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Title: Individually optimized uniform contrast enhancement in CT angiography for the diagnosis of pulmonary thromboembolic disease—A simulation study

Purpose: To improve the diagnostic quality of CT pulmonary angiography (CTPA) by individually optimizing a biphasic contrast injection function to achieve targeted uniform contrast enhancement. To compare the results against a previously reported discrete Fourier transform (DFT) approach. Methods: This simulation study used the CTPA datasets of 27 consecutive patients with pulmonary thromboembolic disease (PE). An optimization approach was developed consisting of (1) computation of the impulse enhancement function (IEF) based on a test bolus scan, and (2) optimization of a biphasic contrast injection function using the IEF in order to achieve targeted uniform enhancement. The injection rates and durations of a biphasic contrast injection function are optimized by minimizing the difference between the resulting contrast enhancement curve and the targeted uniform enhancement curve, while conforming to the clinical constraints of injection rate and total contrast volume. The total contrast volume was limited first to the clinical standard of 65 ml, and then to the same amount used in the DFT approach for comparison. The optimization approach and the DFT approach were compared in terms of the root mean square error (RMSE) and total contrast volume used. Results: When the total contrast volume was limited to 65 ml, the optimizationmore » approach produced significantly better contrast enhancement (closer to the targeted uniform contrast enhancement) than the DFT approach (RMSE 17 HU vs 56 HU,p < 0.00001). On average, the optimization approach used 63 ml contrast, while the DFT approach used 50 ml with four patients exceeding 65 ml. When equivalent total contrast volume was used for individual patient, the optimization approach still generated significantly better contrast enhancement (RMSE 44 HU vs 56 HU, p < 0.01). Constraints for the injection function could be easily accommodated into the optimization process when searching for the optimal biphasic injection function. Conclusions: The optimization approach generated individually optimized biphasic injection functions yielding significantly better contrast enhancement compared to the DFT approach. This new approach has the potential to improve the diagnostic quality of CTPA for PE.« less
Authors:
; ; ;  [1] ;  [2] ;  [3]
  1. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201 (United States)
  2. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201 (United States)
  3. Philips Healthcare, Cleveland, Ohio 44143 (United States)
Publication Date:
OSTI Identifier:
22251916
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 40; Journal Issue: 12; Other Information: (c) 2013 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; BLOOD VESSELS; CALCULATION METHODS; COMPARATIVE EVALUATIONS; DATASETS; DIAGNOSIS; ERRORS; FOURIER TRANSFORMATION; LIMITING VALUES; OPTIMIZATION; PATIENTS; SIMULATION