Feasibility study of using virtual non-contrast images derived from dual-energy CT to replace true non-contrast images in patients diagnosed with papillary thyroid carcinoma

Article type: Research Article

Authors: Zhou, Jiang^{a; 1} | Zhou, Yan^{a; 1} | Hu, Hao^a | Shen, Mei-Ping^b | Ge, Ying-Qian^c | Tao, Xin-Wei^c | Xu, Xiao-Quan^a | Su, Guo-Yi^{a; *} | Wu, Fei-Yun^{a; *}

Affiliations: [a] Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China | [b] Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China | [c] Siemens Healthineers, Shanghai, China

Correspondence: [*] Correspondence to: Fei-Yun Wu, MD, PhD, Professor, Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd., Nanjing, China. Tel.: +86 13815868181/Ext: 210029; E-mail: [email protected] and Guo-Yi Su, PhD, Assistant Professor, Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd., Nanjing, China. Tel.: +86 15195852321/Ext: 210029; [email protected].

Note: [1] Jiang Zhou and Yan Zhou contribute equally to this work.

Abstract: OBJECTIVE:To assess the feasibility of using virtual non-contrast (VNC) images derived from dual-energy computed tomography (DECT) to replace true non-contrast (TNC) images of papillary thyroid carcinoma (PTC) patients. METHODS:Images of 96 PTC patients were retrospectively analyzed. TNC images were acquired under the single-energy mode of DECT after the plain scanning. The arterial and venous phase VNC (VNC-a and VNC-v) images were generated by the post-processing algorithm from the arterial phase and venous phase of contrast-enhanced CT images, respectively. Mean attenuation values, image noise, number and length of calcification were measured. Radiation dose was also calculated. Last, subjective score of image quality was evaluated by a 5-point scale. RESULTS:Signal-to-noise ratio (SNR) of each tissue in TNC images is significantly higher than that of VNC images (p<0.050). Contrast-to-noise ratio (CNR) of fat, muscle, thyroid nodules and internal carotid artery in TNC images is significantly higher than that of VNC images, while CNR in TNC images is lower for cervical vertebra (p<0.001). Calcification is detected on TNC images of 44 patients, while it is omitted on VNC images of 14 patients (31.8%). The subjective score of TNC images is higher than VNC images (p<0.001). The effective dose reduction is 47.6% by avoiding plain scanning. CONCLUSIONS:Considering the different attenuation value, SNR, CNR and especially reduced detection rate of calcification, we deem that VNC images cannot be directly used to replace TNC images in PTC patients, despite the reduced radiation dose.

Keywords: Dual-energy computed tomography (DECT), virtual non-contrast images, papillary thyroid carcinoma, image quality, radiation dose

DOI: 10.3233/XST-210884

Journal: Journal of X-Ray Science and Technology, vol. 29, no. 4, pp. 711-720, 2021