Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Dual-Energy Computed Tomography Arthrography of the Shoulder Joint Using Virtual Monochromatic Spectral Imaging: Optimal Dose of Contrast Agent and Monochromatic Energy Level

  • An, Chansik (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Chun, Yong-Min (Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Sungjun (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Young Han (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Yun, Min Jeong (GE Healthcare) ;
  • Suh, Jin-Suck (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Song, Ho-Taek (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine)
  • Received : 2013.05.03
  • Accepted : 2014.08.14
  • Published : 2014.12.01
⟨ Previous Next ⟩

Abstract

Objective: To optimize the dose of contrast agent and the level of energy for dual-energy computed tomography (DECT) arthrography of the shoulder joint and to evaluate the benefits of the optimized imaging protocol. Materials and Methods: Dual-energy scans with monochromatic spectral imaging mode and conventional single energy scans were performed on a shoulder phantom with 10 concentrations from 0 to 210 mg/mL of iodinated contrast medium at intervals of 15 or 30 mg/mL. Image noise, tissue contrast, and beam hardening artifacts were assessed to determine the optimum dose of contrast agent and the level of monochromatic energy for DECT shoulder arthrography in terms of the lowest image noise and the least beam hardening artifacts while good tissue contrast was maintained. Material decomposition (MD) imaging for bone-iodine differentiation was qualitatively assessed. The optimized protocol was applied and evaluated in 23 patients. Results: The optimal contrast dose and energy level were determined by the phantom study at 60 mg/mL and 72 keV, respectively. This optimized protocol for human study reduced the image noise and the beam-hardening artifacts by 35.9% and 44.5%, respectively. Bone-iodine differentiation by MD imaging was not affected by the iodine concentration or level of energy. Conclusion: Dual-energy scan with monochromatic spectral imaging mode results in reduced image noise and beam hardening artifacts.

