Dual-energy CT spectral and energy weighted data sets: carotid stenosis and plaque detection

Acad Radiol. 2013 Sep;20(9):1144-51. doi: 10.1016/j.acra.2013.02.019.

Abstract

Rationale and objectives: To evaluate dual-energy computed tomography spectral and energy weighted (W) image data sets concerning carotid stenosis and calcified plaque detection.

Materials and methods: Ninety patients were evaluated using contrast media injection. Energy used for dual-energy computed tomography was tin filter with 140/80 kiloVoltage and effective milli Ampere second was 147.4/270.6. Image reconstruction was performed using D30f kernel and 0.0, 0.3, 0.6, 0.8, 1.0 weightings. Data sets were analyzed using both qualitative and quantitative methods.

Results: The signal-to-noise ratio, contrast-to-noise ratio, and figure-of-merit were significantly higher in 0.6-W compared to 140-kV or 80-kV data (all P < .05). Plaque thickness, span, and longitudinal diameters were different for 140-kV, 0.6-W, and 80-kV data (all P < .05). Stenotic intra-luminal diameter was significantly different among 140 kV, 0.6 W, and 80 kV data (all P < .05). A comparison between 0.6 W and digital subtraction angiography was nonsignificant (P > .05) in normal lumen measurement.

Conclusions: The dimension of calcified plaque and carotid artery with contrast media decreased with increased energy. The percentage of carotid artery stenosis does not vary with different energy. Care must be taken for procedural planning like sizing of stents. Measured diameters of the 0.6 W were close to digital subtraction angiography; we suggest that planning should be based on the images acquired using 0.6 weighting.

Keywords: Dual-energy CT; calcification; carotid artery stenosis; energy weighting; image quality; radiation dose.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Angiography / methods*
  • Carotid Stenosis / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Radiographic Image Enhancement / methods
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Radiography, Dual-Energy Scanned Projection / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*
  • Young Adult