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Dual-Energy and Spectral CT in Clinical Practice
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Dual-Energy and Spectral CT in Clinical Practice

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nuclear Medicine & Radiology".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 6702

Special Issue Editor

Dr. Giovanni Foti

E-Mail Website
Guest Editor
Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37042 Verona, Italy
Interests: MSK imaging; CT; DECT; MRI; shoulder; hip; adrenal; liver; pancreas; lung; infectious diseases; endometriosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Dual-energy computed tomography (DECT) currently represents a powerful imaging tool in clinical practice. Thanks to its intrinsic high spatial and contrast resolution, DECT can been used in clinical practice to diagnose brain, body and skeletal disorders in both acute and elective settings. In particular, DECT has been widely used to improve the identification of substances from different spectral information by using dedicated algorithms. In musculo-skeletal radiology, DECT has been proposed as an alternative to MRI for the identification of bone marrow edema. Additionally, monoenergetic reconstruction can be employed for the reduction of metal-induced artifacts, or to increase the conspicuity of contrast material within the arterial and venous vessels or to increase the contrast in the abdominal parenchyma. Finally, DECT has been suggested for the quantitative assessment of bone, fat, and muscle composition.

The aim of this Special Issue is to provide a comprehensive overview of the role of dual-energy and spectral CT applications in clinical practice. Therefore, researchers in the field of DECT are encouraged to submit their findings as original research articles or reviews to this Special Issue.

Dr. Giovanni Foti
Guest Editor

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Keywords

  • dual-energy CT
  • spectral CT
  • bone marrow edema
  • prosthesis
  • liver
  • pancreas
  • lung
  • kidney
  • adrenal
  • brain
  • abdomen
  • cardiac
  • coronary arteries
  • arthritis
  • myeloma

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Published Papers (5 papers)

