ArticleEuropean journal of radiology open2026
Feasibility of single-phase DECT as an alternative to triple-phase CT for imaging-defined risk factors assessment in neuroblastoma for dose reduction.
Article in European journal of radiology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the feasibility of evaluating Imaging-Defined Risk Factors (IDRFs) in Neuroblastoma (NB) patients using venous-phase (VP)-only images in dual-energy CT for radiation dose reduction and examination workflow optimization, compared with conventional triple-phase CECT. Materials and methods: Ninety-four pediatric NB patients (ages 4.92 ± 3.45 y, range 0-17 y), who underwent triple-phase DECT were included. The standard 68 keV images reconstructed using 50 % adaptive statistical iterative reconstruction-V (ASIR-V) served as the control group. The 40 keV images in VP with deep learning image reconstruction (DLIR) were used as the study group. Objective measurements included CT values and standard deviations of the aorta, back muscles, NB lesions; contrast-to-noise ratio (CNR) of the aorta, and edge-rise slope (ERS) of NB lesions and compared by using paired Wilcoxon tests. Two pediatric radiologists independently reviewed images for IDRFs and used a 5-point scale to assess images quality. Weighted Cohen's kappa was generated to analyze the inter-rater differences. Results: The study group had higher arterial CT values (440.81 ± 79.93 HU vs. 340.35 ± 61.14 HU, p < 0.001), similar CNR (30.43 ± 10.91 vs. 28.17 ± 10.05, p = 0.110), and higher ERS (129.31 ± 41.32 vs. 114.06 ± 36.33, p = 0.002). Two radiologists showed no difference in IDRFs assessment with good intra-group consistency, and all images met diagnostic needs with image quality scores exceeded 3. The single-phase DECT reduced radiation dose to 108.84 ± 50.49 mGy-cm, over 60 % lower than the triple-phase CECT. Conclusion: Single venous-phase 40 keV-DECT images demonstrate feasibility for evaluating IDRFs in pediatric NB patients, saving about 60 % radiation dose and optimizing the examination workflow compared to the conventional triple-phase approach.
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