduced. Both the two- and three-PFMs were used to calculate the effective atomic number and electron density from multiple CT numbers. The mean excitation energy was calculated via parameterisation with the effective atomic number, and the SPR was then calculated from the calculated electron density and mean excitation energy. Then, the SPRs from both methods were compared with the theoretical values. To estimate the noise level of the CT numbers obtained from the photon-counting CT, CT numbers, including noise, were simulated to evaluate the robustness of the aforementioned PFMs. For the aluminium and graphite, the maximum relative errors for the SPRs calculated using the two-PFM and three-PFM were 17.1% and 7.1%, respectively. For the PMMA and biological phantom materials, the maximum relative errors for the SPRs calculated using the two-PFM and three-PFM were 5.5% and 2.0%, respectively. It was concluded that the three-PFM, compared with the two-PFM, can yield SPRs that are closer to the theoretical values and is less affected by noise.

[Role of Dual-layer Detector Energy Spectral CT in Resting Myocardial Perfusion Imaging for Patients with Normal Coronary Artery].

Objective To investigate the role of dual-layer detector energy spectral CT in resting myocardial perfusion imaging for patients with normal coronary artery. Methods One hundred and fifty-six patients with suspected coronary heart disease underwent dual-layer detector energy spectral CT coronary angiography,and resting myocardial perfusion imaging was performed for 28 patients with normal coronary artery.According to American Heart Association's 17-segmentmodel,the iodine density and effective atomic number(Zeff value)of each myocardial segment(except for apical segment)were measured and normalized to those of the aorta.All the data were quantitatively evaluated using ANOVA or Friedman test. Results Iodine density and Zeff value of myocardial segments in middle plane were significantly different(all P<0.001).The iodine density and Zeff value showed no significant difference between segments in basal and apical plane(all P > 0.05). Conclusions Iodine density and Zeff value of myocardial segments can be quantitatively evaluated using dual-layer detector energy spectral CT.Resting myocardial perfusion of segments in middle plane are significantly different in patients with normal coronary artery.

Comparison of ITO and ZnO ternary glassy composites in terms of radiation shielding properties by Monte Carlo N-particle transport code and BXCOM.

In the present study, radiation shielding properties of two glassy composite materials that are widely used in electronics, photovoltaic applications, and sensor technology, were investigated in the photon energy range from 15 keV to 15 MeV. The materials chosen were (ITO)/V2O5/B2O3 and ZnO/V2O5/B2O3 including various concentrations of B2O3. Radiation interaction was simulated and shielding parameters calculated by means of the MCNP and BXCOM codes. More specifically, buildup factors, effective electron density ([Formula: see text]) and effective atomic number ([Formula: see text]) were calculated with BXCOM, while mass attenuation coefficients ([Formula: see text]), half-value layer (HVL) and tenth-value layer (TVL) values were calculated with MCNP. The results were compared with those obtained with the WinXCOM code, for validation. Acceptable and preferable results were obtained for both composites as alternative to other glassy shielding materials. The composite including ITO showed better shielding properties than the composite including ZnO. In terms of radiation shielding, both composites turned out to be better than concrete and close to lead.

Phy-X/ZeXTRa: a software for robust calculation of effective atomic numbers for photon, electron, proton, alpha particle, and carbon ion interactions.

