Renal cyst pseudoenhancement: Intraindividual comparison between virtual monochromatic spectral images and conventional polychromatic 120-kVp images obtained during the same CT examination and comparisons among images reconstructed using filtered back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction

Yoshitake Yamada, Minoru Yamada, Koichi Sugisawa, Hirotaka Akita, Eisuke Shiomi, Takayuki Abe, Shigeo Okuda, Masahiro Jinzaki

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Abstract

The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59-85 years; mean age, 73.2±5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0±14.7mm [range, 4-61mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0Hounsfield units [HU]; 95% confidence interval, 2.6-7.4/3.6-8.4HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8HU; 95% confidence interval, 9.8-14.5/10.4-15.1/9.4-14.2HU) (all P<.001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images.

Original languageEnglish
Article numbere754
JournalMedicine (United States)
Volume94
Issue number15
DOIs
Publication statusPublished - 2015 Apr 6

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Cysts
Tomography
Kidney
Least-Squares Analysis
Confidence Intervals
Research Ethics Committees
Informed Consent
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{022b2f23cd8c4f8a96b626a672c7a860,
title = "Renal cyst pseudoenhancement: Intraindividual comparison between virtual monochromatic spectral images and conventional polychromatic 120-kVp images obtained during the same CT examination and comparisons among images reconstructed using filtered back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction",
abstract = "The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59-85 years; mean age, 73.2±5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0±14.7mm [range, 4-61mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0Hounsfield units [HU]; 95{\%} confidence interval, 2.6-7.4/3.6-8.4HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8HU; 95{\%} confidence interval, 9.8-14.5/10.4-15.1/9.4-14.2HU) (all P<.001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images.",
author = "Yoshitake Yamada and Minoru Yamada and Koichi Sugisawa and Hirotaka Akita and Eisuke Shiomi and Takayuki Abe and Shigeo Okuda and Masahiro Jinzaki",
year = "2015",
month = "4",
day = "6",
doi = "10.1097/MD.0000000000000754",
language = "English",
volume = "94",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "15",

}

TY - JOUR

T1 - Renal cyst pseudoenhancement

T2 - Intraindividual comparison between virtual monochromatic spectral images and conventional polychromatic 120-kVp images obtained during the same CT examination and comparisons among images reconstructed using filtered back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction

AU - Yamada, Yoshitake

AU - Yamada, Minoru

AU - Sugisawa, Koichi

AU - Akita, Hirotaka

AU - Shiomi, Eisuke

AU - Abe, Takayuki

AU - Okuda, Shigeo

AU - Jinzaki, Masahiro

PY - 2015/4/6

Y1 - 2015/4/6

N2 - The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59-85 years; mean age, 73.2±5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0±14.7mm [range, 4-61mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0Hounsfield units [HU]; 95% confidence interval, 2.6-7.4/3.6-8.4HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8HU; 95% confidence interval, 9.8-14.5/10.4-15.1/9.4-14.2HU) (all P<.001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images.

AB - The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59-85 years; mean age, 73.2±5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0±14.7mm [range, 4-61mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0Hounsfield units [HU]; 95% confidence interval, 2.6-7.4/3.6-8.4HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8HU; 95% confidence interval, 9.8-14.5/10.4-15.1/9.4-14.2HU) (all P<.001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images.

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