ArticleEuropean radiology2021
Longitudinal reproducibility of attenuation measurements on virtual unenhanced images: multivendor dual-energy CT evaluation.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Reply to the Letter to the Editor: Virtual non-contrast CT should be validated by non-contrast-dependent clinical tasks before replacing true unenhanced abdominal CT.European radiology · 2026Article
- Improved virtual non-contrast images in liver dual-energy CT with deep learning algorithm for image reconstruction.Radiologie (Heidelberg, Germany) · 2026Article
- Dual-layer spectral detector computed tomography for adrenal adenoma characterization: radiation dose reduction and quantitative agreement of multiphase virtual noncontrast with true noncontrast imaging.Quantitative imaging in medicine and surgery · 2025Article
- Virtual Non-Contrast Reconstructions Derived from Dual-Energy CTA Scans in Peripheral Arterial Disease: Comparison with True Non-Contrast Images and Impact on Radiation Dose.Journal of clinical medicine · 2025Article
- Comparison of virtual and true non-contrast images from dual-layer spectral detector computed tomography (CT) in patients with colorectal cancer.Quantitative imaging in medicine and surgery · 2024Article
- What to Expect (and What Not) from Dual-Energy CT Imaging Now and in the Future?Journal of imaging · 2024Review
- Pros and Cons of Dual-Energy CT Systems: "One Does Not Fit All".Tomography (Ann Arbor, Mich.) · 2023Review
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Authors and funding
4 authors at 1 institution in 2 countries.
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Abstract
objectivesThe accuracy of virtual unenhanced (VUE) images has been extensively investigated, yet data on their longitudinal reproducibility is limited. The study purpose was to evaluate the longitudinal reproducibility of VUE attenuation measurements on three different dual-energy CT (DECT) scanner types.
methodsA total of 137 patients with repeated abdominal DECT either on a rapid kV switching (rsDECT; n = 46), a dual-layer detector (dlDECT; n = 43), or a dual-source scanner (dsDECT; n = 48) were retrospectively included. Attenuation was measured on VUE and corresponding contrast-enhanced images in the liver, spleen, kidneys, aorta, portal vein, and fat. Longitudinal reproducibility was evaluated by calculating the absolute inter-scan differences (HU) and the inter-scan variation (%). Measurement pairs with differences ≤ 10 HU were considered reproducible. Influence of contrast-enhanced attenuation on VUE reproducibility was analyzed using linear regression.
resultsThe scanner-specific cohorts showed similar age (p-range: 0.35-0.99), sex (p-range: 0.68-1), body weight (p-range: 0.26-0.87), body diameter (p-range: 0.34-0.76), and inter-scan time (p-range: 0.52-0.83). In total, 94.9% of VUE measurements were reproducible for rsDECT, 93.8% for dlDECT, and 90.6% for dsDECT. Overall inter-scan variation was lowest in fat (4.0 (1.7-8.2)%) and highest in tissues with high contrast enhancement: the aorta (13.3 (4.6-21.3)%), portal vein (10.8 (5.7-19.8)%), and kidneys (10.7 (3.9-18.0)%). Significant differences in inter-scan variation were found between the scanner types for the aorta, portal vein, kidneys, and spleen. Inter-scan differences in contrast-enhanced attenuation significantly influenced inter-scan differences in VUE attenuation (p < 0.001; t-ratio: 4.34).
conclusionsLongitudinal reproducibility of VUE attenuation was high for all scanners, yet inter-scan variation of VUE attenuation was influenced by contrast enhancement, showing greatest magnitude and discrepancy between scanner types in vessels and the kidneys. KEY POINTS: • We found that 94.9% of attenuation measurements on virtual unenhanced images were reproducible for rapid kV switching DECT, 93.8% for dual-layer detector DECT, and 90.6% for dual-source DECT. • Inter-scan variation of attenuation in virtual unenhanced images was comparable between the three scanner types in the liver and fat, whereas inter-scan variation in the spleen, kidneys, portal vein, and aorta showed significant differences between scanner types (p < 0.05). • Inter-scan attenuation differences in contrast-enhanced images significantly influenced inter-scan differences in virtual unenhanced attenuation (p < 0.001, t-ratio: 4.34), suggesting a residual impact of contrast enhancement differences between examinations.
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