Dual-energy computed tomography for non-invasive staging of liver fibrosis: Accuracy of iodine density measurements from contrast-enhanced data

2018 ◽  
Vol 48 (12) ◽  
pp. 1008-1019 ◽  
Author(s):  
Keitaro Sofue ◽  
Masakatsu Tsurusaki ◽  
Achille Mileto ◽  
Tomoko Hyodo ◽  
Kosuke Sasaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Liver Fibrosis ◽  
Dual Energy ◽  
Density Measurements ◽  
Dual Energy Computed Tomography ◽  
Non Invasive ◽  
Contrast Enhanced

scholarly journals Dual-Energy Computed Tomography of the Lung in COVID-19 Patients: Mismatch of Perfusion Defects and Pulmonary Opacities

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 870
Author(s):  
Saif Afat ◽  
Ahmed E. Othman ◽  
Konstantin Nikolaou ◽  
Sebastian Gassenmaier
Keyword(s):  
Computed Tomography ◽  
Dual Energy ◽  
Lung Damage ◽  
Rating System ◽  
Pulmonary Perfusion ◽  
Imaging Studies ◽  
Dual Energy Computed Tomography ◽  
Contrast Enhanced ◽  
Perfusion Defects

To evaluate contrast-enhanced dual-energy computed tomography (DECT) chest examinations regarding pulmonary perfusion patterns and pulmonary opacities in patients with confirmed COVID-19 disease. Fourteen patients with 24 DECT examinations performed between April and May 2020 were included in this retrospective study. DECT studies were assessed independently by two radiologists regarding pulmonary perfusion defects, using a Likert scale ranging from 1 to 4. Furthermore, in all imaging studies the extent of pulmonary opacities was quantified using the same rating system as for perfusion defects. The main pulmonary findings were ground glass opacities (GGO) in all 24 examinations and pulmonary consolidations in 22 examinations. The total lung scores after the addition of the scores of the single lobes showed significantly higher values of opacities compared to perfusion defects, with a median of 12 (9–18) for perfusion defects and a median of 17 (15–19) for pulmonary opacities (p = 0.002). Furthermore, mosaic perfusion patterns were found in 19 examinations in areas with and without GGO. Further studies will be necessary to investigate the pathophysiological background of GGO with maintained perfusion compared to GGO with reduced perfusion, especially regarding long-term lung damage and prognosis.

Correlation of dual energy computed tomography electron density measurements with cerebral glioma grade

2021 ◽  
pp. 197140092110474
Author(s):  
Ritwik Chakrabarti ◽  
Vivek Gupta ◽  
Sameer Vyas ◽  
Kirti Gupta ◽  
Vikram Singh
Keyword(s):  
Computed Tomography ◽  
Electron Density ◽  
Dual Energy ◽  
Low Grade ◽  
High Grade ◽  
Cerebral Glioma ◽  
Density Measurements ◽  
Dual Energy Computed Tomography ◽  
Low Grade Gliomas ◽  
High Grade Gliomas

Objective To correlate dual energy computed tomography electron density measurements with histopathological cerebral glioma grading to determine whether it can be used as a non-invasive predictor of cerebral glioma grade. Materials and methods Fifty patients with suspected cerebral gliomas on imaging scheduled to undergo resection were included. We tested our hypothesis that with increasing glioma grade, increased tumor cellularity should translate into increased electron density and if a statistically significant difference between electron density of low-grade gliomas and high-grade gliomas is seen, we may have a clinical use of dual energy computed tomography as a non-invasive tool to predict cerebral glioma grade. A pre-operative dual energy computed tomography scan of the brain was performed, and electron density measurements calculated from the solid part of the tumor. Obtaining a ratio with electron density of contralateral normal brain parenchyma normalized these values. The minimum, maximum and mean electron density and their normalized values recorded between high-grade gliomas and low-grade gliomas were compared for presence of statistical significance. Results A statistically significant difference was found between all six parameters recorded (minimum electron density and normalized values, mean electron density and normalized values, maximum electron density and normalized values) between low-grade gliomas and high-grade gliomas. The predictivity ranged from 75% (for minimum electron density and maximum normalized values) to 81.25% (for mean normalized values). All six parameters were found to have statistically significant positive correlation with Ki-67 index. Conclusion Dual energy computed tomography electron density measurements in cerebral gliomas are predictive of pre-operative differentiation of low-grade gliomas from high-grade gliomas and show a linear, statistically significant positive correlation with Ki-67 index.

scholarly journals OP0318 THE ROLE OF DUAL ENERGY COMPUTED TOMOGRAPHY (DECT) IN THE DIFFERENTIATION OF GOUT AND CALCIUM PYROPHOSPHATE DEPOSITION DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 196.2-196 ◽  
Author(s):  
D. Kravchenko ◽  
P. Karakostas ◽  
P. Brossart ◽  
C. Behning ◽  
C. Meyer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Calcium Pyrophosphate ◽  
Dual Energy ◽  
Laboratory Parameters ◽  
Dual Energy Computed Tomography ◽  
Non Invasive ◽  
Calcium Pyrophosphate Deposition Disease

