Dual-energy CT Reconstruction Research Articles

One-step inverse generation network for sparse-view dual-energy CT reconstruction and material imaging

Objective. Sparse-view dual-energy spectral computed tomography (DECT) imaging is a challenging inverse problem. Due to the incompleteness of the collected data, the presence of streak artifacts can result in the degradation of reconstructed spectral images. The subsequent material decomposition task in DECT can further lead to the amplification of artifacts and noise. Approach. To address this problem, we propose a novel one-step inverse generation network (OIGN) for sparse-view dual-energy CT imaging, which can achieve simultaneous imaging of spectral images and materials. The entire OIGN consists of five sub-networks that form four modules, including the pre-reconstruction module, the pre-decomposition module, and the following residual filtering module and residual decomposition module. The residual feedback mechanism is introduced to synchronize the optimization of spectral CT images and materials. Main results. Numerical simulation experiments show that the OIGN has better performance on both reconstruction and material decomposition than other state-of-the-art spectral CT imaging algorithms. OIGN also demonstrates high imaging efficiency by completing two high-quality imaging tasks in just 50 seconds. Additionally, anti-noise testing is conducted to evaluate the robustness of OIGN. Significance. These findings have great potential in high-quality multi-task spectral CT imaging in clinical diagnosis.

Optimizing twin-beam dual-energy CT reconstruction: Quantitative consistency and stability assessment in reference to 120 kV: An observational study.

The split filter CT can filter X-ray beam. Theoretically, the split filter CT not only provides a good low-energy beam, but also provides a more robust CT value. The aim of this study was to compare conventional single-energy computed tomography (SECT) and twin-beam dual-energy (TBDE) CT regarding the quantitative consistency and stabilities of HU measurements at different abdominal organs. Forty-four patients were prospectively enrolled to randomly receive SECT and TBDE protocols at either body part of a thorax-abdominal examination. Their overlapping scan coverage was subjected to further image analysis. For TBDE scans, composed images(c-images) and virtual monoenergetic images (VMIs) at 60, 70, 80, and 90 kiloelectron volt (keV) were reconstructed. The attenuations were measured at 5 abdominal organs and compared between SECT and TBDE to characterize quantitative consistency by intraclass correlation coefficients (ICCs), whereas their standard deviations were used to assess the Hounsfield Unit (HU) stability. The c-images, 70 keV and 80 keV VMIs from TBDE provided consistent HU values (all ICCs > 0.8) with the SECT measurements; moreover, these TBDE images had superior HU stability over SECT images in all abdominal measurements except for fat tissue. The best HU stability can be achieved in 80 keV VMIs with the lowest noise level. The c-images and VMIs derived from TBDE can produce consistent values as SECT. The 80 keV images displayed better HU stability and a lower noise level across various abdominal organs.

Dual-energy CT revisited: a focused review of clinical use cases.

Dual-energy CT (DECT) has been available for more than 15 years and has undergone continuous technical development and refinement. Recently, the first photon-counting CT scanner became clinically available and has the potential to further expand the possibilities of spectral imaging. Numerous studies on DECT have been published since its creation, highlighting the clinical applications of the various reconstructions enabled by DECT. The aim of this focused review is to succinctly summarize basic principles and available technical concepts of DECT and to discuss established applications relevant to the daily clinical routine. DECT is instrumental for a broad variety of clinical use cases. While some DECT applications can enhance day-to-day clinical practice, others are still subject to broad-scale validation and should therefore be handled with restraint in the clinical routine. · Virtual monoenergetic images, virtual unenhanced images, and iodine maps are the most well-investigated and relevant dual-energy CT reconstructions for clinical application.. · Low-keV virtual monoenergetic images (VMIs) yield superior image and iodine contrast, which can be leveraged for improved vessel assessment and lesion conspicuity, or to reduce contrast media or radiation dose. VMIs at intermediate energies can serve as a replacement for conventional grey-scale images. VMIs at high keV enable efficient artifact reduction, which can be further optimized in combination with dedicated metal artifact reduction algorithms.. · Iodine maps and virtual unenhanced images can improve lesion detection in oncologic imaging and enable lesion assessment in monophasic CT examinations, which may allow a reduction of correlative and follow-up imaging..

