TY - JOUR
T1 - Focal cystic high-attenuation lesions
T2 - Characterization in renal phantom by using photon-counting spectral CT - Improved differentiation of lesion composition
AU - Boll, Daniel T.
AU - Patil, Neil A.
AU - Paulson, Erik K.
AU - Merkle, Elmar M.
AU - Nelson, Rendon C.
AU - Schindera, Sebastian T.
AU - Roessl, Ewald
AU - Martens, Gerhard
AU - Proksa, Roland
AU - Fleiter, Thorsten R.
AU - Schlomka, Jens Peter
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/1
Y1 - 2010/1
N2 - Purpose: To evaluate the capability of spectral computed tomography (CT) to improve the characterization of cystic high-attenuation lesions in a renal phantom and to test the hypothesis that spectral CT will improve the differentiation of cystic renal lesions with high protein content and those that have undergone hemorrhage or malignant contrast-enhancing transformation. Materials and Methods: A renal phantom that contained cystic lesions grouped in nonenhancing cyst and hemorrhage series and an iodine-enhancing series was developed. Spectral CT is based on new detector designs that may possess energy-sensitive photon-counting abilities, thereby facilitating the assessment of quantitative information about the elemental and molecular composition of tissue or contrast materials. Imaging of the renal phantom was performed with a prototype scanner at 20 mAs and 70 keV, allowing characterization of x-ray photons at 25-34, 34-39, 39-44, 44-49, 49-55, and more than 55 keV. Region of interest analysis was used to determine lesion attenuation values at various x-ray energies. Statistical analysis was performed to assess attenuation patterns and identify distinct levels of attenuation on the basis of curve regression analysis with analysis of variance tables. Results: Spectral CT depicted linear clusters for the cyst (P < .001, R2 > 0.940) and hemorrhage (P < .001, R2 > 0.962) series without spectral overlap. A distinct linear attenuation profile without spectral overlap was also detected for the iodine-enhancing series (P < .001, R2 > 0.964), with attenuation values attained in the 34-39-keV energy bin statistically identified as outliers (mean slope variation, > 37%), corresponding with iodine k-edge effects at 33.2 keV. Conclusion: Spectral CT has the potential to enable distinct characterization of hyperattenuating fluids in a renal phantom by helping identify proteinaceous and hemorrhagic lesions through assessment of their distinct levels of attenuation as well as by revealing iodine-containing lesions through analysis of their specific k-edge discontinuities.
AB - Purpose: To evaluate the capability of spectral computed tomography (CT) to improve the characterization of cystic high-attenuation lesions in a renal phantom and to test the hypothesis that spectral CT will improve the differentiation of cystic renal lesions with high protein content and those that have undergone hemorrhage or malignant contrast-enhancing transformation. Materials and Methods: A renal phantom that contained cystic lesions grouped in nonenhancing cyst and hemorrhage series and an iodine-enhancing series was developed. Spectral CT is based on new detector designs that may possess energy-sensitive photon-counting abilities, thereby facilitating the assessment of quantitative information about the elemental and molecular composition of tissue or contrast materials. Imaging of the renal phantom was performed with a prototype scanner at 20 mAs and 70 keV, allowing characterization of x-ray photons at 25-34, 34-39, 39-44, 44-49, 49-55, and more than 55 keV. Region of interest analysis was used to determine lesion attenuation values at various x-ray energies. Statistical analysis was performed to assess attenuation patterns and identify distinct levels of attenuation on the basis of curve regression analysis with analysis of variance tables. Results: Spectral CT depicted linear clusters for the cyst (P < .001, R2 > 0.940) and hemorrhage (P < .001, R2 > 0.962) series without spectral overlap. A distinct linear attenuation profile without spectral overlap was also detected for the iodine-enhancing series (P < .001, R2 > 0.964), with attenuation values attained in the 34-39-keV energy bin statistically identified as outliers (mean slope variation, > 37%), corresponding with iodine k-edge effects at 33.2 keV. Conclusion: Spectral CT has the potential to enable distinct characterization of hyperattenuating fluids in a renal phantom by helping identify proteinaceous and hemorrhagic lesions through assessment of their distinct levels of attenuation as well as by revealing iodine-containing lesions through analysis of their specific k-edge discontinuities.
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U2 - 10.1148/radiol.09090068
DO - 10.1148/radiol.09090068
M3 - Article
C2 - 20032158
AN - SCOPUS:75349109094
SN - 0033-8419
VL - 254
SP - 270
EP - 276
JO - Radiology
JF - Radiology
IS - 1
ER -