ArticleDiagnostics (Basel, Switzerland)2023
Virtual Monoenergetic Imaging of Lower Extremities Using Dual-Energy CT Angiography in Patients with Diabetes Mellitus.
Article in Diagnostics (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 11 citations in OpenAlex.
- Feasibility of single-phase DECT as an alternative to triple-phase CT for imaging-defined risk factors assessment in neuroblastoma for dose reduction.European journal of radiology open · 2026Article
- Improving image quality and diagnostic confidence for PRETEXT staging in pediatric hepatoblastoma using thin-slice and low-energy virtual monochromatic images in dual-energy CT with deep learning image reconstruction algorithm.BMC medical imaging · 2026Article
- Impact of low-energy virtual monoenergetic imaging in photon-counting CT for pre-TAVI pelvic arteries visualization.La Radiologia medica · 2026Article
- The diagnostic value of dual-energy CTA for visualising below the knee arteries in peripheral arterial disease: A systematic review.European journal of radiology open · 2025Review
- Improving lower-extremity artery depiction and diagnostic confidence using dual-energy technique and popliteal artery monitoring in dual-low dose CT angiography.Scientific reports · 2025Article
- CT Angiography of the Upper Extremities: Review of Acute Arterial Entities.Radiographics : a review publication of the Radiological Society of North America, Inc · 2025Review
- Carotid artery assessment in dual-source photon-counting CT: impact of low-energy virtual monoenergetic imaging on image quality, vascular contrast and diagnostic assessability.La Radiologia medica · 2024Article
- Dual-Energy CT Material Decomposition: The Value in the Detection of Lymph Node Metastasis from Breast Cancer.Diagnostics (Basel, Switzerland) · 2024Article
- Transcatheter Aortic Valve Implantation (TAVI) Planning with Dual-Layer Spectral CT Using Virtual Monoenergetic Image (VMI) Reconstructions and 20 mL of Contrast Media.Journal of clinical medicine · 2024Article
- Improved Coronary Artery Visualization Using Virtual Monoenergetic Imaging from Dual-Layer Spectral Detector CT Angiography.Diagnostics (Basel, Switzerland) · 2023Article
- State-of-the-Art Research: Current Developments in CT Imaging.Diagnostics (Basel, Switzerland) · 2023Article
- Low-iodine 40-keV virtual monoenergetic CT angiography of the lower extremities.Frontiers in cardiovascular medicine · 2023Article
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Authors and funding
15 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundType 2 diabetes mellitus (DM) is the most common metabolic disorder in the world and an important risk factor for peripheral arterial disease (PAD). CT angiography represents the method of choice for the diagnosis, pre-operative planning, and follow-up of vascular disease. Low-energy dual-energy CT (DECT) virtual mono-energetic imaging (VMI) has been shown to improve image contrast, iodine signal, and may also lead to a reduction in contrast medium dose. In recent years, VMI has been improved with the use of a new algorithm called VMI+, able to obtain the best image contrast with the least possible image noise in low-keV reconstructions. PURPOSE: To evaluate the impact of VMI+ DECT reconstructions on quantitative and qualitative image quality in the evaluation of the lower extremity runoff. MATERIALS AND
methodsWe evaluated DECT angiography of lower extremities in patients suffering from diabetes who had undergone clinically indicated DECT examinations between January 2018 and January 2023. Images were reconstructed with standard linear blending (F_0.5) and low VMI+ series were generated from 40 to 100 keV, in an interval of 15 keV. Vascular attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for objective analysis. Subjective analysis was performed using five-point scales to evaluate image quality, image noise, and diagnostic assessability of vessel contrast.
resultsOur final study cohort consisted of 77 patients (41 males). Attenuation values, CNR, and SNR were higher in 40-keV VMI+ reconstructions compared to the remaining VMI+ and standard F_0.5 series (HU: 1180.41 ± 45.09; SNR: 29.91 ± 0.99; CNR: 28.60 ± 1.03 vs. HU 251.32 ± 7.13; SNR: 13.22 ± 0.44; CNR: 10.57 ± 0.39 in standard F_0.5 series) (
conclusionsDECT 40-keV and 55-keV VMI+ showed the highest objective and subjective parameters of image quality, respectively. These specific energy levels for VMI+ reconstructions could be recommended in clinical practice, providing high-quality images with greater diagnostic suitability for the evaluation of lower extremity runoff, and potentially needing a lower amount of contrast medium, which is particularly advantageous for diabetic patients.
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