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Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography

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Abstract

Dual-energy CT can be applied for bone elimination in cerebral CT angiography (CTA). The aim of this study was to compare the results of dual-energy direct bone removal CTA (DE-BR-CTA) with those of digital subtraction angiography (DSA). Twelve patients with intracranial aneurysms and/or ICA stenosis underwent a dual-source CT in dual-energy mode. Post-processing software selectively removed bone structures using the two energy data sets. Three-dimensional images with and without bone removal were reviewed and compared to DSA. Dual-energy bone removal was successful in all patients. For 10 patients, bone removal was good and CTA maximum-intensity projection (MIP) images could be used for vessel evaluation. For two patients, bone removal was moderate with some bone remnants, but this did not inhibit the three-dimensional visualization. Three aneurysms adjacent to the skull base were only partially visible in conventional CTA but were fully visible in DE-BR-CTA. In five patients with ICA stenosis, DE-BR-CTA revealed the stenotic lesions on the MIP images. The correlation between DSA and DE-BR-CTA was good (R 2=0.822), but DE-BR-CTA led to an overestimation of stenosis. DE-BR-CTA was able to eliminate bone structure using only a single CT data acquisition and is useful to evaluate intracranial aneurysms and stenosis.

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References

  1. Agid R, Lee SK, Willinsky RA et al (2006) Acute subarachnoid hemorrhage: using 64-slice multidetector CT angiography to “triage” patients’ treatment. Neuroradiology 48(11):787–794

    Article  PubMed  CAS  Google Scholar 

  2. Hashimoto H, Iida J, Hironaka Y et al (2000) Use of spiral computerized tomography angiography in patients with subarachnoid hemorrhage in whom subtraction angiography did not reveal cerebral aneurysms. J Neurosurg 92(2):278–283

    PubMed  CAS  Google Scholar 

  3. Hirai T, Korogi Y, Ono K et al (2001) Preoperative evaluation of intracranial aneurysms: usefulness of intraarterial 3D CT angiography and conventional angiography with a combined unit-initial experience. Radiology 220(2):499–505

    PubMed  CAS  Google Scholar 

  4. Jayakrishnan VK, White PM, Aitken D et al (2003) Subtraction helical CT angiography of intra- and extracranial vessels: technical considerations and preliminary experience. AJNR Am J Neuroradiol 24(3):451–455

    PubMed  Google Scholar 

  5. Lell M, Anders K, Klotz E et al (2006) Clinical evaluation of bone-subtraction CT angiography (BSCTA) in head and neck imaging. Eur Radiol 16(4):889–897

    Article  PubMed  CAS  Google Scholar 

  6. Sakamoto S, Kiura Y, Shibukawa M et al (2006) Subtracted 3D CT angiography for evaluation of internal carotid artery aneurysms: comparison with conventional digital subtraction angiography. AJNR Am J Neuroradiol 27(6):1332–1337

    PubMed  CAS  Google Scholar 

  7. Tomandl BF, Hammen T, Klotz E et al (2006) Bone-subtraction CT angiography for the evaluation of intracranial aneurysms. AJNR Am J Neuroradiol 27(1):55–59

    PubMed  CAS  Google Scholar 

  8. Venema HW, Hulsmans FJ, den Heeten GJ (2001) CT angiography of the circle of Willis and intracranial internal carotid arteries: maximum intensity projection with matched mask bone elimination-feasibility study. Radiology 218(3):893–898

    PubMed  CAS  Google Scholar 

  9. Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17(6):1510–1517

    Article  PubMed  Google Scholar 

  10. Samuels OB, Joseph GJ, Lynn MJ et al (2000) A standardized method for measuring intracranial arterial stenosis. AJNR Am J Neuroradiol 21(4):643–646

    PubMed  CAS  Google Scholar 

  11. Chiro GD, Brooks RA, Kessler RM et al (1979) Tissue signatures with dual-energy computed tomography. Radiology 131(2):521–523

    PubMed  CAS  Google Scholar 

  12. Millner MR, McDavid WD, Waggener RG et al (1979) Extraction of information from CT scans at different energies. Med Phys 6(1):70–71

