{
    "abstract": "To evaluate the image quality and suitability of Dual-Source Dual-Energy CT venography (DSDE-CTV) with asynchronous virtual monoenergetic images (VMI+) of the entire lower extremity in the context of pre-surgical assessment of complex cases prior to coronary bypass graft as a feasibility study.\nFifteen consecutive patients, consisting of 5 females and 10 males with an average age of 52 \u00b1 17 years underwent DSDE-CTV from the pubic symphysis to the ankles after intravenous injection of an iodinated contrast medium. DSDE-CTV was acquired with tube voltages of 80 kVp and sn140 kVp. Single spectrum images (A - 80 kVp; B - 140 kVp) as well as a linearly blended mixed data set (M_0.6) were reconstructed. By postprocessing, an VMI+ dataset at 40 keV was generated. Objective image quality parameters of the deep and superficial veins of thigh, knee, and calves were measured separately for each location. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Additionally, subjective image quality was assessed independently by two radiologists.\nMean vascular attenuation was 73.9 \u00b1 17.8 HU at B, 113.7 \u00b1 42.2 HU at M_0.6, 119.4 \u00b1 45.5 HU at A, and 201.0 \u00b1 89.7 HU at VMI+. Mean CNR was 6.7 \u00b1 2.0 at 140 keV, 9.25 \u00b1 2.3 in the M_0.6 datasets, 8.7 \u00b1 3.0 at 80 keV, and 12.9 \u00b1 4.3 at 40 keV. Attenuation values were approximately doubled when compared to the reference standard (M_0.6) with significantly improved SNR and CNR (p < 0.05). Subjective image quality scores were highest for VMI+ datasets (4.1 \u00b1 0.5) and lowest for B datasets (2.3 \u00b1 0.37), however differences between VMI+ datasets and M_0.6 datasets did not reach statistical significance.\nPostprocessing of dual-energy CTV with VMI+ significantly increases attenuation of veins and markedly improves SNR and CNR values, thereby improving the diagnostic quality of CTV for the evaluation of deep and superficial veins of the entire lower limb prior to coronary bypass graft.",
    "authors": [
        {
            "affiliation": "Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany. Electronic address: jschmoee@ukaachen.de.",
            "firstname": "Jonas",
            "initials": "J",
            "lastname": "Schmoee"
        },
        {
            "affiliation": "Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.",
            "firstname": "Timm",
            "initials": "T",
            "lastname": "Dirrichs"
        },
        {
            "affiliation": "Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.",
            "firstname": "Kerstin",
            "initials": "K",
            "lastname": "Fehrenbacher"
        },
        {
            "affiliation": "Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.",
            "firstname": "Eric",
            "initials": "E",
            "lastname": "Tietz"
        },
        {
            "affiliation": "University Hospital, RWTH Aachen University, Aachen, Germany.",
            "firstname": "Felix",
            "initials": "F",
            "lastname": "Hardt"
        },
        {
            "affiliation": "Department of Cardiac, Thoracic and Vascular Surgery, University Hospital, RWTH Aachen University, Aachen, Germany.",
            "firstname": "Michael",
            "initials": "M",
            "lastname": "Schmid"
        },
        {
            "affiliation": "Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany; Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany.",
            "firstname": "Robin Fabian",
            "initials": "RF",
            "lastname": "Gohmann"
        },
        {
            "affiliation": "Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.",
            "firstname": "Sebastian Daniel",
            "initials": "SD",
            "lastname": "Reinartz"
        }
    ],
    "conclusions": "Postprocessing of dual-energy CTV with VMI+ significantly increases attenuation of veins and markedly improves SNR and CNR values, thereby improving the diagnostic quality of CTV for the evaluation of deep and superficial veins of the entire lower limb prior to coronary bypass graft.",
    "copyrights": "Copyright \u00a9 2019 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.acra.2019.11.005",
    "journal": "Academic radiology",
    "keywords": [
        "Computed tomography angiography/methods",
        "Dual-energy",
        "Multidetector computed tomography/methods",
        "Phlebography",
        "Phlebography/methods"
    ],
    "methods": null,
    "publication_date": "2019-12-18",
    "pubmed_id": "31843393",
    "results": "Mean vascular attenuation was 73.9 \u00b1 17.8 HU at B, 113.7 \u00b1 42.2 HU at M_0.6, 119.4 \u00b1 45.5 HU at A, and 201.0 \u00b1 89.7 HU at VMI+. Mean CNR was 6.7 \u00b1 2.0 at 140 keV, 9.25 \u00b1 2.3 in the M_0.6 datasets, 8.7 \u00b1 3.0 at 80 keV, and 12.9 \u00b1 4.3 at 40 keV. Attenuation values were approximately doubled when compared to the reference standard (M_0.6) with significantly improved SNR and CNR (p < 0.05). Subjective image quality scores were highest for VMI+ datasets (4.1 \u00b1 0.5) and lowest for B datasets (2.3 \u00b1 0.37), however differences between VMI+ datasets and M_0.6 datasets did not reach statistical significance.",
    "title": "Virtual Monoenergetic Images (VMI+) in Dual-Source Dual-Energy CT Venography (DSDE-CTV) of the Lower Extremity Prior to Coronary Artery Bypass Graft (CABG): A Feasibility Study.",
    "xml": "<Element 'PubmedArticle' at 0x788504c8b380>"
}