Imaging Pearls ❯ Musculoskeletal ❯ Dual Energy
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- “Errors in bone segmentation were found for 1.5% of bones on dual-energy images and 12.4% of bones on single-energy images (p < 0.01). The most important differences were found in the rib cage, sternum, and pelvis. The times required for postprocessing of MIPs were similar for the dual-energy (113.5 seconds) and single-energy (106.8 seconds) techniques. The subjective image quality of the arteries was considered better for dual-energy CTA (4.5 points) than for single-energy CTA (4.1 points) owing to false cutoff of vessels during the bone removal process on the single-energy images (p = 0.026).”
Automatic bone removal technique in whole-body dual-energy CT angiography: performance and image quality
Schulz B et al
AJR 2012 Nov;199(5):W646-50 - “Errors in bone segmentation were found for 1.5% of bones on dual-energy images and 12.4% of bones on single-energy images (p < 0.01). The most important differences were found in the rib cage, sternum, and pelvis. The times required for postprocessing of MIPs were similar for the dual-energy (113.5 seconds) and single-energy (106.8 seconds) techniques.”
Automatic bone removal technique in whole-body dual-energy CT angiography: performance and image quality
Schulz B et al
AJR 2012 Nov;199(5):W646-50 - “ The subjective image quality of the arteries was considered better for dual-energy CTA (4.5 points) than for single-energy CTA (4.1 points) owing to false cutoff of vessels during the bone removal process on the single-energy images (p = 0.026).”
Automatic bone removal technique in whole-body dual-energy CT angiography: performance and image quality
Schulz B et al
AJR 2012 Nov;199(5):W646-50 - “For CTA of the trunk, the dual-energy postprocessing capabilities for 3D visualization are superior to the threshold-based bone removal of single-energy CT. Dual-energy CTA can generate boneless MIP images of substantial quality.”
Automatic bone removal technique in whole-body dual-energy CT angiography: performance and image quality
Schulz B et al
AJR 2012 Nov;199(5):W646-50 - “Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p=0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p=0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p<0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p=0.22).”
Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction
Yamamoto S et al.
Clin Radiol 2010 Mar;65(3):258 - “Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p=0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p=0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p<0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p=0.22).”
Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction
Yamamoto S et al.
Clin Radiol 2010 Mar;65(3):258 - AIM: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms.
CONCLUSION: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.
Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction
Yamamoto S et al.
Clin Radiol 2010 Mar;65(3):258 - “DE CTA has substantial advantages over conventional CTA. Automatic bone subtraction is more time efficient and reliable. Automatic plaque subtraction for the first time provides a true CTA-luminogram which is easy to interpret and reduces the need for further post-processing. DE CTA provides best results in arteries of the thigh; below the knee, plaque subtraction is less accurate.”
Dual energy CT of peripheral arteries: effect of automatic bone and plaque removal on image quality and grading of stenoses.
Meyer BC et al.
Eur J Radiol 2008 Dec;68(3):414-22 - “Residual bone fragments (ribs: 46%, patella: 25%, spine: 4%, pelvis: 2%, tibia 2% of patients) were only observed with ABS. The time needed to manually remove these residual bones was 2.1+/-1.1 min and was significantly lower than the duration of manual bone removal (6.8+/-2.0 min, p<0.0001, paired t-test). A total of 1159 arteries were analyzed. Compromising vessel erosions were observed less frequently in the ABS-B dataset (10.6%) than in the MBS dataset (15.2%, p<0.001, wilcoxon's signed rank test).”
Dual energy CT of peripheral arteries: effect of automatic bone and plaque removal on image quality and grading of stenoses.
Meyer BC et al.
Eur J Radiol 2008 Dec;68(3):414-22
- “ Initial retrospective assessment suggests that dual-energy CT is a sensitive, noninvasive, and reproducible method for identifying uric acid deposits in joints and periarticular soft tissues in patients suspected of having gout.”
Identification of Intraarticular and Periarticular Uric Acid Crystals with Dual-Energy CT: Initial Evaluation
Glazebrook KN et al.
Radiology 2011;261:516-524 - “ Dual-energy CT may be useful in establishing the extent of gout by identifying subclinical tophi and in identifying urate deposits in atypical anatomic sites for gout.”
Identification of Intraarticular and Periarticular Uric Acid Crystals with Dual-Energy CT: Initial Evaluation
Glazebrook KN et al.
Radiology 2011;261:516-524 - “ Unenhanced low dose dual energy CT can add information to joint fluid aspiration in patients suspected of having gout by aiding identification of uric acid deposits within joints and periarticular soft tissues.”
Identification of Intraarticular and Periarticular Uric Acid Crystals with Dual-Energy CT: Initial Evaluation
Glazebrook KN et al.
Radiology 2011;261:516-524