Enhanced visualization of pulmonary perfusion in 4D Dual Energy CT images

Pulmonary embolism (PE) affects up to 600,000 patients and contributes to at least 100,000 deaths every year in the United States alone. Diagnosis of PE can be difficult as most symptoms are unspecific. Computed Tomography (CT) angiography is the reference for diagnosing PE. CT angiography produces grayscale images with darker areas representing any mass filling defects, making the analysis of the images difficult. This article demonstrates a method using the combination of energy levels in Dual Energy CT images to highlight the presence of PE in the lung. The results show that pairing different energy levels from 40 to 140 keV can increase the contrast between well perfused areas and underperfused areas of the lung. In addition, the visualization used in the current study complies with the window/level settings usually employed by radiologists.

[1]  M. Reiser,et al.  Dual-energy CT for the assessment of contrast material distribution in the pulmonary parenchyma. , 2009, AJR. American journal of roentgenology.

[2]  M Thelen,et al.  Pulmonary arteries and lung parenchyma in chronic pulmonary embolism: preoperative and postoperative CT findings. , 1994, Radiology.

[3]  F. Attneave Some informational aspects of visual perception. , 1954, Psychological review.

[4]  Henning Müller,et al.  Benefits of texture analysis of dual energy CT for Computer-Aided pulmonary embolism detection , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[5]  Konstantin Nikolaou,et al.  Dual energy CT for the assessment of lung perfusion--correlation to scintigraphy. , 2008, European journal of radiology.

[6]  Samuel Z Goldhaber,et al.  Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER) , 1999, The Lancet.

[7]  Chris R Chatwin,et al.  Three-Dimensional Selective-Scale Texture Analysis of Computed Tomography Pulmonary Angiograms , 2008, Investigative radiology.

[8]  M. Reiser,et al.  Material differentiation by dual energy CT: initial experience , 2007, European Radiology.

[9]  Rangaraj M. Rangayyan,et al.  Color Image Processing With Biomedical Applications , 2011 .

[10]  A Vieillard-Baron,et al.  New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. , 2001, AJR. American journal of roentgenology.

[11]  Dimitri Van De Ville,et al.  Rotation-covariant texture analysis of 4D dual-energy CT as an indicator of local pulmonary perfusion , 2013, 2013 IEEE 10th International Symposium on Biomedical Imaging.

[12]  D. Hosmer,et al.  A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. , 1991, Archives of internal medicine.

[13]  Joon Beom Seo,et al.  Dual-energy CT for assessment of the severity of acute pulmonary embolism: pulmonary perfusion defect score compared with CT angiographic obstruction score and right ventricular/left ventricular diameter ratio. , 2010, AJR. American journal of roentgenology.

[14]  Murat Topbas,et al.  The role of risk factors in delayed diagnosis of pulmonary embolism. , 2011, The American journal of emergency medicine.