The purpose of the present work is robust calculation of effective atomic numbers ([Formula: see text]s) for photon, electron, proton, alpha particle and carbon ion interactions through the newly developed software, Phy-X/ZeXTRa (Zeff of materials for X-Type Radiation attenuation). A pool of total mass attenuation and energy absorption coefficients (for photons) and total mass stopping powers (for charged particles) for elements was constructed first. Then, a matrix of interaction cross sections for elements Z = 1-92 was constructed. Finally, effective atomic numbers were calculated for any material by interpolating adjacent cross sections through a linear logarithmic interpolation formula. The results for [Formula: see text] for photon interaction were compared with those calculated through Mayneord's formula, which suggests a single-valued [Formula: see text] for any material for low-energy photons for which photoelectric absorption is the dominant interaction process. The single-valued [Formula: see text] was found to agree well with that obtained by other methods, in the low-energy region. In addition, [Formula: see text] values of various materials of biological interest were compared with those obtained experimentally at 59.54 keV. In general, the agreement between values calculated with Phy-X/ZeXTRa and Auto-Zeff and those measured were satisfactory. A comparison of [Formula: see text] values for photon energy absorption calculated with Phy-X/ZeXTRa and literature values for a nucleotide base, adenine, was made, and the relative difference (RD) in [Formula: see text] between Phy-X/ZeXTRa and literature values was found to be 2% < RD < 11%, at low photon energies (1-100 keV), while it was less than 1% at energies higher than 100 keV. Highest [Formula: see text] values were observed at low photon energies, where photoelectric absorption dominates photon interaction. For electrons, corresponding RD(%) values in [Formula: see text] were found to be in the range 0.4 ≤ RD(%) ≤ 1.7, while for heavy charged particle interactions it was 2.4 ≤ RD(%) ≤ 4.2 for total proton interaction and 0 ≤ RD(%) ≤ 8 for total alpha particle interaction. In view of the importance of [Formula: see text] for identifying and differentiating tissues in diagnostic imaging as well as for estimating accurate dose in radiotherapy and particle-beam therapy, Phy-X/ZeXTRa could be used for fast and accurate calculation of [Formula: see text] in a wide energy range for both photon and charged particle (electrons, protons, alpha particles and C ions) interactions.

Experimental feasibility of dual-energy computed tomography based on the Thomson scattering X-ray source.

Unlike large-scale and expensive synchrotron radiation facilities, the Thomson scattering X-ray source can provide quasi-monochromatic, energy-tunable and high-brightness X-ray pulses with a small footprint and moderate cost, making it an excellent candidate for dual-energy and multi-energy imaging at laboratories and hospitals. Here, the first feasibility study on dual-energy computed tomography (CT) based on this type of light source is reported, and the effective atomic number and electron-density distribution of a standard phantom consisting of polytetrafluoroethylene, water and aluminium is derived. The experiment was carried out at the Tsinghua Thomson scattering X-ray source with peak energies of 29 keV and 68 keV. Both the reconstructed effective atomic numbers and the retrieved electron densities of the three materials were compared with their theoretical values. It was found that these values were in agreement by 0.68% and 2.60% on average for effective atomic number and electron density, respectively. These results have verified the feasibility of dual-energy CT based on the Thomson scattering X-ray source and will further expand the scope of X-ray imaging using this type of light source.

Assessment of quantification accuracy and image quality of a full-body dual-layer spectral CT system.

The performance of a recently introduced spectral computed tomography system based on a dual-layer detector has been investigated. A semi-anthropomorphic abdomen phantom for CT performance evaluation was imaged on the dual-layer spectral CT at different radiation exposure levels (CTDIvol of 10 mGy, 20 mGy and 30 mGy). The phantom was equipped with specific low-contrast and tissue-equivalent inserts including water-, adipose-, muscle-, liver-, bone-like materials and a variation in iodine concentrations. Additionally, the phantom size was varied using different extension rings to simulate different patient sizes. Contrast-to-noise (CNR) ratio over the range of available virtual mono-energetic images (VMI) and the quantitative accuracy of VMI Hounsfield Units (HU), effective-Z maps and iodine concentrations have been evaluated. Central and peripheral locations in the field-of-view have been examined. For all evaluated imaging tasks the results are within the calculated theoretical range of the tissue-equivalent inserts. Especially at low energies, the CNR in VMIs could be boosted by up to 330% with respect to conventional images using iDose/spectral reconstructions at level 0. The mean bias found in effective-Z maps and iodine concentrations averaged over all exposure levels and phantom sizes was 1.9% (eff. Z) and 3.4% (iodine). Only small variations were observed with increasing phantom size (+3%) while the bias was nearly independent of the exposure level (±0.2%). Therefore, dual-layer detector based CT offers high quantitative accuracy of spectral images over the complete field-of-view without any compromise in radiation dose or diagnostic image quality.

Characterization of Incidental Renal Mass With Dual-Energy CT: Diagnostic Accuracy of Effective Atomic Number Maps for Discriminating Nonenhancing Cysts From Enhancing Masses.

