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Abstract：
BACKGROUND: Prostate cancer is one of the most common malignant tumors in middle-aged and elderly men and carries significant prognostic implications, and recent studies suggest that dual-energy computed tomography (DECT) utilizing new virtual monoenergetic images can enhance cancer detection rates. This study aimed to assess the impact of virtual monoenergetic images reconstructed from DECT arterial phase scans on the image quality of prostate lesions and their diagnostic performance for prostate cancer.
METHODS: We conducted a retrospective analysis of 83 patients with prostate cancer or prostatic hyperplasia who underwent DECT scans at Meizhou People\'s Hospital between July 2019 and December 2023. The variables analyzed included age, tumor diameter and serum prostate-specific antigen (PSA) levels, among others. We also compared CT values, signal-to-noise ratio (SNR), subjective image quality ratings, and contrast-to-noise ratio (CNR) between virtual monoenergetic images (40-100 keV) and conventional linear blending images. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic efficacy of virtual monoenergetic images (40 keV and 50 keV) compared to conventional images.
RESULTS: Virtual monoenergetic images at 40 keV showed significantly higher CT values (168.19 ± 57.14) compared to conventional linear blending images (66.66 ± 15.5) for prostate cancer (P < 0.001). The 50 keV images also demonstrated elevated CT values (121.73 ± 39.21) compared to conventional images (P < 0.001). CNR values for the 40 keV (3.81 ± 2.13) and 50 keV (2.95 ± 1.50) groups were significantly higher than the conventional blending group (P < 0.001). Subjective evaluations indicated markedly better image quality scores for 40 keV (median score of 5) and 50 keV (median score of 5) images compared to conventional images (P < 0.05). ROC curve analysis revealed superior diagnostic accuracy for 40 keV (AUC: 0.910) and 50 keV (AUC: 0.910) images based on CT values compared to conventional images (AUC: 0.849).
CONCLUSIONS: Virtual monoenergetic images reconstructed at 40 keV and 50 keV from DECT arterial phase scans substantially enhance the image quality of prostate lesions and improve diagnostic efficacy for prostate cancer.
METHODS: We conducted a retrospective analysis of 83 patients with prostate cancer or prostatic hyperplasia who underwent DECT scans at Meizhou People\'s Hospital between July 2019 and December 2023. The variables analyzed included age, tumor diameter and serum prostate-specific antigen (PSA) levels, among others. We also compared CT values, signal-to-noise ratio (SNR), subjective image quality ratings, and contrast-to-noise ratio (CNR) between virtual monoenergetic images (40-100 keV) and conventional linear blending images. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic efficacy of virtual monoenergetic images (40 keV and 50 keV) compared to conventional images.
RESULTS: Virtual monoenergetic images at 40 keV showed significantly higher CT values (168.19 ± 57.14) compared to conventional linear blending images (66.66 ± 15.5) for prostate cancer (P < 0.001). The 50 keV images also demonstrated elevated CT values (121.73 ± 39.21) compared to conventional images (P < 0.001). CNR values for the 40 keV (3.81 ± 2.13) and 50 keV (2.95 ± 1.50) groups were significantly higher than the conventional blending group (P < 0.001). Subjective evaluations indicated markedly better image quality scores for 40 keV (median score of 5) and 50 keV (median score of 5) images compared to conventional images (P < 0.05). ROC curve analysis revealed superior diagnostic accuracy for 40 keV (AUC: 0.910) and 50 keV (AUC: 0.910) images based on CT values compared to conventional images (AUC: 0.849).
CONCLUSIONS: Virtual monoenergetic images reconstructed at 40 keV and 50 keV from DECT arterial phase scans substantially enhance the image quality of prostate lesions and improve diagnostic efficacy for prostate cancer.
摘要：
背景：前列腺癌是中老年男性最常见的恶性肿瘤之一，具有重要的预后意义，最近的研究表明，利用新的虚拟单能量图像的双能量计算机断层扫描（DECT）可以提高癌症的检出率。这项研究旨在评估从DECT动脉期扫描重建的虚拟单能量图像对前列腺病变的图像质量及其对前列腺癌的诊断性能的影响。
方法：回顾性分析2019年7月至2023年12月在梅州市人民医院行DECT扫描的83例前列腺癌或前列腺增生患者。分析的变量包括年龄，肿瘤直径和血清前列腺特异性抗原（PSA）水平，在其他人中。我们还比较了CT值，信噪比(SNR)，主观图像质量评级，虚拟单能量图像（40-100keV）和常规线性混合图像之间的对比度噪声比（CNR）。进行接收器工作特征（ROC）曲线分析，以评估虚拟单能量图像（40keV和50keV）与常规图像相比的诊断功效。
结果：40keV的虚拟单能量图像显示，与常规线性混合图像（66.66±15.5）相比，前列腺癌的CT值（168.19±57.14）明显更高（P<0.001）。与常规图像相比，50keV图像还显示出升高的CT值（121.73±39.21）（P<0.001）。40keV（3.81±2.13）和50keV（2.95±1.50）组的CNR值明显高于常规混合组（P<0.001）。主观评价表明,与常规图像相比,40keV(中值评分5)和50keV(中值评分5)图像的图像质量评分明显更好(P<0.05)。ROC曲线分析显示,与常规图像(AUC:0.849)相比,基于CT值的40keV(AUC:0.910)和50keV(AUC:0.910)图像的诊断准确性更高。
结论：从DECT动脉期扫描在40keV和50keV重建的虚拟单能量图像显著提高了前列腺病变的图像质量，提高了前列腺癌的诊断效能。
方法：回顾性分析2019年7月至2023年12月在梅州市人民医院行DECT扫描的83例前列腺癌或前列腺增生患者。分析的变量包括年龄，肿瘤直径和血清前列腺特异性抗原（PSA）水平，在其他人中。我们还比较了CT值，信噪比(SNR)，主观图像质量评级，虚拟单能量图像（40-100keV）和常规线性混合图像之间的对比度噪声比（CNR）。进行接收器工作特征（ROC）曲线分析，以评估虚拟单能量图像（40keV和50keV）与常规图像相比的诊断功效。
结果：40keV的虚拟单能量图像显示，与常规线性混合图像（66.66±15.5）相比，前列腺癌的CT值（168.19±57.14）明显更高（P<0.001）。与常规图像相比，50keV图像还显示出升高的CT值（121.73±39.21）（P<0.001）。40keV（3.81±2.13）和50keV（2.95±1.50）组的CNR值明显高于常规混合组（P<0.001）。主观评价表明,与常规图像相比,40keV(中值评分5)和50keV(中值评分5)图像的图像质量评分明显更好(P<0.05)。ROC曲线分析显示,与常规图像(AUC:0.849)相比,基于CT值的40keV(AUC:0.910)和50keV(AUC:0.910)图像的诊断准确性更高。
结论：从DECT动脉期扫描在40keV和50keV重建的虚拟单能量图像显著提高了前列腺病变的图像质量，提高了前列腺癌的诊断效能。