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Research

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11 pages, 5034 KiB  
Article
Identification of Achille’s Tendon Tears: Diagnostic Accuracy of Dual-Energy CT with Respect to MRI
by Giovanni Foti, Luca Bortoli, Matteo Tronu, Sabrina Montefusco, Gerardo Serra, Roberto Filippini and Venanzio Iacono
J. Clin. Med. 2024, 13(15), 4426; https://doi.org/10.3390/jcm13154426 - 29 Jul 2024
Viewed by 965
Abstract
Background: The aim was to assess the diagnostic accuracy of DECT in diagnosing Achilles tendon tears, using MRI as the reference for diagnosis. Methods: This feasibility study conducted prospectively at a single center included consecutive patients suffering from ankle pain who [...] Read more.
Background: The aim was to assess the diagnostic accuracy of DECT in diagnosing Achilles tendon tears, using MRI as the reference for diagnosis. Methods: This feasibility study conducted prospectively at a single center included consecutive patients suffering from ankle pain who underwent DECT and MRI between April 2023 and October 2023. A total of three radiologists, blinded to the patient’s clinical data, assessed the images. Achille Tendon injuries were diagnosed in case of thickened and inflamed tendons or in case of a partial or complete tear. Diagnostic accuracy values of DECT were calculated using a multi-reader approach. Inter-observer agreement was calculated using k statistics. Results: The final study population included 22 patients (mean age 48.5 years). At MRI, Achille’s tendon lesion was present in 12 cases (54.5%) with 2 cases of complete rupture, 8 cases of partial tear (5 with tendon retraction), and 2 cases of tendon thickening. The mean thickness of injured tendons was 10 mm. At DECT, R1 was allowed to correctly classify 20/22 cases (90.9%), R2 19/22 cases (86.4%), and R3 18/22 cases (81.8%). At DECT, the mean thickness of the positively scored tendon was 10 mm for R1, 10.2 mm for R2, and 9.8 mm for R3. A very good agreement was achieved with regard to the evaluation of tears (k = 0.94), thickness (k = 0.96), and inflammatory changes (k = 0.82). Overall agreement was very good (k = 0.88). Conclusions: DECT showed a good diagnostic performance in identifying Achille’s tendon tears, with respect to MRI. Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in Clinical Practice)
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12 pages, 2780 KiB  
Article
Dual-Energy CT in Acute Stroke: Could Non-Contrast CT Be Replaced by Virtual Non-Contrast CT? A Feasibility Study
by Guillaume Herpe, Alexandra Platon, Pierre-Alexandre Poletti, Karl O. Lövblad, Paolo Machi, Minerva Becker, Michel Muster, Thomas Perneger and Rémy Guillevin
J. Clin. Med. 2024, 13(13), 3647; https://doi.org/10.3390/jcm13133647 - 21 Jun 2024
Viewed by 1200
Abstract
Purpose: We aimed to evaluate whether virtual non-contrast cerebral computed tomography (VNCCT) reconstructed from intravenous contrast-enhanced dual-energy CT (iv-DECT) could replace non-contrast CT (NCCT) in patients with suspected acute cerebral ischemia. Method: This retrospective study included all consecutive patients in whom NCCT followed [...] Read more.
Purpose: We aimed to evaluate whether virtual non-contrast cerebral computed tomography (VNCCT) reconstructed from intravenous contrast-enhanced dual-energy CT (iv-DECT) could replace non-contrast CT (NCCT) in patients with suspected acute cerebral ischemia. Method: This retrospective study included all consecutive patients in whom NCCT followed by iv-DECT were performed for suspected acute ischemia in our emergency department over a 1-month period. The Alberta Stroke Program Early CT Score (ASPECTS) was used to determine signs of acute ischemia in the anterior and posterior circulation, the presence of hemorrhage, and alternative findings, which were randomly evaluated via the consensus reading of NCCT and VNCCT by two readers blinded to the final diagnosis. An intraclass correlation between VNCCT and NCCT was calculated for the ASPECTS values. Both techniques were evaluated for their ability to detect ischemic lesions (ASPECTS <10) when compared with the final discharge diagnosis (reference standard). Results: Overall, 148 patients (80 men, mean age 64 years) were included, of whom 46 (30%) presented with acute ischemia, 6 (4%) presented with intracerebral hemorrhage, 11 (7%) had an alternative diagnosis, and 85 (59%) had no pathological findings. The intraclass correlation coefficients of the two modalities were 0.97 (0.96–0.98) for the anterior circulation and 0.77 (0.69–0.83) for the posterior circulation. The VNCCT’s sensitivity for detecting acute ischemia was higher (41%, 19/46) than that of NCCT (33%, 15/46). Specificity was similar between the two techniques, at 94% (97/103) and 98% (101/103), respectively. Conclusions: Our results show that VNCCT achieved a similar diagnostic performance as NCCT and could, thus, replace NCCT in assessing patients with suspected acute cerebral ischemia. Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in Clinical Practice)
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14 pages, 2804 KiB  
Article
The Clinical Utility of Lower Extremity Dual-Energy CT Angiography in the Detection of Bone Marrow Edema in Diabetic Patients with Peripheral Artery Disease
by Chiara Floridi, Laura Maria Cacioppa, Tommaso Valeri, Nicolo Rossini, Marzia Rosati, Vincenzo Vento, Alessandro Felicioli, Marco Macchini, Roberto Candelari, Marina Carotti and Andrea Giovagnoni
J. Clin. Med. 2024, 13(6), 1536; https://doi.org/10.3390/jcm13061536 - 7 Mar 2024
Cited by 3 | Viewed by 1262
Abstract
(1) Background: Type 2 diabetes is a major cause of incidences and the progression of peripheral artery disease (PAD). Bone marrow edema (BME) is an important finding suggestive of underlying bone inflammation in non-traumatic diabetic patients with PAD. Our aim was to [...] Read more.
(1) Background: Type 2 diabetes is a major cause of incidences and the progression of peripheral artery disease (PAD). Bone marrow edema (BME) is an important finding suggestive of underlying bone inflammation in non-traumatic diabetic patients with PAD. Our aim was to evaluate the presence, severity, and clinical implications of BME detected by virtual non-calcium application (VNCa) of dual-energy CT angiography (DE-CTA). (2) Methods: A consecutive series of 76 diabetic patients (55 men; mean age 71.6 ± 11.2 yrs) submitted to lower limb DE-CTA for PAD evaluation and revascularization planning, which were retrospectively analyzed. VNCa images were independently and blindly revised for the presence, location, and severity of BME by two radiologists with 10 years of experience. BME and non-BME groups were evaluated in terms of PAD clinical severity and 6-month secondary major amputation rate. (3) Results: BME was present in 17 (22%) cases, while 59 (78%) patients were non-BME. The BME group showed a significantly higher incidence of major amputation (p < 0.001) and a significantly higher number of patients with advanced clinical stages of PAD compared to the non-BME group (p = 0.024). (4) Conclusions: Lower limb DE-CTA with VNCa application is a useful tool in the detection of BME in diabetic patients with PAD, simultaneously enabling the evaluation of the severity and location of the arterial disease for revascularization planning. BME presence could be a marker of clinically severe PAD and a possible risk factor for revascularization failure. Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in Clinical Practice)
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Review