Multi-Stage Dual-domain Networks with Informative Prior and Self-Augmentation for Dual-Energy Limited-Angle CT Reconstruction

Multi-Stage Dual-domain Networks with Informative Prior and Self-Augmentation for Dual-Energy Limited-Angle CT Reconstruction

MB-DECTNet: a model-based unrolling network for accurate 3D dual-energy CT reconstruction from clinically acquired helical scans

Objective. Over the past several decades, dual-energy CT (DECT) imaging has seen significant advancements due to its ability to distinguish between materials. DECT statistical iterative reconstruction (SIR) has exhibited potential for noise reduction and enhanced accuracy. However, its slow convergence and substantial computational demands render the elapsed time for 3D DECT SIR often clinically unacceptable. The objective of this study is to accelerate 3D DECT SIR while maintaining subpercentage or near-subpercentage accuracy. Approach. We incorporate DECT SIR into a deep-learning model-based unrolling network for 3D DECT reconstruction (MB-DECTNet), which can be trained end-to-end. This deep learning-based approach is designed to learn shortcuts between initial conditions and the stationary points of iterative algorithms while preserving the unbiased estimation property of model-based algorithms. MB-DECTNet comprises multiple stacked update blocks, each containing a data consistency layer (DC) and a spatial mixer layer, with the DC layer functioning as a one-step update from any traditional iterative algorithm. Main results. The quantitative results indicate that our proposed MB-DECTNet surpasses both the traditional image-domain technique (MB-DECTNet reduces average bias by a factor of 10) and a pure deep learning method (MB-DECTNet reduces average bias by a factor of 8.8), offering the potential for accurate attenuation coefficient estimation, akin to traditional statistical algorithms, but with considerably reduced computational costs. This approach achieves 0.13% bias and 1.92% mean absolute error and reconstructs a full image of a head in less than 12 min. Additionally, we show that the MB-DECTNet output can serve as an initializer for DECT SIR, leading to further improvements in results. Significance. This study presents a model-based deep unrolling network for accurate 3D DECT reconstruction, achieving subpercentage error in estimating virtual monoenergetic images for a full head at 60 and 150 keV in 30 min, representing a 40-fold speedup compared to traditional approaches. These findings have significant implications for accelerating DECT SIR and making it more clinically feasible.

Dual energy CT reconstruction using the constrained one step spectral image reconstruction algorithm.

The constrained one-step spectral CT Image Reconstruction method (cOSSCIR) has been developed to estimate basis material maps directly from spectral CT data using a model of the polyenergetic x-ray transmissions and incorporating convex constraints into the inversion problem. This 'one-step' approach has been shown to stabilize the inversion in the case of photon-counting CT, and may provide similar benefits to dual-kV systems that utilize integrating detectors. Since the approach does not require the same rays be acquired for every spectral measurement, cOSSCIR can apply to dual energy protocols and systems used clinically, such as fast and slow kV switching systems and dual sourcescanning. The purpose of this study is to investigate the use of cOSSCIR applied to dual-kV data, using both registered and unregistered spectral acquisitions, specifically slow and fast kV switching imaging protocols. For this application, cOSSCIR is investigated using inverse crime simulations and dual-kV experiments. This study is the first demonstration of cOSSCIR on the dual-kV reconstructionproblem. An integrating detector model was developed for the purpose of reconstructing dual-kV data, and an inverse crime study was used to validate the detector model within the cOSSCIR framework using a simulated pelvic phantom. Experiments were also used to evaluate cOSSCIR on the dual energy problem. Dual-kV data was obtained from a physical phantom containing analogs of adipose, bone, and liver tissues, with the aim of recovering the material coefficients in the bone and adipose basis material maps. cOSSCIR was applied to acquisitions where all rays performed both spectral measurements (registered) and fast and slow kV switching acquisitions (unregistered). cOSSCIR was also compared to two image-domain decomposition approaches, where image-domain methods are the conventional approach for decomposing unregistered spectraldata. Simulations demonstrate the application of cOSSCIR to the dual-kV inversion problem by successfully recovering the material basis maps on ideal data, while further showing that unregistered data presents a more challenging inversion problem. In our experimental reconstructions, the recovered basis material coefficient errors were found to be less than 6.5% in the bone, adipose, and liver regions for both registered and unregistered protocols. Similarly, the errors were less than 4% in the 50 keV virtual mono-energetic images, and the recovered material decomposition vectors nearly overlap their corresponding ground-truth vectors. Additionally, a preliminary two material decomposition study of iodine quantification recovered an average concentration of 9.2 mg/mL from a 10 mg/mL experimental iodineanalog. Using our integrating detector and spectral models, cOSCCIR is capable of accurately recovering material basis maps from dual-kV data for both registered and unregistered data. The material decomposition quantification compare favorably to the image domain approaches, and our results were not affected by the imaging protocol. Our results also suggest the extension of cOSSCIR to iodine quantification using two materialdecomposition.