OBJECTIVE: The purpose of this study was to assess the diagnostic accuracy of effective atomic number maps reconstructed from dual-energy contrast-enhanced data for discriminating between nonenhancing renal cysts and enhancing masses. MATERIALS AND METHODS: Two hundred six patients (128 men, 78 women; mean age, 64 years) underwent a CT renal mass protocol (single-energy unenhanced and dual-energy contrast-enhanced nephrographic imaging) at two different hospitals. For each set of patients, two blinded, independent observers performed measurements on effective atomic number maps from contrast-enhanced dual-energy data. Renal mass assessment on unenhanced and nephrographic images, corroborated by imaging and medical records, was the reference standard. The diagnostic accuracy of effective atomic number maps was assessed with ROC analysis. RESULTS: Significant differences in mean effective atomic numbers (Zeff) were observed between nonenhancing and enhancing masses (set A, 8.19 vs 9.59 Zeff; set B, 8.05 vs 9.19 Zeff; sets combined, 8.13 vs 9.37 Zeff) (p < 0.0001). An effective atomic number value of 8.36 Zeff was the optimal threshold, rendering an AUC of 0.92 (95% CI, 0.89-0.94), sensitivity of 90.8% (158/174 [95% CI, 85.5-94.7%]), specificity of 85.2% (445/522 [95% CI, 81.9-88.2%]), and overall diagnostic accuracy of 86.6% (603/696 [95% CI, 83.9-89.1%]). CONCLUSION: Nonenhancing renal cysts, including hyperattenuating cysts, can be discriminated from enhancing masses on effective atomic number maps generated from dual-energy contrast-enhanced CT data. This technique may be of clinical usefulness when a CT protocol for comprehensive assessment of renal masses is not available.

Evaluation of Urinary Stone Composition and Differentiation between Urinary Stones and Phleboliths Using Single-source Dual-energy Computed Tomography.

The aim of this study was to investigate the utility of single-source dual-energy computed tomography (SS-DECT) composition analysis in characterizing different types of urinary stones and differentiating them from phleboliths. This study included 29 patients with urinary stones who were scheduled for surgery. All patients were scanned, first using single-energy computed tomography acquisition and then DECT acquisition on SS-DECT. Dual-energy data were archived to a Gemstone spectral imaging (GSI) viewer (GE Healthcare, Milwaukee, WI, USA). Hounsfield units (HU) and effective atomic numbers (Zeff) were estimated using the GSI viewer. The results of dual-energy analysis were compared with the biochemical constitution of the stones. The chemical analysis determined that the stones included 32 calcium-based, 6 cystine and 1 struvite stone. Both HU and Zeff values were helpful in differentiating calcium-based stones from cystine and struvite stones and phleboliths. The Zeff values of phleboliths were significantly higher than those for struvite and cystine stones, whereas it was difficult to distinguish phleboliths from struvite and cystine stones using the HU values. Composition analysis using SS-DECT is helpful for distinguishing urinary stone types and discriminating phleboliths from urinary stones. Zeff values may be more useful than HU values for differentiating urinary stones from phleboliths.

A study of effective atomic number and electron density of gel dosimeters and human tissues for scattering of gamma rays: momentum transfer, energy and scattering angle dependence.

The objective of this work was to study water- and tissue-equivalent properties of some gel dosimeters, human tissues and water, for scattering of photons using the effective atomic number (Z eff). The Rayleigh to Compton scattering ratio (R/C) was used to obtain Z eff and electron density (N e ) of gel dosimeters, human tissues and water considering a 10-2-109 momentum transfer, q (Å-1). In the present work, a logarithmic interpolation procedure was used to estimate R/C as well as Z eff of the chosen materials in a wide scattering angle (1°-180°) and energy range (0.001-100 MeV). The Z eff of the chosen materials was found to increase as momentum transfer increases, for q > ~1 Å-1. At fixed scattering angle and energy, Z eff of the material first increases and then becomes constant for high momentum transfers (q ≥ 3 Å-1), which indicates that Z eff is almost independent of energy and scattering angle for the chosen materials. Based on the Z eff data and the continuous momentum transfer range (10-2-109 Å-1), MAGIC, PAGAT and soft tissue were found to be water-equivalent materials, since their differences (%) relative to water are significantly low (≤3.2 % for MAGIC up to 103 Å-1, ≤2.9 % for PAGAT up to 109 Å-1, and ≤3.8 % for soft tissue up to 109 Å-1), while the Fricke gel was not found to be water equivalent. PAGAT was found to be a soft tissue-equivalent material in the entire momentum transfer range (<4.3 %), while MAGAT has shown to be tissue equivalent for brain (≤8.1 % up to 10 Å-1) and lung (<8.2 % up to 10 Å-1) tissues. The Fricke gel dosimeter has shown to be adipose tissue equivalent for most of the momentum range considered (<10 %).

