ArticleNeuroradiology2021
Virtual monochromatic dual-energy CT reconstructions improve detection of cerebral infarct in patients with suspicion of stroke.
Article in Neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Diagnostic accuracy of dual-energy CT in distinguishing intracerebral hemorrhage from contrast staining: a systematic review and meta-analysis with radiation dose assessment.La Radiologia medica · 2026Pooled it
- Stroke Evaluation in the Interventional Suite Using Dual-Layer Detector Cone-Beam CT: a First-in-human Prospective Cohort Study (the Next Generation X-ray Imaging System Trial).Clinical neuroradiology · 2024Trial
- Spectral CTA-based quantitative differentiation of infarcted and non-infarcted ASPECTS regions in acute stroke.European radiology experimental · 2026Article
- Acute stroke diagnosis: diagnostic efficacy of dual-layer spectral computed tomography for non-contrast ischemic sign detection.Quantitative imaging in medicine and surgery · 2025Article
- Applications of spectral CT in emergency department imaging, with a focus on neuroimaging.Emergency radiology · 2025Review
- AI-Assisted Edema Map Optimization Improves Infarction Detection in Twin-Spiral Dual-Energy CT.Brain sciences · 2025Article
- Dual Energy CT for Deep Learning-Based Segmentation and Volumetric Estimation of Early Ischemic Infarcts.Journal of imaging informatics in medicine · 2025Article
- The Impact of Weighting Factors on Dual-Energy Computed Tomography Image Quality in Non-Contrast Head Examinations: Phantom and Patient Study.Diagnostics (Basel, Switzerland) · 2025Article
- Ischemic core detection threshold of computed tomography perfusion (CTP) in acute stroke.La Radiologia medica · 2024Article
- Clinical Applications of Dual-Energy Computed Tomography for Acute Ischemic Stroke.Stroke (Hoboken, N.J.) · 2024Review
- Dual-energy computed tomography angiography-based quantification of lesion net water uptake to identify stroke onset time.Heliyon · 2024Article
- Deep learning reconstruction for improving the visualization of acute brain infarct on computed tomography.Neuroradiology · 2024Article
- Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets.Scientific reports · 2023Article
- Virtual monoenergetic images by spectral detector computed tomography may improve image quality and diagnostic ability for ischemic lesions in acute ischemic stroke.Acta radiologica (Stockholm, Sweden : 1987) · 2023Article
- Virtual monoenergetic dual-energy CT reconstructions at 80 keV are optimal non-contrast CT technique for early stroke detection.The neuroradiology journal · 2022Article
- ASPECTS estimation using dual-energy CTA-derived virtual non-contrast in large vessel occlusion acute ischemic stroke: a dose reduction opportunity for patients undergoing repeat CT?Neuroradiology · 2022Article
- Review
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeEarly infarcts are hard to diagnose on non-contrast head CT. Dual-energy CT (DECT) may potentially increase infarct differentiation. The optimal DECT settings for differentiation were identified and evaluated.
methodsOne hundred and twenty-five consecutive patients who presented with suspected acute ischemic stroke (AIS) and underwent non-contrast DECT and subsequent DWI were retrospectively identified. The DWI was used as reference standard. First, virtual monochromatic images (VMI) of 25 patients were reconstructed from 40 to 140 keV and scored by two readers for acute infarct. Sensitivity, specificity, positive, and negative predictive values for infarct detection were compared and a subset of VMI energies were selected. Next, for a separate larger cohort of 100 suspected AIS patients, conventional non-contrast CT (NCT) and selected VMI were scored by two readers for the presence and location of infarct. The same statistics for infarct detection were calculated. Infarct location match was compared per vascular territory. Subgroup analyses were dichotomized by time from last-seen-well to CT imaging.
resultsA total of 80-90 keV VMI were marginally more sensitive (36.3-37.3%) than NCT (32.4%; p > 0.680), with marginally higher specificity (92.2-94.4 vs 91.1%; p > 0.509) for infarct detection. Location match was superior for VMI compared with NCT (28.7-27.4 vs 19.5%; p < 0.010). Within 4.5 h from last-seen-well, 80 keV VMI more accurately detected infarct (58.0 vs 54.0%) and localized infarcts (27.1 vs 11.9%; p = 0.004) than NCT, whereas after 4.5 h, 90 keV VMI was more accurate (69.3 vs 66.3%).
conclusionNon-contrast 80-90 keV VMI best differentiates normal from infarcted brain parenchyma.
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