Synthetic dual-energy CT reconstruction from single-energy CT Using artificial intelligence.

To develop and assess the utility of synthetic dual-energy CT (sDECT) images generated from single-energy CT (SECT) using two state-of-the-art generative adversarial network (GAN) architectures for artificial intelligence-based image translation. In this retrospective study, 734 patients (389F; 62.8 years ± 14.9) who underwent enhanced DECT of the chest, abdomen, and pelvis between January 2018 and June 2019 were included. Using 70-keV as the input images (n = 141,009) and 50-keV, iodine, and virtual unenhanced (VUE) images as outputs, separate models were trained using Pix2PixHD and CycleGAN. Model performance on the test set (n = 17,839) was evaluated using mean squared error, structural similarity index, and peak signal-to-noise ratio. To objectively test the utility of these models, synthetic iodine material density and 50-keV images were generated from SECT images of 16 patients with gastrointestinal bleeding performed at another institution. The conspicuity of gastrointestinal bleeding using sDECT was compared to portal venous phase SECT. Synthetic VUE images were generated from 37 patients who underwent a CT urogram at another institution and model performance was compared to true unenhanced images. sDECT from both Pix2PixHD and CycleGAN were qualitatively indistinguishable from true DECT by a board-certified radiologist (avg accuracy 64.5%). Pix2PixHD had better quantitative performance compared to CycleGAN (e.g., structural similarity index for iodine: 87% vs. 46%, p-value < 0.001). sDECT using Pix2PixHD showed increased bleeding conspicuity for gastrointestinal bleeding and better removal of iodine on synthetic VUE compared to CycleGAN. sDECT from SECT using Pix2PixHD may afford some of the advantages of DECT.

Motion-compensated scheme for sequential scanned statistical iterative dual-energy CT reconstruction

Objective. Dual-energy computed tomography (DECT) has been widely used to reconstruct numerous types of images due its ability to better discriminate tissue properties. Sequential scanning is a popular dual-energy data acquisition method as it requires no specialized hardware. However, patient motion between two sequential scans may lead to severe motion artifacts in DECT statistical iterative reconstructions (SIR) images. The objective is to reduce the motion artifacts in such reconstructions. Approach. We propose a motion-compensation scheme that incorporates a deformation vector field into any DECT SIR. The deformation vector field is estimated via the multi-modality symmetric deformable registration method. The precalculated registration mapping and its inverse or adjoint are then embedded into each iteration of the iterative DECT algorithm. Main results. Results from a simulated and clinical case show that the proposed framework is capable of reducing motion artifacts in DECT SIRs. Percentage mean square errors in regions of interest in the simulated and clinical cases were reduced from 4.6% to 0.5% and 6.8% to 0.8%, respectively. A perturbation analysis was then performed to determine errors in approximating the continuous deformation by using the deformation field and interpolation. Our findings show that errors in our method are mostly propagated through the target image and amplified by the inverse matrix of the combination of the Fisher information and Hessian of the penalty term. Significance. We have proposed a novel motion-compensation scheme to incorporate a 3D registration method into the joint statistical iterative DECT algorithm in order to reduce motion artifacts caused by inter-scan motion, and successfully demonstrate that interscan motion corrections can be integrated into the DECT SIR process, enabling accurate imaging of radiological quantities on conventional SECT scanners, without significant loss of either computational efficiency or accuracy.

MCR toolkit: A GPU-based toolkit for multi-channel reconstruction of preclinical and clinical x-ray CT data.

