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Quantitative analysis of iodine enhancement

Case Study
Philips CT Clinical Science Philips Healthcare • USA

Clinical history

A 77 year-old male was examined and was found to have several liver lesions. Dual-energy CT was used to assess the level of iodine enhancement in each lesion.

Method

A contrast-enhanced DECT study was performed using a Philips iCT 256-slice CT scanner. The images were reconstructed using the iDose4 iterative reconstruction technique (Figure 1a and b), and were assessed using the Spectral Analysis application (extended Brilliance Workspace version 4.5, Philips Healthcare). Regions of interest (ROIs) were placed in two lesions and a visually homogenous region of liver parenchyma, and dual-energy analysis was performed.

Image scan parameters

 

  • Axial scan mode
  • iDose4 Level 4
  • 80 / 140 kVp
  • 460 / 90 mAs 
  • 2.5 mm slice thickness
  • 0.5 second rotation speed 
  • 64 × 0.625 mm collimation
  • 75.2 mGy × cm DLP
  • (32cm) 9.4 x 2 mGy CTDIvol
  • 1.13 mSv effective dose
Figure 1a Figure 1b
Figure 1a
Figure 1b
Figure 2a Lesion enhancement visualized at 80 kVp.Figure 2b Lesion enhancement visualized at 140 kVp.
Figure 2a
Figure 2b
Lesion enhancement visualized at 80 kVp.
Lesion enhancement visualized at 140 kVp.

Figure 3: Dual energy CT map iDose4 reduced image noise and allowed greater detail to be seen in the quantitative analysis.
Figure 3: Dual energy CT map
iDose4 reduced image noise and allowed greater detail to be seen in the quantitative analysis.

Diagnosis

Quantitative analysis of iodine enhancement was performed on the dual-energy data in delayed phase images relative to liver parenchyma (Figure 2a and 2b). One lesion (ROI 2 in Figure 2a and 2b) demonstrated washout in the delayed enhancement phase, subsequent to early enhancement in the arterial phase. The other lesion (ROI 1 in Figure 2a and 2b) demonstrated central hypoenhancement in the delayed phase and other phases. The use of the iDose4 iterative reconstruction technique reduced image noise and allowed greater detail to be seen in the quantitative analysis (Figure 3).

Clinical significance

Quantitative analysis of the iodine enhancement was demonstrated using a combination of dual-energy CT acquisition and an iterative reconstruction technique. The advanced technologies of the iCT, in combination with iDose4, allow imaging at low dose with high image quality.


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Apr 20, 2012

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Case Study
iCT, IntelliSpace Portal
abdomen, Body, contrast-enhanced, Dual Energy, Extended Brilliance Workspace 4.5, iDose4, image quality, lesions, liver, low dose, quantitative CT, Spectral Analysis
 

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