Abstract
BackgroundThis retrospective study aimed to investigate the usefulness of the optimized kiloelectron volt (keV) for virtual monoenergetic imaging (VMI) combined with iodine map in dual-energy computed tomography enterography (DECTE) in the diagnosis of Crohn’s disease (CD).MethodsSeventy-two patients (mean age: 41.89 ± 17.28 years) with negative computed tomography enterography (CTE) were enrolled for investigating the optimized VMI keV in DECTE by comparing subjective and objective parameters of VMIs that were reconstructed from 40 to 90 keV. Moreover, 68 patients (38.27 ± 15.10 years; 35 normal and 33 CD) were included for evaluating the diagnostic efficacy of DECTE iodine map at the optimized VMI energy level and routine CTE for CD and active CD. Statistical analysis for all data was conducted.ResultsObjective and subjective imaging evaluations showed the best results at 60 keV for VMIs. The CT values of the normal group, active subgroup, and CD group during the small intestinal phase at routine 120 kVp or 60 keV VMI had significant differences. The diagnostic efficacy of an iodine map was the best when NIC = 4% or fat value = 45.8% for CD, whereas NIC < 0.35 or the fat value < 0.38 for active CD. The combined routine CTE and optimized VMI improved the diagnostic efficacy (P < 0.001).ConclusionsVMI at 60 keV provided the best imaging quality on DECTE. NIC and fat value provided important basis for active CD evaluation. Routine CTE combined with VMI at 60 keV improved the diagnostic efficiency for CD.
Highlights
This retrospective study aimed to investigate the usefulness of the optimized kiloelectron volt for virtual monoenergetic imaging (VMI) combined with iodine map in dual-energy computed tomography enterography (DECTE) in the diagnosis of Crohn’s disease (CD)
Screening of the optimized VMI energy level Baseline of patients A total of 72 patients (40 male and 32 female) with negative CTE were enrolled for investigation of the optimized kiloelectron volt (keV) of VMI in DECTE
CD: Crohn’s disease; CTE: computed tomography enterography; VMI: virtual monoenergetic imaging; ICC: intraclass correlation coefficient; 95% CI: 95% confidence interval
Summary
This retrospective study aimed to investigate the usefulness of the optimized kiloelectron volt (keV) for virtual monoenergetic imaging (VMI) combined with iodine map in dual-energy computed tomography enterography (DECTE) in the diagnosis of Crohn’s disease (CD). Chen et al BMC Medical Imaging (2021) 21:185 endoscopy, multi-slice computed tomography enterography (MSCTE), which is less expensive than magnetic resonance enterography, has become a popular and suitable way for a routine monitoring in CD patients [5,6,7]. The extent of the enhancements in the field of MSCTE has been closely connected with CD activities, there are many overlaps between the imaging characteristics of CD and other abdominal lesions [8,9,10]. To avoid a misdiagnosis of CD, a distinguishable and clear image of the lesions is essential for a fast and accurate diagnosis
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