The advancement of x-ray CT into the domains of photon counting spectral imaging and dynamic cardiac and perfusion imaging has created many new challenges and opportunities for clinicians and researchers. To address challenges such as dose constraints and scanning times while capitalizing on opportunities such as multi-contrast imaging and low-dose coronary angiography, these multi-channel imaging applications require a new generation of CT reconstruction tools. These new tools should exploit the relationships between imaging channels during reconstruction to set new image quality standards while serving as a platform for direct translation between the preclinical and clinical domains. We outline and demonstrate a new Multi-Channel Reconstruction (MCR) Toolkit for GPU-based analytical and iterative reconstruction of preclinical and clinical multi-energy and dynamic x-ray CT data. To promote open science, open-source distribution of the Toolkit will coincide with the release of this publication (GPL v3; gitlab.oit.duke.edu/dpc18/mcr-toolkit-public). The MCR Toolkit source code is implemented in C/C++ and NVIDIA's CUDA GPU programming interface, with scripting support from MATLAB and Python. The Toolkit implements matched, separable footprint CT reconstruction operators for projection and backprojection in two geometries: planar, cone-beam CT (CBCT) and 3rd generation, cylindrical multi-detector row CT (MDCT). Analytical reconstruction is performed using filtered backprojection (FBP) for circular CBCT, weighted FBP (WFBP) for helical CBCT, and cone-parallel projection rebinning followed by WFBP for MDCT. Arbitrary combinations of energy and temporal channels are iteratively reconstructed under a generalized multi-channel signal model for joint reconstruction. We solve this generalized model algebraically using the split Bregman optimization method and the BiCGSTAB(l) linear solver interchangeably for both CBCT and MDCT data. Rank-sparse kernel regression (RSKR) and patch-based singular value thresholding (pSVT) are used to regularize the energy and time dimensions, respectively. Under a Gaussian noise model, regularization parameters are estimated automatically from the input data, dramatically reducing algorithm complexity for end users. Multi-GPU parallelization of the reconstruction operators is supported to manage reconstruction times. Denoising with RSKR and pSVT and post-reconstruction material decomposition are illustrated with preclinical and clinical cardiac photon-counting (PC)CT data. A digital MOBY mouse phantom with cardiac motion is used to illustrate single energy (SE), multi-energy (ME), time resolved (TR), and combined multi-energy and time-resolved (METR) helical, CBCT reconstruction. A fixed set of projection data is used across all reconstruction cases to demonstrate the Toolkit's robustness to increasing data dimensionality. Identical reconstruction code is applied to in vivo cardiac PCCT data acquired in a mouse model of atherosclerosis (METR). Clinical cardiac CT reconstruction is illustrated using the XCAT phantom and the DukeSim CT simulator, while dual-source, dual-energy CT reconstruction is illustrated for data acquired with a Siemens Flash scanner. Benchmarking results with NVIDIA RTX 8000 GPU hardware demonstrate 61%-99% efficiency in scaling computation from one to four GPUs for these reconstruction problems. The MCR Toolkit provides a robust solution for temporal and spectral x-ray CT reconstruction problems and was built from the ground up to facilitate translation of CT research and development between preclinical and clinical applications.

Virtual Monoenergetic Imaging of Lower Extremities Using Dual-Energy CT Angiography in Patients with Diabetes Mellitus.

Type 2 diabetes mellitus (DM) is the most common metabolic disorder in the world and an important risk factor for peripheral arterial disease (PAD). CT angiography represents the method of choice for the diagnosis, pre-operative planning, and follow-up of vascular disease. Low-energy dual-energy CT (DECT) virtual mono-energetic imaging (VMI) has been shown to improve image contrast, iodine signal, and may also lead to a reduction in contrast medium dose. In recent years, VMI has been improved with the use of a new algorithm called VMI+, able to obtain the best image contrast with the least possible image noise in low-keV reconstructions. To evaluate the impact of VMI+ DECT reconstructions on quantitative and qualitative image quality in the evaluation of the lower extremity runoff. We evaluated DECT angiography of lower extremities in patients suffering from diabetes who had undergone clinically indicated DECT examinations between January 2018 and January 2023. Images were reconstructed with standard linear blending (F_0.5) and low VMI+ series were generated from 40 to 100 keV, in an interval of 15 keV. Vascular attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for objective analysis. Subjective analysis was performed using five-point scales to evaluate image quality, image noise, and diagnostic assessability of vessel contrast. Our final study cohort consisted of 77 patients (41 males). Attenuation values, CNR, and SNR were higher in 40-keV VMI+ reconstructions compared to the remaining VMI+ and standard F_0.5 series (HU: 1180.41 ± 45.09; SNR: 29.91 ± 0.99; CNR: 28.60 ± 1.03 vs. HU 251.32 ± 7.13; SNR: 13.22 ± 0.44; CNR: 10.57 ± 0.39 in standard F_0.5 series) (p < 0.0001). Subjective image rating was significantly higher in 55-keV VMI+ images compared to the other VMI+ and standard F_0.5 series in terms of image quality (mean score: 4.77), image noise (mean score: 4.39), and assessability of vessel contrast (mean value: 4.57) (p < 0.001). DECT 40-keV and 55-keV VMI+ showed the highest objective and subjective parameters of image quality, respectively. These specific energy levels for VMI+ reconstructions could be recommended in clinical practice, providing high-quality images with greater diagnostic suitability for the evaluation of lower extremity runoff, and potentially needing a lower amount of contrast medium, which is particularly advantageous for diabetic patients.

