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  • Title: [Effect of a noise-optimized virtual monoenergetic reconstruction technique on dual-energy CT for image quality of inflammatory bowel disease].
    Author: Yang H, Wu X, Jiang B, Deng K, Sun J, Mei X.
    Journal: Zhong Nan Da Xue Xue Bao Yi Xue Ban; 2018 Aug 28; 43(8):875-881. PubMed ID: 30197316.
    Abstract:
    To assess the value of noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique on objective and subjective image quality in patients with inflammatory bowel disease (IBD) undergoing abdominal dual-energy computed tomography (DECT).
 Methods: Datasets from 32 patients (22 men, 10 women) with IBD, who underwent abdominal DECT, were reconstructed by using the standard linearly blended (M_0.6), traditional monoenergetic (VMI) and VMI+ algorithms in 10-keV intervals from 40-100 keV. Attenuation in IBD lesions was measured to perform objective evaluation using signal-to-noise (SNR) and contrast-to-noise ratios (CNR). Subjective evaluation was performed by 3 independent blinded radiologists using 5-point Likert scales. The overall image quality, image sharpness, lesion delineation, and image noise were analyzed. 
 Results: Mean SNR and CNR peaked at 40 keV VMI+ series (SNR 8.28±2.34, CNR 5.10±2.10) and they were significantly higher than those in linearly blended (SNR 5.82±1.44, CNR 1.53±0.86) and all VMI series (all P<0.01). Subjective image parameter was the highest for the 50 keV VMI+ series regarding overall image quality (mean 4.80, all P<0.01). The highest image sharpness scores were observed at 40 and 50 keV VMI+ reconstructions (mean 4.14 and 4.25, respectively; P=0.415). VMI+ series at 40 keV provided the highest lesion delineation (mean 4.52, all P<0.01). Image noise was low at the 100 keV VMI+ and VMI series (mean 4.58 and 4.40, respectively; P≥0.11).
 Conclusion: Low-keV VMI+ reconstructions improves SNR, CNR, and subjective image quality significantly in patients with IBD. 目的：评估炎症性肠病(inflammatory bowel disease，IBD)患者腹部双能量CT(dual-energy CT，DECT)扫描不同能级噪声优化的虚拟单能量图像(noise-optimized virtual monoenergetic imaging，VMI+)的主观和客观图像质量，得出最佳重建参数，提高IBD诊断准确率。方法：选取2016年4月到2017年6月确诊为IBD的32名患者腹部DECT扫描图像进行线性融合(M_0.6)、VMI+、传统虚拟单能量图像(virtual monoenergetic imaging，VMI)重建，虚拟能级为40~100 keV，间隔为10 keV。以病变肠段部位的图像信噪比(signal-to-noise ratio，SNR)和对比噪声比(contrast-to-noise ratio，CNR)作为客观图像质量评价标准，主观图像质量评价由3名放射科医生对总体图像质量、锐利度、病变轮廓、噪声4个方面进行双盲评估。结果：客观图像质量评价最佳重建参数为40 keV VMI+(SNR 8.28±2.34；CNR 5.10±2.10)，优于线性融合图像(SNR 5.82±1.44；CNR 1.53±0.86)和传统VMI(P<0.01)。主观图像质量评价中，50 keV VMI+总体图像质量(均值4.80)高于其他图像(P<0.01)，40和50 keV VMI+锐利度最高(均值分别为4.14和4.25，P=0.415)，40 keV VMI+显示病变轮廓能力评分高于其他图像(均值4.52，P<0.01)。100 keV VMI+和100 keV VMI噪声最低(均值分别为4.58和4.40，P≥0.11)。结论：相比于线性融合和传统VMI重建，低能级VMI+可显著提高IBD病变部位的腹部DECT扫描图像的主观和客观图像质量。.
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