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. 2022 Feb;40(2):177-183.
doi: 10.1007/s11604-021-01195-5. Epub 2021 Sep 13.

Usefulness of advanced monoenergetic reconstruction technique in dual-energy computed tomography for detecting bladder cancer

Motoo Nakagawa  1 , Taku Naiki  2 , Aya Naiki-Ito  3 , Yoshiyuki Ozawa  4 , Masashi Shimohira  4 , Masahiro Ohnishi  4 , Yuta Shibamoto  4
Affiliations

Usefulness of advanced monoenergetic reconstruction technique in dual-energy computed tomography for detecting bladder cancer

Motoo Nakagawa et al. Jpn J Radiol. 2022 Feb.

Abstract

Purpose: Detecting bladder cancer (BC) in routine CT images is important but is sometimes difficult when cancer is small. We evaluated the ability of 40-keV advanced monoenergetic images to depict BC.

Materials and methods: Fifty-two patients with a median age of 74 years (range 45-92) who were diagnosed as BC with transurethral resection or cystectomy, were included. They were examined with contrast-enhanced dual-energy CT (DE-CT) and advanced virtual monoenergetic images (40 keV) were reconstructed. For evaluating depictability of BC on 40-keV or virtual-120-kVp images, the difference in CT number between the cancer and bladder wall (BC-BW value) were calculated. We also subjectively assessed depictability of BC in virtual-120-kVp and 40-keV images using a 4-grade Likert scale (3: clear, 0: not visualized).

Results: In 42 of 52 patients, BC-BW values could be calculated because BC was detected on CT images. The mean BC-BW value at 40 keV was significantly higher than that of virtual 120 kVp [80.5 ± 54 (SD) vs. 11.4 ± 12.5 HU, P < 0.01]. Average scores of subjective evaluations in the virtual-120-kVp and 40-keV images were 1.7 ± 1.2 and 2.1 ± 1.2, respectively (P < 0.001).

Conclusion: The advanced monoenergetic reconstruction technique reconstructed using DE-CT image is useful to depict BC.

Keywords: Advanced virtual monoenergetic image; Bladder cancer; Dual energy CT.

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Conflict of interest statement

The other authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Stage pT1 invasive urothelial carcinoma in a 61-year-old man. Transverse CT images (a 40 keV, b 120 kVp, c excretory phase 120 kVp) show a mass (arrows) on the posterior bladder wall. The mass is more clearly depicted on 40-keV than on 120-kVp images (40 keV, grade 2; 120 kVp, grade 1; excretory phase, grade 3)
Fig. 2
Fig. 2
Stage pT1 invasive urothelial carcinoma with divergent differentiation in a 66-year-old man. Sagittal CT images (a 40 keV, b 120 kVp, c excretory phase 120 kVp) show a mass (arrows) on the dome of the bladder. The mass is not depicted on the excretory phase image because the anterior part of the inside of the bladder is not enhanced. The mass is more clearly depicted on 40-keV than on 120-kVp images (40 keV, grade 3; 120 kVp, grade 2; excretory phase, grade 0)
See this image and copyright information in PMC

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