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Carotid and cerebrovascular dual-energy computed tomography angiography: Optimization of window settings for virtual monoenergetic imaging reconstruction

2020; Elsevier BV; Volume: 130; Linguagem: Inglês

10.1016/j.ejrad.2020.109166

1872-7727

Tommaso D’Angelo, Lukas Lenga, Christophe Arendt, Andreas Bucher, Julia L. Peterke, Damiano Caruso, Silvio Mazziotti, Giorgio Ascenti, Alfredo Blandino, Mohamed I. A. Othman, Simon S. Martin, Moritz H. Albrecht, Boris Bodelle, Thomas J. Vogl, Julian L. Wichmann,

Cardiac Imaging and Diagnostics

Purpose Dedicated post-processing of dual-energy computed tomography angiography (DE-CTA) datasets has been shown to allow for increased vascular contrast. The goal of our study was to define optimal window settings for displaying virtual monoenergetic images (VMI) reconstructed from dual-energy carotid and cerebrovascular DE-CTA. Methods Fifty-seven patients who underwent clinically-indicated carotid and cerebrovascular third-generation dual-source DE-CTA were retrospectively evaluated. Standard linearly-blended (M_0.6), 70-keV traditional VMI (M70), and 40-keV noise-optimized VMI (M40+) reconstructions were analyzed. For M70 and M40+ datasets, the subjectively best window setting (width and level, B–W/L) was independently determined by two observers and subsequently related with aortic arch attenuation to calculate optimized values (O–W/L) using linear regression. Subjective evaluation of image quality (IQ) between W/L settings were assessed by two additional readers. Repeated measures analysis of variance were performed to compare W/L settings and IQ indices between M_0.6, M70, and M40 + . Results B–W/L and O–W/L for M70 were 580/210 and 560/200, and for M40+ were 1630/570 and 1560/550, respectively, higher than standard DE-CTA W/L settings (450/100). Highest subjective scores were observed for M40+ regarding overall IQ (all p < 0.001). Conclusion Application of O–W/L settings is mandatory to optimize subjective IQ of VMI reconstructions of DE-CTA.