Spinal Hematoma Visualized with Dual-energy CT-derived Electron Density Overlay Maps.

HomeRadiologyRecently Published PreviousNext Reviews and CommentaryFree AccessImages in RadiologySpinal Hematoma Visualized with Dual-energy CT-derived Electron Density Overlay MapsChristian Nelles, Simon Lennartz Christian Nelles, Simon Lennartz Author AffiliationsInstitute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany.Address correspondence to S.L. (email: [email protected]).Christian NellesSimon Lennartz Published Online:Apr 11 2023https://doi.org/10.1148/radiol.222680MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In A 67-year-old man was admitted to the hospital with spontaneous, sudden-onset, severe thoracic back pain, radiating to the neck and lower back, accompanied by an episode of transient paraplegia of unknown severity, which lasted for 30–45 minutes. Three years prior, he had undergone mechanical aortic valve replacement with resection of an ascending aortic aneurysm associated with a bicuspid aortic valve. Consecutively, he had been treated with phenprocoumon for anticoagulation, with an international normalized ratio value of 4.5 at the time of admission (therapeutic range: 2.0–3.0). As the symptoms raised suspicion for aortic dissection, CT angiography of the chest and abdomen was performed with dual-layer dual-energy CT (dlDECT). dlDECT is a detector-based dual-energy CT technique in which a stacked scintillator registers lower energetic photons in the upper layer, whereas higher energetic photons are detected within the subjacent layer (1). The examination did not show signs of aortic dissection or other acute vascular pathologic conditions. Apart from persistent back pain, the patient’s symptoms receded. He was kept under surveillance for 3 days, after which worsening of the pain and the development of new high-grade paraplegia occurred, prompting an emergency MRI examination of the spine. The MRI scan showed extensive spinal hematoma, ranging from T1 to L1, with the maximum diameter and spinal cord compression at the level of T4-6 but without abnormal signal intensity of the spinal cord (Figure, A). The hematoma could not unequivocally be assigned to either the epi- or subdural space. Additionally, subarachnoid hemorrhage was noted along the cauda equina. The patient underwent successful emergency surgical evacuation of the hematoma, which during surgery showed extension to both the epi- and subdural as well as the subarachnoid space. Because digital subtraction angiography scans showed no vascular cause of the hematoma, spontaneous hemorrhage due to over-anticoagulation was determined as the most likely cause. After surgery, the pain and neurologic symptoms resolved rapidly, and the patient was discharged for subsequent rehabilitation. At retrospective review, different spectral data were reconstructed to determine if any of them might have facilitated earlier diagnosis of spinal hematoma with CT. Besides conventional images, virtual noncontrast and iodine images were also unremarkable. However, electron density overlay maps (Figure, B) clearly depicted the hematoma. The increased content of hemoglobin within the hematoma results in a higher material density at this location with a lesser effect on the average atomic number. There is only one study that showed that electron density maps may improve detection of prevertebral hematoma (2), which is in line with the finding in the case presented here. However, the application for detecting intraspinal hematoma has not been described yet. This might be a promising topic for systematic scientific evaluation, as electron density maps could improve CT-based detection of spinal hematoma in the emergency setting, potentially decreasing morbidity by enabling earlier treatment.(A) MRI scans of the spine in a 67-year-old man. Sagittal T2-weighted (top left) and T1-weighted (top right) images and axial contrast-enhanced, fat-saturated, T1-weighted image (bottom) show extensive spinal hematoma (arrows). The maximum diameter is located at the level of thoracic vertebrae T4-6 with effacement of the perimedullary cerebrospinal fluid and spinal cord compression. (B) Dual-layer dual-energy CT reconstructions show the corresponding CT angiography scans of the chest. Electron density overlay images (left) clearly depict the hematoma (green; arrows) that is protruding in the spinal canal. Conventional images (right) in the sagittal and axial plane. The hematoma is almost entirely imperceivable (arrows).Download as PowerPointOpen in Image Viewer Disclosures of conflicts of interest: C.N. No relevant relationships. S.L. Senior deputy editor for Radiology In Training; member of the Radiology editorial board.