Keywords

References

  1. Buckwalter KA. CT Arthrography. Clin Sports Med 2006;25:899-915 https://doi.org/10.1016/j.csm.2006.06.002
  2. Chandnani VP, Yeager TD, DeBerardino T, Christensen K, Gagliardi JA, Heitz DR, et al. Glenoid labral tears: prospective evaluation with MRI imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol 1993;161:1229-1235 https://doi.org/10.2214/ajr.161.6.8249731
  3. Choo HJ, Lee SJ, Kim OH, Seo SS, Kim JH. Comparison of three-dimensional isotropic T1-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography of the shoulder. Radiology 2012;262:921-931 https://doi.org/10.1148/radiol.11111261
  4. Jung JY, Yoon YC, Yi SK, Yoo J, Choe BK. Comparison study of indirect MR arthrography and direct MR arthrography of the shoulder. Skeletal Radiol 2009;38:659-667 https://doi.org/10.1007/s00256-009-0660-7
  5. Lecouvet FE, Simoni P, Koutaïssoff S, Vande Berg BC, Malghem J, Dubuc JE. Multidetector spiral CT arthrography of the shoulder. Clinical applications and limits, with MR arthrography and arthroscopic correlations. Eur J Radiol 2008;68:120-136 https://doi.org/10.1016/j.ejrad.2008.02.025
  6. Waldt S, Bruegel M, Ganter K, Kuhn V, Link TM, Rummeny EJ, et al. Comparison of multislice CT arthrography and MR arthrography for the detection of articular cartilage lesions of the elbow. Eur Radiol 2005;15:784-791 https://doi.org/10.1007/s00330-004-2585-9
  7. Roger B, Skaf A, Hooper AW, Lektrakul N, Yeh L, Resnick D. Imaging findings in the dominant shoulder of throwing athletes: comparison of radiography, arthrography, CT arthrography, and MR arthrography with arthroscopic correlation. AJR Am J Roentgenol 1999;172:1371-1380 https://doi.org/10.2214/ajr.172.5.10227520
  8. Deng K, Zhang CQ, Li W, Wang JJ, Wang XY, Pang T, et al. Preliminary application of high-definition CT Gemstone Spectral Imaging in hand and foot tendons. Korean J Radiol 2012;13:743-751 https://doi.org/10.3348/kjr.2012.13.6.743
  9. Hur J, Kim YJ, Lee HJ, Nam JE, Hong YJ, Kim HY, et al. Cardioembolic stroke: dual-energy cardiac CT for differentiation of left atrial appendage thrombus and circulatory stasis. Radiology 2012;263:688-695 https://doi.org/10.1148/radiol.12111691
  10. Lee YH, Park KK, Song HT, Kim S, Suh JS. Metal artefact reduction in gemstone spectral imaging dual-energy CT with and without metal artefact reduction software. Eur Radiol 2012;22:1331-1340 https://doi.org/10.1007/s00330-011-2370-5
  11. Coursey CA, Nelson RC, Boll DT, Paulson EK, Ho LM, Neville AM, et al. Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? Radiographics 2010;30:1037-1055 https://doi.org/10.1148/rg.304095175
  12. Johnson T, Fink C, Schonberg SO, Reiser MF. Dual Energy CT in Clinical Practice. Newyork: Springer, 2011
  13. Zhang D, Li X, Liu B. Objective characterization of GE discovery CT750 HD scanner: gemstone spectral imaging mode. Med Phys 2011;38:1178-1188 https://doi.org/10.1118/1.3551999
  14. Matsumoto K, Jinzaki M, Tanami Y, Ueno A, Yamada M, Kuribayashi S. Virtual monochromatic spectral imaging with fast kilovoltage switching: improved image quality as compared with that obtained with conventional 120-kVp CT. Radiology 2011;259:257-262 https://doi.org/10.1148/radiol.11100978
  15. Lin XZ, Miao F, Li JY, Dong HP, Shen Y, Chen KM. High-definition CT Gemstone spectral imaging of the brain: initial results of selecting optimal monochromatic image for beam-hardening artifacts and image noise reduction. J Comput Assist Tomogr 2011;35:294-297 https://doi.org/10.1097/RCT.0b013e3182058d5c
  16. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Statist Soc 1995;B57:289-300
  17. Yu L, Christner JA, Leng S, Wang J, Fletcher JG, McCollough CH. Virtual monochromatic imaging in dual-source dual-energy CT: radiation dose and image quality. Med Phys 2011;38:6371-6379 https://doi.org/10.1118/1.3658568
  18. Cochet H, Couderc S, Pele E, Amoretti N, Moreau-Durieux MH, Hauger O. Rotator cuff tears: should abduction and external rotation (ABER) positioning be performed before image acquisition? A CT arthrography study. Eur Radiol 2010;20:1234-1241 https://doi.org/10.1007/s00330-009-1635-8
  19. Fritz J, Fishman EK, Small KM, Winalski CS, Horger MS, Corl F, et al. MDCT arthrography of the shoulder with datasets of isotropic resolution: indications, technique, and applications. AJR Am J Roentgenol 2012;198:635-646 https://doi.org/10.2214/AJR.11.7078
  20. Kim YJ, Choi JA, Oh JH, Hwang SI, Hong SH, Kang HS. Superior labral anteroposterior tears: accuracy and interobserver reliability of multidetector CT arthrography for diagnosis. Radiology 2011;260:207-215 https://doi.org/10.1148/radiol.11101176
  21. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 2000;16:677-694 https://doi.org/10.1053/jars.2000.17715
  22. Bushnell BD, Creighton RA, Herring MM. Bony instability of the shoulder. Arthroscopy 2008;24:1061-1073 https://doi.org/10.1016/j.arthro.2008.05.015
  23. Tauber M, Resch H, Forstner R, Raffl M, Schauer J. Reasons for failure after surgical repair of anterior shoulder instability. J Shoulder Elbow Surg 2004;13:279-285 https://doi.org/10.1016/j.jse.2004.01.008
  24. Moser T, Dosch JC, Moussaoui A, Dietemann JL. Wrist ligament tears: evaluation of MRI and combined MDCT and MR arthrography. AJR Am J Roentgenol 2007;188:1278-1286 https://doi.org/10.2214/AJR.06.0288
  25. Schmid MR, Schertler T, Pfirrmann CW, Saupe N, Manestar M, Wildermuth S, et al. Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging. Radiology 2005;237:1008-1013 https://doi.org/10.1148/radiol.2373041450

Cited by

  1. Dual-Energy CT in Musculoskeletal Imaging: What Is the Role Beyond Gout? vol.213, pp.3, 2019, https://doi.org/10.2214/ajr.19.21095