Dual-Layer Detector Spectral CT in the Evaluation of Hepatocellular Carcinoma
Objective To evaluate the value of dual-layer detector spectral CT(DLCT)virtual monoenergetic images in the assessment of hepatocellular carcinoma(HCC).Methods A retrospective analysis was conducted on the clinical imaging data of 30 HCC patients who underwent examination in the Department of Radiology at the Henan Provincial People's Hospital between July 2023 and October 2023.All patients underwent a triphasic scan(plain scan,arterial phase,and portal venous phase)of the upper abdomen.Spectral image data was reconstructed using post-processing workstations to obtain four sets of virtual monoenergetic images(40 keV,50 keV,60 keV,and 120 keV)and 120 kV mixed energy images.Image analysis was performed on these five groups using objective evaluation metrics including CT value,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),as well as subjective scoring for image quality assessment.Results The subjective scores for 40 keV,50 keV,60 keV,120 keV,and 120 kV were(4.54±0.29),(3.78±0.17),(3.30±0.46),(2.28±0.24),and(3.02±0.24)respectively,with statistically significant differences in pairwise comparisons(P＜0.05).Among them,the 40 keV received the highest score,and as the energy level increased,the subjective score for image quality decreased progressively,indicating that the image quality score decreased with increasing energy levels,with the 120 kV image quality being higher than that of 120 keV.The image indicators at different energy levels showed significant variation.At 40 keV,the image CT value,CNR,and SNR were significantly higher than those at 50 keV,60 keV,120 keV,and 120 kV,with statistically significant differences(P＜0.05).As the energy levels increased(40 keV,50 keV,60 keV,120 keV),the CNR and SNR of the lesions gradually decreased.The CT value,CNR,and SNR at 120 kV were between those at 60 keV and 120 keV,suggesting that at 120 kV,the display quality of the patient's lesion was intermediate between 60 keV and 120 keV;at 40 keV,the display quality of the patient's lesion was superior to higher energy levels,and image quality at 40 keV,50 keV,60 keV,and 120 keV was inversely proportional to the energy level.Conclusion Low keV virtual monoenergetic imaging with dual-layer detector CT can improve the CT value,SNR,and CNR of HCC lesions and has a good image quality score,allowing for better display of HCC lesions in the arterial phase.
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