Julian Lukas Wichmann MD, Presenter: Nothing to Disclose

Eva-Maria Noske, Abstract Co-Author: Nothing to Disclose

Johannes Kraft, Abstract Co-Author: Nothing to Disclose

Iris Burck MD, Abstract Co-Author: Nothing to Disclose

Claudia Frellesen, Abstract Co-Author: Nothing to Disclose

Josef Matthias Kerl MD, Abstract Co-Author: Research Consultant, Siemens AG Speakers Bureau, Siemens AG

Ralf W. Bauer MD, Abstract Co-Author: Research Consultant, Siemens AG Speakers Bureau, Siemens AG

Boris Bodelle MD, Abstract Co-Author: Nothing to Disclose

Thomas Lehnert MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, PhD, Abstract Co-Author: Nothing to Disclose

Boris Schulz MD, Abstract Co-Author: Nothing to Disclose

To evaluate virtual monoenergetic reconstructions of dual-energy computed tomography (DECT) regarding their impact on objective and subjective image quality in patients with head and neck squamous cell carcinoma (SCC).

71 Patients (53 male, 18 female; 59.3 years ± 12.0) with biopsy-confirmed untreated primary (n = 55) or recurrent (n = 16) head and neck SCC underwent DECT. Standard linear blending (30% of 80 kVp, 70% of 140 kVp) and four virtual monoenergetic image series at 40, 60, 80, 100 keV were reconstructed. Attenuation of tumor and other anatomic landmarks and image noise were measured, lesion contrast-to-noise ratio (CNR) was calculated. Two observers subjectively rated each image series using a 5-point scale regarding overall image quality, tumor delineation, image sharpness and noise.

Tumor attenuation peaked in the 40 keV reconstructions (140.2 HU ± 42.6) followed by the 60 keV (121.7 HU ± 25.5) and M_0.3 series (102.7 ± 22.3; all P < 0.001). Calculated lesion CNR was superior in the 60 keV reconstructions (6.76 ± 3.43) compared to the M_0.3 (5.24 ± 2.98; P < 0.006) and all other monoenergetic series (all P < 0.001). Subjective image quality (4.22; κ = 0.411) and tumor delineation was highest for the 60 keV reconstructions (4.35; κ = 0.459) followed by the M_0.3 series (3.81; κ = 0.394; 3.77; κ = 0.451; all P < 0.001). Differences between both series regarding image sharpness were non-significant (3.81 vs. 3.79; P = 0.78). Subjective rating regarding absence of image noise was rated highest for the 80 and 100 keV series (4.31 vs. 4.34; P = 0.522).

Virtual monoenergetic reconstructions at 60 keV of DECT data significantly improve objective tumor enhancement and CNR while subjective overall image quality and tumor delineation are also superior compared to the standard linear blending setting in patients with head and neck SCC.

Objective and subjective image quality can be significantly improved using monoenergetic reconstructions of DECT data in patients with head and neck squamous cell carcinoma.

Wichmann, J, Noske, E, Kraft, J, Burck, I, Frellesen, C, Kerl, J, Bauer, R, Bodelle, B, Lehnert, T, Vogl, T, Schulz, B, Virtual Monoenergetic Reconstructions of Dual-Energy CT Improve Image Quality and Delineation of Head and Neck Squamous Cell Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001012.html