Optimizing computed tomography enterography with virtual monoenergetic imaging of second-generation dual-layer spectral CT in inflammatory bowel disease
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Second-generation dual-layer spectral computed tomography enterography (DLCTE) provides advanced virtual monoenergetic imaging (VMI) that may overcome conventional computed tomography (CT) enterography limitations in inflammatory bowel disease (IBD). This study aimed to identify the optimal VMI energy level in spectral CT enterography for IBD using quantitative and qualitative image quality assessments. Methods: This case-control study retrospectively analyzed 44 patients with endoscopically confirmed active IBD undergoing DLCTE. Conventional polyenergetic images (PEIs) and VMIs (40-100 keV, 10-keV increments) were reconstructed across non-contrast, arterial, and venous phases. Quantitative metrics [contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), CT attenuation, image noise] and subjective image quality (5-point Likert scale) were compared between PEIs and VMIs. Results: 16.2±5.4]. Despite comparable noise levels between VMI 40-50 keV and PEIs (P>0.05), VMI ≥60 keV demonstrated significantly reduced noise (P<0.001). In subjective analyses, 40 keV VMI was consistently identified as the optimal reconstruction parameter among low-energy VMIs, receiving the highest ratings for overall image quality. Conclusions: The dual-layer detector spectral CT low-level VMI can optimize the image quality of CTE in IBD, and is useful to evaluate the intestinal inflammatory range. Among them, the VMI 60 keV imaging has the best display and can increase the diagnostic confidence in active IBD, and it is suitable for clinical promotion and use.
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W4416613406