Virtual versus true non-contrast images of the brain from spectral detector CT: comparison of attenuation values and image quality

Rivka Kessner*, Jennifer Sommer, Nils Große Hokamp, Kai R. Laukamp, Ameya Nayate

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Prior studies focused on utilization of dual-energy computed tomography (DECT) to better detect intracranial pathology and to reduce artifacts. It is still unclear whether virtual non-contrast (VNC) images of DECT can replace true non-contrast (TNC) images. Purpose: To compare attenuation values and image quality of VNC images to TNC images of the brain, obtained using spectral detector CT (SDCT). Material and Methods: We retrospectively evaluated patients that underwent head CT with and without contrast material, on a SDCT scanner at our institution (n = 33). The attenuation values of different brain structures were obtained from TNC images, the conventional images of the post-contrast exams (n = 16) or the CT angiography (CTA) (n = 17), and the derived VNC images. In total, 591 regions of interest were obtained, including white and gray matter. Two neuroradiologists independently evaluated the image quality of the VNC and TNC images, using a 5-point Likert scale. Results: The mean difference between the attenuation values on the VNC versus the TNC images was <4 HU for almost all the structures. The difference reached statistical significance (P < 0.05) for the deep gray structures but not for the white matter. The image quality score of the TNC images was 5 in all the patients (excellent gray–white matter differentiation). The scores of the VNC images differed between post-contrast and CTA examinations, with means of 4.9 ± 0.3 (excellent) and 3.2 ± 0.4 (fair), respectively (P < 0.001). Conclusion: Our results show minor differences between attenuation values of different brain structures on VNC versus TNC images of SDCT.

Original languageEnglish
Pages (from-to)776-783
Number of pages8
JournalActa Radiologica
Volume64
Issue number2
DOIs
StatePublished - Feb 2023

Keywords

  • Brain computed tomography
  • attenuation values
  • spectral detector computed tomography
  • virtual non-contrast images

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