Diagnosis of an Acute Anterior Wall Infarction in Dual-Energy CT

Due to its high morbidity and mortality, myocardial infarction is the leading cause of death worldwide. Against this background, rapid diagnosis is of immense importance. Especially in case of an atypical course, the correct diagnosis may be delayed and thus lead to increased mortality rates. In this report, we present a complex case of acute coronary syndrome. A triple-rule-out CT examination was performed in dual-energy CT (DECT) mode. While pulmonary artery embolism and aortic dissection could be ruled out with conventional CT series, the presence of anterior wall infarction was only detectable on DECT reconstructions. Subsequently, adequate and rapid therapy was then initiated leading to survival of the patient.

SPEAR-Net: Self-Prior Enhanced Artifact Removal Network for Limited-Angle DECT

Dual-energy computed tomography (DECT) is a fully functional instrument for disease detection in clinical practice because of its ability to identify substances and quantify materials. In some practical applications, due to the limitation of scanning conditions, projection data can only be collected from a limited angle, and the consistency of measurement cannot be guaranteed. Existing dual-energy CT reconstruction methods fail to address well the severe artifacts and noise in dual-energy CT images caused by limited-angle scanning. In this paper, we proposed a Self-Prior Enhanced Artifact Removal Network (SPEAR-Net) for limited-angle DECT, which can effectively combine the complementary information in the high- and low-energy domains and self-prior information to contribute positively to the reconstruction of high-quality dual-energy CT images. The SPEAR-Net consists of an image-domain self-prior network(IP-Net), two dual-energy image-domain networks(DIP-Net), and a dual-energy sinogram-domain self-prior network(DSP-Net). Specifically, the IP-Net and DIP-Net are adopted to extract the features of the dual-energy CT reconstructed images under dual-quarter scanning as prior information. The self-prior projection obtained from the forward projection of the prior CT image is harnessed by DSP-Net to complete the dual-energy limited-angle projection data and to facilitate the performance of SPEAR-Net in removing artifacts in the reconstructed dual-energy images. Qualitative and quantitative analyses demonstrate the superior capability of SPEAR-Net in dual-energy limited-angle projection data complementation, detail preservation, and artifact removal. Two popular DECT applications, virtual non-contrast (VNC) imaging and iodine contrast agent quantification, reveal that images reconstructed by SPEAR-Net have promising clinical significance.

Deep learning image reconstruction algorithm reduces image noise while alters radiomics features in dual-energy CT in comparison with conventional iterative reconstruction algorithms: a phantom study.

To compare image quality between a deep learning image reconstruction (DLIR) algorithm and conventional iterative reconstruction (IR) algorithms in dual-energy CT (DECT) and to assess the impact of these algorithms on radiomics robustness. A phantom with clinical-relevant densities was imaged on seven DECT scanners with the same voxel size using typical abdominal-pelvis examination protocols. On one DECT scanner, raw data were reconstructed using both conventional IR (adaptive statistical iterative reconstruction-V, ASIR-V) and DLIR. Nine sets of corresponding images were generated on other six DECT scanners using scanner-equipped conventional IR. Regions of interest were delineated through rigid registrations. Image quality was compared. Pyradiomics platform was used for radiomics feature extraction. Test-retest repeatability was assessed by Bland-Altman analysis for repeated scans. Inter-reconstruction algorithm reproducibility between conventional IR and DLIR was tested by intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC). Inter-scanner reproducibility was evaluated by coefficient of variation (CV) and quartile coefficient of dispersion (QCD). Robust features were identified. DLIR significantly improved image quality. Ninety-four radiomics features were extracted and nine features were considered as robust. 93.87% features were repeatable between repeated scans. ASIR-V images showed higher reproducibility to other conventional IR than DLIR (ICC mean, 0.603 vs 0.558, p = 0.001; CCC mean, 0.554 vs 0.510, p = 0.004). 7.45% and 26.83% features were reproducible among scanners evaluated by CV and QCD, respectively. DLIR improves quality of DECT images but may alter radiomics features compared to conventional IR. Nine robust DECT radiomics features were identified. • DLIR improves DECT image quality in terms of signal-to-noise ratio and contrast-to-noise ratio compared with ASIR-V and showed the highest noise reduction rate and lowest peak frequency shift. • Most of radiomics features are repeatable between repeated DECT scans, while inter-reconstruction algorithm reproducibility between conventional IR and DLIR, and inter-scanner reproducibility, are low. • Although DLIR may alter radiomics features compared to IR algorithms, nine radiomics features survived repeatability and reproducibility analysis among DECT scanners and reconstruction algorithms, which allows further validation and clinical-relevant analysis.

