Non-linear image blending improves visualization of head and neck primary squamous cell carcinoma compared to linear blending in dual-energy CT.

AIM To compare non-linear and linear image-blending post-processing techniques in dual-energy CT (DECT) of primary head and neck squamous cell carcinoma (SCC) regarding subjective and objective image quality. MATERIALS AND METHODS Head and neck DECT studies from 69 patients (48 male, 21 female; mean age 62.3 years) were retrospectively evaluated. All tumour lesions were histologically confirmed SCC. Linearly blended 80/140 kVp images series with varying weighting factors of 0.3 (M_0.3), 0.6 and 0.8 were compared with non-linearly blended images. Attenuation of tumour lesion, various soft-tissue structures, the internal jugular vein, and image noise were measured, tumour signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Overall image quality, delineation of tumour lesion, image sharpness, and noise level were rated individually by three radiologists using five-point Likert scales. Interobserver agreement was calculated using intraclass correlation coefficient (ICC). RESULTS Enhancement of tumour lesions (non-linear, 137.5 ± 20.1 HU; M_0.3, 92.7 ± 14.4 HU; M_0.6, 110 ± 15.4 HU; M_0.8, 123 ± 18.2 HU), CNR (non-linear, 12 ± 8; M_0.3, 4 ± 4.7; M_0.6, 7.5 ± 5.5; M_0.8, 8 ± 5.5), subjective overall image quality and tumour delineation were significantly increased (all p < 0.001) with the non-linear blending technique compared to all investigated linear blending weighting factors. Overall interobserver agreement was substantial (ICC 0.70; 95% CI: 0.66-0.73). CONCLUSION Post-processing of DECT using a non-linear blending technique provides improved objective and subjective image quality of head and neck SCC compared to linearly blended images series.

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

[2]  M G Mack,et al.  Image Quality and Radiation Dose of Dual-Energy CT of the Head and Neck Compared with a Standard 120-kVp Acquisition , 2011, American Journal of Neuroradiology.

[3]  Ralf W. Bauer,et al.  Dual-Energy CT of Head and Neck Cancer: Average Weighting of Low- and High-Voltage Acquisitions to Improve Lesion Delineation and Image Quality—Initial Clinical Experience , 2012, Investigative radiology.

[4]  Thomas Flohr,et al.  Image Fusion in Dual Energy Computed Tomography: Effect on Contrast Enhancement, Signal-to-Noise Ratio and Image Quality in Computed Tomography Angiography , 2009, Investigative radiology.

[5]  Y. Yamashita,et al.  Low-kilovoltage, high-tube-current MDCT of liver in thin adults: pilot study evaluating radiation dose, image quality, and display settings. , 2011, AJR. American journal of roentgenology.

[6]  Richard A. Robb,et al.  Dual energy CT: How to best blend both energies in one fused image? , 2008, SPIE Medical Imaging.

[7]  B. Schmidt,et al.  Dual Energy CT With Nonlinear Image Blending Improves Visualization of Delayed Myocardial Contrast Enhancement in Acute Myocardial Infarction , 2013, Investigative radiology.

[8]  T. Lehnert,et al.  Non-linear blending of dual-energy CT data improves depiction of late iodine enhancement in chronic myocardial infarction , 2014, The International Journal of Cardiovascular Imaging.

[9]  Hersh Chandarana,et al.  Dual-source dual-energy MDCT of pancreatic adenocarcinoma: initial observations with data generated at 80 kVp and at simulated weighted-average 120 kVp. , 2010, AJR. American journal of roentgenology.

[10]  B. Krauss,et al.  Dual-energy computed tomography (DECT) in renal masses: nonlinear versus linear blending. , 2012, Academic radiology.

[11]  D. Hough,et al.  Evaluation of non-linear blending in dual-energy computed tomography. , 2008, European journal of radiology.

[12]  Zheng-yu Jin,et al.  Clinical Value of Dual-energy CT in Detection of Pancreatic Adenocarcinoma: Investigation of the Best Pancreatic Tumor Contrast to Noise Ratio. , 2012, Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih.

[13]  P. Hou,et al.  Use of non-linear image blending with dual-energy CT improves vascular visualization in abdominal angiography. , 2014, Clinical radiology.

[14]  C. Czerny,et al.  Can dual-energy CT improve the assessment of tumor margins in oral cancer? , 2014, Oral oncology.

[15]  G. Rubin,et al.  Coronary artery: quantitative evaluation of normal diameter determined with electron-beam CT compared with cine coronary angiography initial experience. , 2003, Radiology.

[16]  Thomas J. Vogl,et al.  Comparison of dual-energy CT-derived iodine content and iodine overlay of normal, inflammatory and metastatic squamous cell carcinoma cervical lymph nodes , 2013, European Radiology.

[17]  J. Paul.  Individually adapted coronary 64-slice CT angiography based on precontrast attenuation values, using different kVp and tube current settings: evaluation of image quality , 2011, The International Journal of Cardiovascular Imaging.

[18]  Lifeng Yu,et al.  Pilot multi-reader study demonstrating potential for dose reduction in dual energy hepatic CT using non-linear blending of mixed kV image datasets , 2011, European Radiology.

[19]  T. Yamanaka,et al.  Evaluation of cartilage invasion by laryngeal and hypopharyngeal squamous cell carcinoma with dual-energy CT. , 2012, Radiology.

[20]  S. Schoenberg,et al.  Current oncologic concepts and emerging techniques for imaging of head and neck squamous cell cancer , 2012, GMS current topics in otorhinolaryngology, head and neck surgery.

[21]  Takeshi Nakaura,et al.  Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. , 2005, Radiology.

[22]  H. Maier,et al.  Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases. , 2013, European journal of radiology.

[23]  R. Sader,et al.  Dual-energy CT applications in head and neck imaging. , 2012, AJR. American journal of roentgenology.