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22 pages, 2403 KiB  
Review
Spectral Photon-Counting Computed Tomography: Technical Principles and Applications in the Assessment of Cardiovascular Diseases
by Antonella Meloni, Erica Maffei, Alberto Clemente, Carmelo De Gori, Mariaelena Occhipinti, Vicenzo Positano, Sergio Berti, Ludovico La Grutta, Luca Saba, Riccardo Cau, Eduardo Bossone, Cesare Mantini, Carlo Cavaliere, Bruna Punzo, Simona Celi and Filippo Cademartiri
J. Clin. Med. 2024, 13(8), 2359; https://doi.org/10.3390/jcm13082359 - 18 Apr 2024
Cited by 3 | Viewed by 2597
Abstract
Spectral Photon-Counting Computed Tomography (SPCCT) represents a groundbreaking advancement in X-ray imaging technology. The core innovation of SPCCT lies in its photon-counting detectors, which can count the exact number of incoming x-ray photons and individually measure their energy. The first part of this [...] Read more.
Spectral Photon-Counting Computed Tomography (SPCCT) represents a groundbreaking advancement in X-ray imaging technology. The core innovation of SPCCT lies in its photon-counting detectors, which can count the exact number of incoming x-ray photons and individually measure their energy. The first part of this review summarizes the key elements of SPCCT technology, such as energy binning, energy weighting, and material decomposition. Its energy-discriminating ability represents the key to the increase in the contrast between different tissues, the elimination of the electronic noise, and the correction of beam-hardening artifacts. Material decomposition provides valuable insights into specific elements’ composition, concentration, and distribution. The capability of SPCCT to operate in three or more energy regimes allows for the differentiation of several contrast agents, facilitating quantitative assessments of elements with specific energy thresholds within the diagnostic energy range. The second part of this review provides a brief overview of the applications of SPCCT in the assessment of various cardiovascular disease processes. SPCCT can support the study of myocardial blood perfusion and enable enhanced tissue characterization and the identification of contrast agents, in a manner that was previously unattainable. Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in Clinical Practice)
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Other

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3 pages, 165 KiB  
Reply
Reply to Maffulli, N.; Spiezia, F. Comment on “Foti et al. Identification of Achille’s Tendon Tears: Diagnostic Accuracy of Dual-Energy CT with Respect to MRI. J. Clin. Med. 2024, 13, 4426”
by Giovanni Foti, Luca Bortoli, Matteo Tronu, Sabrina Montefusco, Gerardo Serra, Roberto Filippini and Venanzio Iacono
J. Clin. Med. 2024, 13(23), 7323; https://doi.org/10.3390/jcm13237323 - 2 Dec 2024
Viewed by 202
Abstract
I need to thank my colleagues for their valuable comments on the recently published paper entitled “Identification of Achille’s Tendon Tears: Diagnostic Accuracy of Dual-Energy CT with Respect to MRI” [...] Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in Clinical Practice)
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