Background:Differentiation of gout and calcium pyrophosphate deposition disease (CPPD) is sometimes difficult as patients often present with a similar clinical picture. Arthrocentesis and subsequent polarization microscopy (PM) remains the gold standard but novel diagnostic approaches such as non-invasive dual energy computed tomography (DECT) have recently been validated for gout. Currently, limited data is available on DECT in patients with CPPD.Objectives:To analyse the diagnostic impact of DECT in gout and CPPD when compared to the gold standard of PM. We further compared the results of PM to ultrasound (US), conventional radiographs (CR), and suspected clinical diagnosis (SCD). Additionally, 15 laboratory parameters were analysed.Methods:Twenty-six patients diagnosed with gout (n = 18) or CPPD (n = 8) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed colour coded, as well as 80 and 120 kV DECT images for signs of monosodium urate (MSU) crystals or CPP deposition. US and CR from the patient’s initial visit along with the SCD were also compared to PM. US examinations were performed by certified musculoskeletal ultrasound specialists. The association of up to 15 laboratory parameters such as uric acid, thyroid stimulating hormone, and C-reactive protein (CRP) with the PM results was analysed.Results:Sensitivity of DECT for gout was 67% (95% CI 0.41-0.87) with a specificity of 88% (95% CI 0.47-1.0). Concerning CPPD, the sensitivity and specificity of DECT was 63% (95% CI 0.25-0.91) and 83% (95% CI 0.59-0.96) respectively. US had the highest sensitivity of 89% (95% CI 0.65-0.99) with a specificity of 75% (95% CI 0.35-0.97) for gout, while the sensitivity and specificity for CPPD were 88% (95% CI 0.47-1.0) and 89% (95% CI 0.65-0.99) respectively. The SCD had the second highest sensitivity for gout at 78% (95% CI 0.52-0.94) with a comparable sensitivity of 63% (95% CI 0.25-0.92) for CPPD. Uric acid levels were elevated in 33% of gout patients and 25% of CPPD patients. While elevated CRP levels were observed in 59% of gout patients and in 88% of CPPD patients, none of the 15 analysed laboratory parameters were found to be significantly linked.Conclusion:DECT provides a non-invasive diagnostic tool for gout but might have a lower sensitivity than suggested by previous studies (67% vs 90%1). DECT sensitivity for CPPD was 63% (95% CI 0.25-0.91) in a sample group of eight patients. Both US and the SCD had higher sensitivities than DECT for gout and CPPD. Further studies with larger patient cohorts are needed in order to determine the diagnostic utility of DECT in CPPD.References:[1]Bongartz, Tim; Glazebrook, Katrina N.; Kavros, Steven J.; Murthy, Naveen S.; Merry, Stephen P.; Franz, Walter B. et al. (2015): Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. InAnnals of the rheumatic diseases74 (6), pp. 1072–1077. DOI: 10.1136/annrheumdis-2013-205095.Disclosure of Interests:None declared

scholarly journals The role of dual energy computed tomography in the differentiation of acute gout flares and acute calcium pyrophosphate crystal arthritis

2021 ◽  
Author(s):  
Dmitrij Kravchenko ◽  
Pantelis Karakostas ◽  
Daniel Kuetting ◽  
Carsten Meyer ◽  
Peter Brossart ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Sensitivity And Specificity ◽  
Calcium Pyrophosphate ◽  
Dual Energy ◽  
Lower Sensitivity ◽  
Acute Gout ◽  
Dual Energy Computed Tomography ◽  
Non Invasive ◽  
Crystal Arthritis ◽  
Gout Flares

Abstract Objectives To analyse the diagnostic impact of dual energy computed tomography (DECT) in acute gout flares and acute calcium pyrophosphate (CPP) crystal arthritis when compared to the gold standard of arthrocentesis with compensated polarised light microscopy. Microscopy results were also compared to musculoskeletal ultrasound (MUS), conventional radiographs, and the suspected clinical diagnosis (SCD). Methods Thirty-six patients with a suspected gout flare (n = 24) or acute CPP crystal arthritis (n = 11, n = 1 suffered from neither) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed DECT images for signs of monosodium urate crystals or calcium pyrophosphate deposition. Results Sensitivity of DECT for gout was 63% (95% CI 0.41–0.81) with a specificity of 92% (0.41–0.81) while sensitivity and specificity for acute CPP arthritis were 55% (0.23–0.83) and 92% (0.74–0.99), respectively. MUS had the highest sensitivity of all imaging modalities with 92% (0.73–0.99) and a specificity of 83% (0.52–0.98) for gout, while sensitivity and specificity for acute CPP crystal arthritis were 91% (0.59–1.00) and 92% (0.74–0.99), respectively. Conclusion DECT is an adequate non-invasive diagnostic tool for acute gout flares but might have a lower sensitivity than described by previous studies. Both MUS and SCD had higher sensitivities than DECT for acute gout flares and acute CPP crystal arthritis. Key Points• DECT offers a lower sensitivity for acute gout flares than previously described.• DECT sensitivity for acute CPP crystal arthritis is less than the already validated ultrasound.

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