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Can Realistic Liver Tissue Surrogates Accurately Quantify the Impact of Reduced-kV Imaging on Attenuation and Contrast of Parenchyma and Lesions?


Euler, Andre; Solomon, Justin; FitzGerald, Paul F; Samei, Ehsan; Nelson, Rendon C (2019). Can Realistic Liver Tissue Surrogates Accurately Quantify the Impact of Reduced-kV Imaging on Attenuation and Contrast of Parenchyma and Lesions? Academic Radiology, 26(5):640-650.

Abstract

RATIONALE AND OBJECTIVES To assess if a liquid tissue surrogate for the liver (LTSL) can emulate contrast-enhanced liver parenchyma and lesions and quantify the impact of reduced-kV imaging as a function of lesion contrast, phase of enhancement, and phantom size. MATERIALS AND METHODS First, CT attenuation of LTSL- and water-iodine solutions were measured as a function of iodine concentration and tube potential. For each solution, the iodine concentration was determined to emulate liver parenchyma at 120kV. CT attenuation for both solutions was predicted for different tube potentials and compared to published patient data. Second, liver parenchyma in late arterial phase (LA: +92 HU at 120 kV) and portal venous phase (PV: +112 HU at 120 kV) was emulated using LTSL-iodine and a two-size phantom. Fourteen setups of hyper- and hypoattenuating lesions (lesion-to-parenchyma contrast (C) = -50 to +50HU) were created. Each combination of C, phase, and size was imaged at 80, 100, 120, and 140kV at constant radiation dose. CT attenuation, C, and lesion-to-parenchyma contrast-to-noise ratio (CNR) were assessed and compared to a theoretical model. RESULTS LTSL-iodine more accurately emulated the CT attenuation of liver parenchyma across different tube potentials compared to water-iodine solutions. The theoretical model was confirmed by the empirical measurements using LTSL-iodine solutions: attenuation, C, and CNR increased when the tube potential decreased (p < 0.001). This trend was independent of lesion contrast, phase, and size. The absolute improvement in C and CNR, however, was inversely related to the magnitude of C at 140kV. CONCLUSION LTSL accurately emulated the energy-dependent CT attenuation characteristics of contrast-enhanced liver parenchyma and lesions. The relative improvement in C and CNR by applying reduced-kV imaging was independent of lesion contrast, phase, and size while the absolute improvement decreased for low-contrast lesions.

Abstract

RATIONALE AND OBJECTIVES To assess if a liquid tissue surrogate for the liver (LTSL) can emulate contrast-enhanced liver parenchyma and lesions and quantify the impact of reduced-kV imaging as a function of lesion contrast, phase of enhancement, and phantom size. MATERIALS AND METHODS First, CT attenuation of LTSL- and water-iodine solutions were measured as a function of iodine concentration and tube potential. For each solution, the iodine concentration was determined to emulate liver parenchyma at 120kV. CT attenuation for both solutions was predicted for different tube potentials and compared to published patient data. Second, liver parenchyma in late arterial phase (LA: +92 HU at 120 kV) and portal venous phase (PV: +112 HU at 120 kV) was emulated using LTSL-iodine and a two-size phantom. Fourteen setups of hyper- and hypoattenuating lesions (lesion-to-parenchyma contrast (C) = -50 to +50HU) were created. Each combination of C, phase, and size was imaged at 80, 100, 120, and 140kV at constant radiation dose. CT attenuation, C, and lesion-to-parenchyma contrast-to-noise ratio (CNR) were assessed and compared to a theoretical model. RESULTS LTSL-iodine more accurately emulated the CT attenuation of liver parenchyma across different tube potentials compared to water-iodine solutions. The theoretical model was confirmed by the empirical measurements using LTSL-iodine solutions: attenuation, C, and CNR increased when the tube potential decreased (p < 0.001). This trend was independent of lesion contrast, phase, and size. The absolute improvement in C and CNR, however, was inversely related to the magnitude of C at 140kV. CONCLUSION LTSL accurately emulated the energy-dependent CT attenuation characteristics of contrast-enhanced liver parenchyma and lesions. The relative improvement in C and CNR by applying reduced-kV imaging was independent of lesion contrast, phase, and size while the absolute improvement decreased for low-contrast lesions.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Radiology, Nuclear Medicine and Imaging
Language:English
Date:1 May 2019
Deposited On:13 Dec 2018 09:18
Last Modified:29 Jul 2020 08:23
Publisher:Elsevier
ISSN:1076-6332
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.acra.2018.08.008
PubMed ID:30269958

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