    Article  PubMed  CAS  Google Scholar 

  13. Genant HK, Boyd D (1977) Quantitative bone mineral analysis using dual energy computed tomography. Invest Radiol 12(6):545–551

    Article  PubMed  CAS  Google Scholar 

  14. Laval-Jeantet AM, Cann CE, Roger B et al (1984) A postprocessing dual energy technique for vertebral CT densitometry. J Comput Assist Tomogr 8(6):1164–1167

    Article  PubMed  CAS  Google Scholar 

  15. Kelcz F, Joseph PM, Hilal SK (1979) Noise considerations in dual energy CT scanning. Med Phys 6(5):418–425

    Article  PubMed  CAS  Google Scholar 

  16. Primak AN, Fletcher JG, Vrtiska TJ et al (2007) Noninvasive differentiation of uric acid versus non-uric acid kidney stones using dual-energy CT. Acad Radiol 14(12):1441–1447

    Article  PubMed  Google Scholar 

  17. Scheffel H, Stolzmann P, Frauenfelder T et al (2007) Dual-energy contrast-enhanced computed tomography for the detection of urinary stone disease. Invest Radiol 42(12):823–829

    Article  PubMed  Google Scholar 

  18. Graser A, Johnson TR, Bader M et al (2008) Dual energy CT characterization of urinary calculi: initial in vitro and clinical experience. Invest Radiol 43(2):112–119

    Article  PubMed  Google Scholar 

  19. Sun C, Miao F, Wang XM et al (2008) An initial qualitative study of dual-energy CT in the knee ligaments. Surg Radiol Anat 30(5):443–447

    Article  PubMed  Google Scholar 

  20. Pozzi-Mucelli F, Bruni S, Doddi M et al (2007) Detection of intracranial aneurysms with 64 channel multidetector row computed tomography: comparison with digital subtraction angiography. Eur J Radiol 64(1):15–26

    Article  PubMed  Google Scholar 

  21. Gorzer H, Heimberger K, Schindler E (1994) Spiral CT angiography with digital subtraction of extra- and intracranial vessels. J Comput Assist Tomogr 18(5):839–841

    Article  PubMed  CAS  Google Scholar 

  22. Hoit DA, Malek AM (2006) Fusion of three-dimensional calcium rendering with rotational angiography to guide the treatment of a giant intracranial aneurysm: technical case report. Neurosurgery 58(1 Suppl):173–174

    Article  Google Scholar 

  23. Nguyen-Huynh MN, Wintermark M, English J et al (2008) How accurate is CT angiography in evaluating intracranial atherosclerotic disease? Stroke 39(4):1184–1188

    Article  PubMed  Google Scholar 

  24. Bash S, Villablanca JP, Jahan R et al (2005) Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography. AJNR Am J Neuroradiol 26(5):1012–1021

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, National Cardiovascular Center, Osaka, Japan

    Yoshiyuki Watanabe, Kensuke Uotani, Tetsuro Nakazawa, Masahiro Higashi, Naoaki Yamada, Yoshiro Hori, Suzu Kanzaki, Tetsuya Fukuda & Hiroaki Naito

  2. Department of Radiology, St. Luke’s International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8565, Japan

    Yoshiyuki Watanabe

  3. Siemens Asahi Medical Technologies, Tokyo, Japan

    Toshihide Itoh

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  1. Yoshiyuki Watanabe
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  2. Kensuke Uotani
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  3. Tetsuro Nakazawa
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  4. Masahiro Higashi
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  5. Naoaki Yamada
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  6. Yoshiro Hori
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  7. Suzu Kanzaki
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  8. Tetsuya Fukuda
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  9. Toshihide Itoh
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  10. Hiroaki Naito
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Correspondence to Yoshiyuki Watanabe.

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Watanabe, Y., Uotani, K., Nakazawa, T. et al. Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography. Eur Radiol 19, 1019–1024 (2009). https://doi.org/10.1007/s00330-008-1213-5

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  • DOI: https://doi.org/10.1007/s00330-008-1213-5

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