Carotid and cerebrovascular dual-energy computed tomography angiography: Optimization of window settings for virtual
Tommaso D'Angelo1, Lukas Lenga2, Christophe T Arendt2
1Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, Via Consolare Valeria 1, 98100, Messina, Italy.
Purpose:
Dedicated post-processing of dual-energy computed tomography angiography (DE-CTA) datasets has been shown to allow for increased vascular contrast. The goal of our study was to define optimal window settings for displaying virtual monoenergetic images (VMI) reconstructed from dual-energy carotid and cerebrovascular DE-CTA.
Methods:
Fifty-seven patients who underwent clinically-indicated carotid and cerebrovascular third-generation dual-source DE-CTA were retrospectively evaluated. Standard linearly-blended (M_0.6), 70-keV traditional VMI (M70), and 40-keV noise-optimized VMI (M40+) reconstructions were analyzed. For M70 and M40+ datasets, the subjectively best window setting (width and level, B-W/L) was independently determined by two observers and subsequently related with aortic arch attenuation to calculate optimized values (O-W/L) using linear regression. Subjective evaluation of image quality (IQ) between W/L settings were assessed by two additional readers. Repeated measures analysis of variance were performed to compare W/L settings and IQ indices between M_0.6, M70, and M40 + .
Results:
B-W/L and O-W/L for M70 were 580/210 and 560/200, and for M40+ were 1630/570 and 1560/550, respectively, higher than standard DE-CTA W/L settings (450/100). Highest subjective scores were observed for M40+ regarding overall IQ (all p < 0.001).
Conclusion:
Application of O-W/L settings is mandatory to optimize subjective IQ of VMI reconstructions of DE-CTA.
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