Dual-layer spectral detector computed tomography for adrenal adenoma characterization: radiation dose reduction and quantitative agreement of multiphase virtual noncontrast with true noncontrast imaging
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Computed tomography (CT) is the preferred imaging modality for evaluating adrenal lesions; however, the associated radiation exposure remains a significant concern. Dual-layer spectral detector CT (SDCT)-derived virtual noncontrast (VNC) images may reduce radiation exposure by eliminating dedicated noncontrast scans, yet their agreement with true noncontrast (TNC) imaging remains debated. This study aimed to quantitatively evaluate the agreement and image quality of VNC images [reconstructed from the arterial phase (VNCa) and portal venous phase (VNCp)] compared to TNC images in adrenal adenomas stratified by lipid content, and to assess the radiation dose reduction. Methods: -tests and Wilcoxon signed-rank tests. The radiation dose with and without TNC was calculated. Results: 1.55±0.67; P<0.001). In lipid-rich adenomas, VNC images overestimated CT attenuation, showing high absolute attenuation errors (VNCaerror: 9.92±6.49 HU; VNCperror: 8.50±5.17 HU), although these remained within the acceptable threshold of ≤10 HU. In the subjective scores of image quality, TNC images outperformed VNC images [TNC: median 5, interquartile range (IQR) 5-5; VNC: median 5 (IQR 4-5); P<0.001], although VNC scores remained high. No significant statistical difference was observed between the VNCa and VNCp scores (P>0.05). For most of the surrounding nonadenoma tissues, VNC and TNC images demonstrated good agreement, with attenuation differences consistently within ≤10 HU. Replacing TNC images with VNCa images could reduce the effective dose by approximately 32.63% for lipid-poor adenomas. Conclusions: Our findings suggest that for lipid-poor adenomas, VNCa demonstrates high agreement with TNC and provides superior image quality, supporting its use as a TNC substitute for reduced radiation dose. For lipid-rich adenomas, VNC should be applied with caution due to the potential risk of attenuation overestimation. Subtype classification remains essential in such studies.
Authors: Deying Wen, Wen Li, Ling Zhao, Qinglin Du, Xiaoyu Tong, Ailin Liang, Tengxin Wang, Zheng Li, Xiaodi Zhang, Haiwei Liu, Yan Ren, Jiayu Sun
Institutions: Sichuan University, West China Hospital of Sichuan University
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W4413369233