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Dual-energy CT angiography-derived virtual non-contrast images for follow-up of patients with surgically clipped aneurysms: a retrospective study

  • Su Young Yun
  • Young Jin HeoEmail author
  • Hae Woong Jeong
  • Jin Wook Baek
  • Hye Jung Choo
  • Gi Won Shin
  • Sung Tae Kim
  • Young Gyun Jeong
  • Ji Young Lee
  • Hyun Seok Jung
Diagnostic Neuroradiology
  • 29 Downloads

Abstract

Purpose

To evaluate the diagnostic performance, image quality, artifacts, and radiation doses of virtual non-contrast (VNC) images, relative to true non-contrast (TNC) images, in patients with surgically clipped aneurysms.

Methods

Seventy-six patients who underwent unenhanced computed tomography (CT) and dual-energy (DE)-CT angiography after surgical clipping of 85 intracranial aneurysms were included in the study. Diagnostic performances of VNC and TNC images were compared with respect to sensitivity, specificity, and positive and negative predictive values. The results of quantitative and qualitative analyses were compared between VNC and TNC images. Radiation doses were also compared between VNC and TNC images.

Results

Diagnostic performance of VNC images was lower than that of TNC images; however, addition of contrast-enhanced images improved diagnostic performance. Image noise and mean attenuation of VNC images were significantly higher than those of TNC images in the centrum semiovale, cerebellum, and pons. The quality of VNC images was excellent or sufficient (85.5% for observer 1, 85.5% for observer 2), and complete acceptance of VNC images was achieved in 64.5% for observer 1 and in 71.0% for observer 2; however, the addition of contrast-enhanced images increased the level of acceptance (92.0% for observer 1, 90.9% for observer 2). Clip artifacts were significantly lower in VNC images than in TNC images. CT dose index, dose-length product, and effective dose were significantly lower without TNC images.

Conclusion

VNC images showed lower diagnostic performance and image quality, and higher image noise than TNC images; however, VNC images could reduce clip artifacts and radiation doses.

Keywords

Dual-energy CT angiography Virtual non-contrast Surgical clipping Brain 

Notes

Compliance with ethical standards

Funding

This study was funded by the DongKook Life Science. Co., Ltd., Republic of Korea.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Su Young Yun
    • 1
  • Young Jin Heo
    • 1
    Email author
  • Hae Woong Jeong
    • 1
  • Jin Wook Baek
    • 1
  • Hye Jung Choo
    • 1
  • Gi Won Shin
    • 1
  • Sung Tae Kim
    • 2
  • Young Gyun Jeong
    • 2
  • Ji Young Lee
    • 3
  • Hyun Seok Jung
    • 4
  1. 1.Department of RadiologyInje University Busan Paik HospitalBusanSouth Korea
  2. 2.Department of NeurosurgeryInje University Busan Paik HospitalBusanSouth Korea
  3. 3.Department of Internal MedicineInje University Busan Paik HospitalBusanSouth Korea
  4. 4.Department of RadiologyWonkwang University HospitalIksanSouth Korea

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