Characterizing incidental mass lesions in abdominal dual-energy CT compared to conventional contrast-enhanced CT.

Incidental findings are common in abdominal computed tomography (CT) and often warrant further investigations with economic implications as well as implications for patients. To evaluate the potential of dual-energy CT (DECT) in the identification and/or characterization of abdominal incidental mass lesions compared to conventional contrast-enhanced CT. This retrospective study from a major tertiary hospital included 96 patients, who underwent contrast-enhanced abdominal DECT. Incidental lesions in adrenals, kidneys, liver, and pancreas were evaluated by two board-certified abdominal radiologists. Observer 1 only had access to standard CT reconstructions, while observer 2 had access to standard CT as well as DECT reconstructions. Disagreements were resolved by consensus review and used as a reference for observers using McNemar's test. Observers 1 and 2 identified a total of 40 and 34 findings, respectively. Furthermore, observer 1 registered 13 lesions requiring follow-up, of which seven (two renal and five adrenal lesions) were resolved following consensus review using DECT (P = 0.008). The inter-observer agreement was near perfect (κ = 0.82). DECT has the potential to improve the immediate characterization of incidental findings when compared to conventional CT for abdominal imaging.

Dual-Energy CT for the Detection of Portal Vein Thrombosis: Improved Diagnostic Performance Using Virtual Monoenergetic Reconstructions.

Purpose: To investigate the diagnostic performance of noise-optimized virtual monoenergetic images (VMI+) in dual-energy CT (DECT) of portal vein thrombosis (PVT) compared to standard reconstructions. Method: This retrospective, single-center study included 107 patients (68 men; mean age, 60.1 ± 10.7 years) with malignant or cirrhotic liver disease and suspected PVT who had undergone contrast-enhanced portal-phase DECT of the abdomen. Linearly blended (M_0.6) and virtual monoenergetic images were calculated using both standard VMI and noise-optimized VMI+ algorithms in 20 keV increments from 40 to 100 keV. Quantitative measurements were performed in the portal vein for objective contrast-to-noise ratio (CNR) calculation. The image series showing the greatest CNR were further assessed for subjective image quality and diagnostic accuracy of PVT detection by two blinded radiologists. Results: PVT was present in 38 subjects. VMI+ reconstructions at 40 keV revealed the best objective image quality (CNR, 9.6 ± 4.3) compared to all other image reconstructions (p < 0.01). In the standard VMI series, CNR peaked at 60 keV (CNR, 4.7 ± 2.1). Qualitative image parameters showed the highest image quality rating scores for the 60 keV VMI+ series (median, 4) (p ≤ 0.03). The greatest diagnostic accuracy for the diagnosis of PVT was found for the 40 keV VMI+ series (sensitivity, 96%; specificity, 96%) compared to M_0.6 images (sensitivity, 87%; specificity, 92%), 60 keV VMI (sensitivity, 87%; specificity, 97%), and 60 keV VMI+ reconstructions (sensitivity, 92%; specificity, 97%) (p ≤ 0.01). Conclusions: Low-keV VMI+ reconstructions resulted in significantly improved diagnostic performance for the detection of PVT compared to other DECT reconstruction algorithms.

Multi-channel convolutional analysis operator learning for dual-energy CT reconstruction

Objective. Dual-energy computed tomography (DECT) has the potential to improve contrast and reduce artifacts and the ability to perform material decomposition in advanced imaging applications. The increased number of measurements results in a higher radiation dose, and it is therefore essential to reduce either the number of projections for each energy or the source x-ray intensity, but this makes tomographic reconstruction more ill-posed. Approach. We developed the multi-channel convolutional analysis operator learning (MCAOL) method to exploit common spatial features within attenuation images at different energies and we propose an optimization method which jointly reconstructs the attenuation images at low and high energies with mixed norm regularization on the sparse features obtained by pre-trained convolutional filters through the convolutional analysis operator learning (CAOL) algorithm. Main results. Extensive experiments with simulated and real computed tomography data were performed to validate the effectiveness of the proposed methods, and we report increased reconstruction accuracy compared with CAOL and iterative methods with single and joint total variation regularization. Significance. Qualitative and quantitative results on sparse views and low-dose DECT demonstrate that the proposed MCAOL method outperforms both CAOL applied on each energy independently and several existing state-of-the-art model-based iterative reconstruction techniques, thus paving the way for dose reduction.