Investigation of the effective atomic numbers of dosimetric materials for electrons, protons and alpha particles using a direct method in the energy region 10 keV-1 GeV: a comparative study.

A direct method has been used for the first time, to compute effective atomic numbers (Z eff) of water, air, human tissues, and some organic and inorganic compounds, for total electron proton and alpha particle interaction in the energy region 10 keV-1 GeV. The obtained values for Z eff were then compared to those obtained using an interpolation procedure. In general, good agreement has been observed for electrons, and the difference (%) in Z eff between the results of the direct and the interpolation method was found to be <10 % for all materials, in the energy range from 10 keV to 1 MeV. More specifically, results of the two methods were found to agree well (Dif. <10 %) for air, calcium fluoride, kapton polyimide film, paraffin wax and plastic scintillator in the entire energy region with respect to the total electron interaction. On the other hand, values for Z eff calculated using both methods for protons and alpha particles generally agree with each other in the high-energy region above 10 MeV.

Technical note: Error analysis of material-decomposition-based effective atomic number quantification method.

BACKGROUND: The effective atomic number (Zeff ) is widely applied to the identification of unknown materials. One method to determine the Zeff is material-decomposition-based spectral X-ray imaging. The method relies on certain approximations of the X-ray interaction cross-sections such as empirical model coefficients. The impact of such approximations on the accuracy of Zeff quantification has not been fully investigated. PURPOSE: To perform an error analysis of the material-decomposition-based Zeff quantification method and propose a coefficient calibration-in-groups method to improve the modeling accuracy and reduce the Zeff quantification error. METHODS: The model of the material-decomposition-based Zeff quantification method relies on the dependence of the interaction cross-sections  (σPE ) on the atomic number Z and corresponding coefficient, that is, σ PE ∝ Z m $\sigma _\mathrm{PE}\propto Z^m$ . In this work, all the data is from the National Institute of Standards and Technology (NIST) website. First, the coefficient m is calibrated through a logarithmic fitting method to quickly determine the m values for any certain energy and Zeff ranges. Then materials including elements and common compounds with Zeff ranging from 6-20 are selected as the objects whose effective atomic numbers are to be quantified. Different combinations of basis materials are applied to decompose the object materials and their quantification errors are analyzed. With the help of error analysis, the object materials are divided into high-error and low-error groups based on the decomposition coefficient ratio a m i n / a m a x $a_{min}/a_{max}$ , which is found to have a strong correlation with error, and their coefficients are calibrated in groups. Finally, the average errors of three m selection strategies: (1) using an empirical m value of 3.94, which is also considered a standard method; (2) using a single m value, which is calibrated through the logarithmic fitting method; (3) using different m values calibrated in groups, are calculated to test the effectiveness of our method. RESULTS: The approximation of the X-ray interaction cross-section leads to certain errors in Zeff quantification and the error distributions for different basis materials are different. The average errors for most basis material combinations (C(6)/Ca(20), C(6)/Al(13), Al(13)/Ca(20), C(6)/Ne(10), Na(11)/P(15)) are lower than 0.5, maintaining good average accuracy. While the average error for S(16)/Ca(20) is up to 0.8461, leading to more misjudgments on atomic number. Meanwhile, the error distribution regularity can be observed. The Pearson's correlation coefficients of absolute errors and decomposition coefficient ratios are 0.743, 0.8432 and 0.7126 for basis material combinations C(6)/Ca(20), C(6)/Al(13) and Al(13)/Ca(20), indicating a good correlation. The method using either empirical m value of 3.94 or single calibrated m value of 4.619 has relatively high average errors. The proposed method using different m values calibrated in groups has the lowest average errors 0.254, 0.203 and 0.169, which are reduced by 21.6%(0.07), 3.8%(0.008) and 62.9%(0.286) respectively compared with the standard method. CONCLUSIONS: The error analysis demonstrates that the approximation of X-ray interaction cross-sections leads to inevitable errors, while also revealing certain error distribution regularity. The coefficient calibrated-in-groups method has better modeling accuracy and has effectively reduced the error compared with the standard method using a single empirical m value of 3.94.

Multivendor comparison of quantification accuracy of effective atomic number by Dual-Energy CT: A phantom study.

