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. 2021 Apr;50(4):693-703.
doi: 10.1007/s00256-020-03603-9. Epub 2020 Sep 18.

Dual-energy CT arthrography: a feasibility study

Rashpal Sandhu  1 , Mercan Aslan  1 , Nancy Obuchowski  2 , Andrew Primak  3 , Wadih Karim  1 , Naveen Subhas  4
Affiliations

Dual-energy CT arthrography: a feasibility study

Rashpal Sandhu et al. Skeletal Radiol. 2021 Apr.

Abstract

Objective: To evaluate the feasibility of producing 2-dimensional (2D) virtual noncontrast images and 3-dimensional (3D) bone models from dual-energy computed tomography (DECT) arthrograms and to determine whether this is best accomplished using 190 keV virtual monoenergetic images (VMI) or virtual unenhanced (VUE) images.

Materials and methods: VMI and VUE images were retrospectively reconstructed from patients with internal derangement of the shoulder or knee joint who underwent DECT arthrography between September 2017 and August 2019. A region of interest was placed in the area of brightest contrast, and the mean attenuation (in Hounsfield units [HUs]) was recorded. Two blinded musculoskeletal radiologists qualitatively graded the 2D images and 3D models using scores ranging from 0 to 3 (0 considered optimal).

Results: Twenty-six patients (mean age ± SD, 57.5 ± 16.8 years; 6 women) were included in the study. The contrast attenuation on VUE images (overall mean ± SD, 10.5 ± 16.4 HU; knee, 19.3 ± 10.7 HU; shoulder, 5.0 ± 17.2 HU) was significantly lower (p < 0.001 for all comparisons) than on VMI (overall mean ± SD, 107.7 ± 43.8 HU; knee, 104.6 ± 31.1 HU; shoulder, 109.6 ± 51.0 HU). The proportion of cases with optimal scores (0 or 1) was significantly higher with VUE than with VMI for both 2D and 3D images (p < 0.001).

Conclusions: DECT arthrography can be used to produce 2D virtual noncontrast images and to generate 3D bone models. The VUE technique is superior to VMI in producing virtual noncontrast images.

Keywords: CT arthrography; CT technique; Dual-energy CT; Virtual monoenergetic; Virtual noncontrast.

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