Abstract
BackgroundTo assess the feasibility of dual-contrast spectral photon-counting computed tomography (SPCCT) for liver imaging.MethodsWe present an SPCCT in-silico study for simultaneous mapping of the complementary distribution in the liver of two contrast agents (CAs) subsequently intravenously injected: a gadolinium-based contrast agent and an iodine-based contrast agent. Four types of simulated liver lesions with a characteristic arterial and portal venous pattern (haemangioma, hepatocellular carcinoma, cyst, and metastasis) are presented. A material decomposition was performed to reconstruct quantitative iodine and gadolinium maps. Finally, a multi-dimensional classification algorithm for automatic lesion detection is presented.ResultsOur simulations showed that with a single-scan SPCCT and an adapted contrast injection protocol, it was possible to reconstruct contrast-enhanced images of the liver with arterial distribution of the iodine-based CA and portal venous phase of the gadolinium-based CA. The characteristic patterns of contrast enhancement were visible in all liver lesions. The approach allowed for an automatic detection and classification of liver lesions using a multi-dimensional analysis.ConclusionsDual-contrast SPCCT should be able to visualise the characteristic arterial and portal venous enhancement with a single scan, allowing for an automatic lesion detection and characterisation, with a reduced radiation exposure.
Highlights
To assess the feasibility of dual-contrast spectral photon-counting computed tomography (SPCCT) for liver imaging
We present the potential of a sequential injection procedure, including a first intravenous injection of a gadoliniumbased contrast agent (CA) (CA1) and a second injection of an iodine-based CA (CA2), with a specific time gap depending on the individual circulation time
The material decomposition was allowed to differentiate between liver enhancement of CA1 and CA2, as shown in Figs. 4 and 5, where we show the distribution of both CAs within the liver parenchyma, in addition to a conventional Computed tomography (CT) image, for comparison
Summary
To assess the feasibility of dual-contrast spectral photon-counting computed tomography (SPCCT) for liver imaging. Computed tomography (CT) is a standard imaging technique for detection and characterisation of focal liver lesions, the majority of them being benign (cysts and haemangiomas). In clinical routine it is important to differentiate benign lesions from malignant lesions, Muenzel et al European Radiology Experimental (2017) 1:25 as the liver is a preferential organ for metastases of many primary tumours and benign and malignant lesions may coexist. A controversial discussion concerns dynamic phases (native, early and late arterial, portal venous, equilibrium) in the setting of different liver pathologies [4,5,6]. A standard CT liver protocol typically includes an arterial and portal venous contrastenhanced series and, when thought to be necessary, a native unenhanced scan
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