Interventional High Monoenergetic Spectral CT for Percutaneous Thermal Ablation Procedures

Area of Science:

• Medical Imaging
• Radiology
• Interventional Radiology

Background:

• Percutaneous thermal ablation requires precise image guidance.
• Metal artifacts from ablation probes can obscure critical structures on conventional CT images.
• Spectral CT offers advanced capabilities for artifact reduction.

Purpose of the Study:

• To assess the clinical utility of spectral CT for image guidance in percutaneous thermal ablation.
• To investigate the effectiveness of high monoenergetic (MonoE) spectral CT imaging in reducing metal artifacts.
• To compare MonoE spectral CT with conventional CT for ablation probe visualization.

Main Methods:

• A phantom study quantified metal artifacts using conventional and MonoE spectral CT (CCT).
• Reader studies with 10 patient cases involved radiologists selecting optimal MonoE settings and rating image quality.
• Likert scores were used to evaluate radiologist preference for MonoE versus conventional CCT.

Main Results:

• High MonoE spectral CT (150 keV) reduced metal artifacts by 63% compared to conventional CCT.
• Radiologists preferred MonoE settings around 151 keV.
• A mean Likert score of 1.2 indicated a preference for MonoE spectral CT, particularly when the probe was near critical structures.

Conclusions:

• High MonoE spectral CT is clinically preferred over conventional CCT for percutaneous thermal ablation.
• Spectral CT, at clinically feasible time frames, can effectively reduce metal artifacts while preserving soft tissue contrast.
• The findings support the use of 150 keV spectral CT images for improved visualization during ablation procedures.