PURPOSE: Our study aimed to compare the accuracy of the effective atomic number (Zeff) of five dual-energy CT (DECT) from three vendors and different generations under different scanning parameters. METHODS: Zeff accuracy of five DECT scanners with twelve tube voltage configurations was evaluated by using the TomoTherapy cheese phantom. The potential dose dependence of the Zeff was investigated using three radiation dose (5, 15, and 25 mGy), and the robustness of Zeff was simulated for different organs of the body by placing the inserts at different positional depths. Bias and mean absolute percentage error (MAPE) were used to characterize the accuracy of Zeff. Data underwent analysis using one-way ANOVA, followed by the Turky and LSD post hoc tests, simple linear regression, and linear mixed models. RESULTS: All tube voltage configurations had a bias of less than 1. Dual layer detector DECT (dl-DECT) -140 kV has the lowest MAPE (1.79 %±1.93 %). The third generation dual source DECT (ds-DECT) and the second generation rapid switch DECT (rs-DECT) have higher MAPE than their predecessor DECT. The results of the linear mixed model showed that tube voltage configuration (F=16.92, p < 0.001) and insert type (F=53.26, p < 0.001) significantly affect the MAPE. In contrast, radiation dose only has a significant effect on the MAPE of rs-DECT. The inserts position does not affect the final MAPE. CONCLUSION: When scanning different inserts, Zeff accuracy varies by vendor and DECT generation. Of all the scanners, dl-DECT had the highest Zeff accuracy. Upgrading DECT generation doesn't lead to higher accuracy, or even lower.

Role of effective atomic number of paraspinal muscles in the prediction of acute vertebral fracture risk assessment: a cross-sectional case-control study.

OBJECTIVES: We aim to investigate the relations among effective atomic number (Zeff), density, and area of paraspinal muscles, volumetric bone mineral density (vBMD), and acute vertebral fractures (VF) by using spectral base images (SBIs) and routine CT images. METHODS: A total of 223 patients (52 men and 171 women) with acute lumber VF and 776 subjects (286 men and 390 women) without VF of at least 60 years were enrolled and underwent dual-layer detector CT scans. We quantified the cross-sectional area, density (paraSMD), and Zeff of paraspinal muscles by CT images and SBIs and measured vBMD of the lumbar spine by quantitative CT. RESULTS: Higher vBMD was associated with lower VF risk in both sexes (adjusted OR, 0.33 and 0.43). After adjusting for age and body mass index, the associations of paraSMD with VF were not significant in men, and in women the association was borderline significant (OR, 0.80; 95% CI, 0.64-1.00). However, higher Zeff of paraspinal muscles was associated with lower VF risk in men (adjusted OR, 0.59; 0.36-0.96) but not in women. The associations of all muscle indexes with VF were not significant after further adjusting for vBMD. CONCLUSIONS: A higher Zeff of paraspinal muscles is associated with lower VF risk in older men but not in older women. The density, area, and Zeff of paraspinal muscles were not vBMD independent risk factors for acute VF. ADVANCES IN KNOWLEDGE: The effective atomic number of paraspinal muscles might be a potential marker for VF risk prediction.

Characterization of Normal Bone in the Equine Distal Limb with Effective Atomic Number and Electron Density Determined with Single-Source Dual Energy and Detector-Based Spectral Computed Tomography.

Single-source dual energy (SSDECT) and detector-based spectral computed tomography (DBSCT) are emerging technologies allowing the interrogation of materials that have different attenuation properties at different energies. Both technologies enable the calculation of effective atomic number (EAN), an index to determine tissue composition, and electron density (ED), which is assumed to be associated with cellularity in tissues. In the present prospective observational study, EAN and ED values were determined for 16 zones in normal subchondral and trabecular bone of 37 equine cadaver limbs. Using both technologies, the following findings were obtained: 1. palmar/plantar EAN zone values in the fetlock increased significantly with increasing age of the horse; 2. all EAN and ED values were significantly lower in the trabecular bone than in the subchondral bone of all phalanges; 3. in the distal phalanx and navicular bone, most EAN and ED values were significantly lower compared to the proximal and middle phalanx; and 4. some EAN and ED values were significantly different between front and hind limbs. Several EAN and ED values significantly differed between SSDECT and DBSCT. The reported EAN and ED values in the subchondral and trabecular bone of the equine distal limb may serve as preliminary reference values and aid future evaluation and classification of diseases.