Dual-Energy CT and Virtual Low-Energy Reconstruction for 3D Visualization of Thin Bone

Dual-Energy CT and Virtual Low-Energy Reconstruction for 3D Visualization of Thin Bone

Virtual monoenergetic dual-energy CT reconstructions at 80 keV are optimal non-contrast CT technique for early stroke detection.

Virtual monoenergetic (VM) dual-energy computed tomography (DE-CT) enables grey-to-white matter contrast-to-noise ratio optimization, potentially increasing ischaemic brain oedema visibility. The aim of this study was to compare the diagnostic accuracy of VM and standard DE-CT reconstructions for early stroke detection. Consecutive patients with non-contrast DE-CT of the brain scanned within 12 h of stroke symptom onset were prospectively included in the study. Patients with other significant brain pathology were excluded. Two radiologists jointly evaluated standard and VM reconstructions (from 40 to 190 keV at increments of 10 keV) for early stroke signs on a four-point Likert scale: (a) stroke definitely present, (b) stroke probably present, (c) probably no stroke, and (d) definitely no stroke. Follow-up imaging and clinical data served as the standard of reference. Diagnostic accuracy was evaluated by receiver operating characteristic analysis. Stroke incidence among 184 patients was 76%. In 64 patients follow-up imaging served as the standard of reference: ischemic brain oedema detection was significantly more accurate on VM reconstructions at 80 keV compared with standard DE-CT reconstructions (area under the curve (AUC) = 0.821 vs. AUC = 0.672, p = 0.002). The difference was most prominent within the first 3 h after symptom onset (at 11%, AUC = 0.819 vs. AUC = 0.709, p = 0.17) and in patients with National Institutes of Health Stroke Scale above 16 (at 37.5%, AUC = 1 vs. AUC = 0.625, p = 0.14). VM DE-CT reconstructions at 80 keV appear to be the optimal non-contrast CT technique for diagnosing early ischaemic stroke, particularly within the first 3 h after symptom onset and in severely ill patients.

Fast and effective single-scan dual-energy cone-beam CT reconstruction and decomposition denoising based on dual-energy vectorization.

Flat-panel detector (FPD) based dual-energy cone-beam computed tomography (DE-CBCT) is a promising imaging technique for dedicated clinical applications. In this paper, we proposed a fully analytical method for fast and effective single-scan DE-CBCT image reconstruction and decomposition. A rotatable Mo filter was inserted between an x-ray source and imaged object to alternately produce low and high-energy x-ray spectra. First, filtered-backprojection (FBP) method was applied on down-sampled projections to reconstruct low and high-energy images. Then, the two images were converted into a vectorized form represented with an amplitude and an argument image. Using amplitude image as a guide, a joint bilateral filter was applied to denoise the argument image. Then, high-quality dual-energy images were recovered from the amplitude image and the denoised argument image. Finally, the recovered dual-energy images were further used for low-noise material decomposition and electron density synthesis. Imaging was conducted on a Catphan® 600 phantom and an anthropomorphic head phantom. The proposed method was evaluated via comparison with the traditional two-scan method and a commonly used filtering method (HYPR-LR). On the Catphan® 600 phantom, the proposed method successfully reduced streaking artifacts and preserved spatial resolution and noise-power-spectrum (NPS) pattern. In the electron density image, the proposed method increased contrast-to-noise ratio (CNR) by more than 2.5 times and achieved <1.2% error for electron density values. On the anthropomorphic head phantom, the proposed method greatly improved the soft-tissue contrast and the fine detail differentiation ability. In the selected ROIs on different human tissues, the differences between the CT number obtained by the proposed method and that by the two-scan method were less than 4HU. In the material images, the proposed method suppressed noise by over 75.5% compared with two-scan results, and by over 40.4% compared with HYPR-LR results. Implementation of the whole algorithm took 44.5s for volumetric imaging, including projection preprocessing, FBP reconstruction, joint bilateral filtering, and material decomposition. Using down-sampled projections in single-scan DE-CBCT, the proposed method could effectively and efficiently produce high-quality DE-CBCT images and low-noise material decomposition images. This method demonstrated superior performance on spatial resolution enhancement, NPS preservation, noise reduction, and electron density accuracy, indicating better prospect in material differentiation and dose calculation.