Abstract
Objective To compare the conventional non-enhanced and virtual non-enhanced images of dual-energy computed tomography (CT) in evaluating solitary pulmonary nodules (SPNs). Methods Forty-seven patients with SPNs proved by pathology underwent conventional and enhanced thoracic DECT.The virtual non-enhanced CT images and iodine images were reconstructed based on the enhanced imaging data.The mean CT number,noise,signal to noise (SNR),nodual diameter of SPNs were compared between the true non-contrast CT (TNCT) and the virtual non-contrast CT (VNCT),with pairedttest.The image quality and detectability of calcification were also compared.The diagnostic accuracy for malignant nodulesbased on the increased CT values and iodineenhanced image were compared.The independent t test was used to compare the increased CT number of SPNs and iodine images.The single-phase radioation dose of the single energy,was compared with dual energy scan. Results No significant difference in the mean CT Number (t=1.556,P>0.05),noise (t=-0.357,P>0.05),SNR (t=0.767,P>0.05) on TNCT and VNCT.The mean CT Number,the noise,and SNR were (29.90±12.43) vs (27.52±16.67) HU,(9.60±3.74) vs (9.88± 2.90),and (3.07±1.93) vs (2.76±2.36),respectively.The increased CT number of SPNs with TNCT and VNCT from baseline were (18.63±8.03) and (20.45±9.13) HU.The CT number of iodine image was (23.82±9.20) HU.A significant difference was observed between the TNCT and iodineed image (t=-2.371,P<0.05).The quality scores of VNCT image wasslightly worse than TNCT image.The detectability rate of calcification on VNCT was 92.3% (72/78).The iodine image carried the highest diagnostic sensitivity rate and accuracy rate,82.3% (28/34) and 74.5% (35/47),respectively.The highest specificity rate was 76.9% (10/13) from the increased CT number with VNCT.No significant difference in single-phase radiation dose was observed between TNCT and VNCT,(5.68±1.31) vs. (4.89±1.27) mSv. Conclusions VNCT could be obtained with similar image quality as TNCT.This methods might favor a reduction in radiation exposure. Key words: Solitary pulmonary nodule; Tomography,X-ray computed
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