Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging

Autores
Rodriguez Granillo, Gaston Alfredo; Cirio, Juan; Morales, Celina; Safady, Jorge; Fontana, Lucia; Fernandez, Martin; Diluca, Pablo; Lylyk, Pedro
Año de publicación
2024
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
The potential clinical usefulness of electron density (ED) imaging, that can be directly estimated using dual-layer spectral computed tomography (CT), has been poorly investigated. We explored whether ED imaging might improve thrombus identification compared to conventional imaging in vitro. We evaluated mechanical thrombectomy material obtained from patients with acute ischemic stroke (AIS) treated in a tertiary level stroke center and immediately fixed in 10% neutral buffered formalin and stored in polystyrene test tubes. The test tubes were immersed in a bucket of water for evaluation by spectral CT, along with scattered control tubes. All images were obtained using a dual-layer detector CT scanner. Each tube was assessed using multiparametric side-by-side view of conventional CT (120 kVp), low monoenergetic imaging (40 keV), and ED images. Fifty-eight polystyrene tubes were analyzed, comprising 52 tubes with thrombectomy material of at least 1 mm2 size obtained from 52 AIS patients, and six control tubes filled with formalin. ED imaging identified accurately the presence of material in all tubes, whereas 2 (3%) of the tubes containing thrombus were not identified by conventional CT, leading to a very good agreement between observers for the presence of material using conventional CT and ED imaging (kappa =0.84, P<0.001). Using ED imaging, thrombus material showed a mean density of 108.8±2.9 percent ED relative to water (%EDW), water had a mean density of 100.0±0.3 %EDW, and formalin a mean density of 103.5±1.2 %EDW. Compared to conventional imaging and 40 keV monoenergetic, ED imaging had a significantly higher signal-to-noise ratio (conventional 10.4±7.0, vs. 40 keV 11.5±8.4, vs. ED 490.0±304.5, P<0.001) and contrast-to-noise ratio (CNR) (conventional 4.3±4.3, vs. 40 keV 5.7±11.2, vs. ED 37.8±29.1, P<0.001). In this in-vitro study, we demonstrated improved visualization of thrombus with ED imaging compared to conventional imaging and low monoenergetic imaging, with a significant increase in CNR.
Fil: Rodriguez Granillo, Gaston Alfredo. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Cirio, Juan. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Morales, Celina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiopatología Cardiovascular; Argentina
Fil: Safady, Jorge. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Fontana, Lucia. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Fernandez, Martin. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Diluca, Pablo. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Lylyk, Pedro. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Materia
DUAL ENERGY
COMPUTED TOMOGRAPHY
SPECTRAL
TISSUE CHARACTERIZATION
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acceso abierto
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https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/260798
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oai_identifier_str oai:ri.conicet.gov.ar:11336/260798
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imagingRodriguez Granillo, Gaston AlfredoCirio, JuanMorales, CelinaSafady, JorgeFontana, LuciaFernandez, MartinDiluca, PabloLylyk, PedroDUAL ENERGYCOMPUTED TOMOGRAPHYSPECTRALTISSUE CHARACTERIZATIONhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3The potential clinical usefulness of electron density (ED) imaging, that can be directly estimated using dual-layer spectral computed tomography (CT), has been poorly investigated. We explored whether ED imaging might improve thrombus identification compared to conventional imaging in vitro. We evaluated mechanical thrombectomy material obtained from patients with acute ischemic stroke (AIS) treated in a tertiary level stroke center and immediately fixed in 10% neutral buffered formalin and stored in polystyrene test tubes. The test tubes were immersed in a bucket of water for evaluation by spectral CT, along with scattered control tubes. All images were obtained using a dual-layer detector CT scanner. Each tube was assessed using multiparametric side-by-side view of conventional CT (120 kVp), low monoenergetic imaging (40 keV), and ED images. Fifty-eight polystyrene tubes were analyzed, comprising 52 tubes with thrombectomy material of at least 1 mm2 size obtained from 52 AIS patients, and six control tubes filled with formalin. ED imaging identified accurately the presence of material in all tubes, whereas 2 (3%) of the tubes containing thrombus were not identified by conventional CT, leading to a very good agreement between observers for the presence of material using conventional CT and ED imaging (kappa =0.84, P<0.001). Using ED imaging, thrombus material showed a mean density of 108.8±2.9 percent ED relative to water (%EDW), water had a mean density of 100.0±0.3 %EDW, and formalin a mean density of 103.5±1.2 %EDW. Compared to conventional imaging and 40 keV monoenergetic, ED imaging had a significantly higher signal-to-noise ratio (conventional 10.4±7.0, vs. 40 keV 11.5±8.4, vs. ED 490.0±304.5, P<0.001) and contrast-to-noise ratio (CNR) (conventional 4.3±4.3, vs. 40 keV 5.7±11.2, vs. ED 37.8±29.1, P<0.001). In this in-vitro study, we demonstrated improved visualization of thrombus with ED imaging compared to conventional imaging and low monoenergetic imaging, with a significant increase in CNR.Fil: Rodriguez Granillo, Gaston Alfredo. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Cirio, Juan. Clinica la Sagrada Familia. Instituto Medico Eneri; ArgentinaFil: Morales, Celina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiopatología Cardiovascular; ArgentinaFil: Safady, Jorge. Clinica la Sagrada Familia. Instituto Medico Eneri; ArgentinaFil: Fontana, Lucia. Clinica la Sagrada Familia. Instituto Medico Eneri; ArgentinaFil: Fernandez, Martin. Clinica la Sagrada Familia. Instituto Medico Eneri; ArgentinaFil: Diluca, Pablo. Clinica la Sagrada Familia. Instituto Medico Eneri; ArgentinaFil: Lylyk, Pedro. Clinica la Sagrada Familia. Instituto Medico Eneri; ArgentinaAME Publishing Company2024-04info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/260798Rodriguez Granillo, Gaston Alfredo; Cirio, Juan; Morales, Celina; Safady, Jorge; Fontana, Lucia; et al.; Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging; AME Publishing Company; Cardiovascular Diagnosis and Therapy; 14; 2; 4-2024; 304-3102223-36522223-3660CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://cdt.amegroups.org/article/view/123793/htmlinfo:eu-repo/semantics/altIdentifier/doi/10.21037/cdt-24-28info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:06:09Zoai:ri.conicet.gov.ar:11336/260798instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:06:10.1CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
title Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
spellingShingle Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
Rodriguez Granillo, Gaston Alfredo
DUAL ENERGY
COMPUTED TOMOGRAPHY
SPECTRAL
TISSUE CHARACTERIZATION
title_short Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
title_full Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
title_fullStr Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
title_full_unstemmed Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
title_sort Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging
dc.creator.none.fl_str_mv Rodriguez Granillo, Gaston Alfredo
Cirio, Juan
Morales, Celina
Safady, Jorge
Fontana, Lucia
Fernandez, Martin
Diluca, Pablo
Lylyk, Pedro
author Rodriguez Granillo, Gaston Alfredo
author_facet Rodriguez Granillo, Gaston Alfredo
Cirio, Juan
Morales, Celina
Safady, Jorge
Fontana, Lucia
Fernandez, Martin
Diluca, Pablo
Lylyk, Pedro
author_role author
author2 Cirio, Juan
Morales, Celina
Safady, Jorge
Fontana, Lucia
Fernandez, Martin
Diluca, Pablo
Lylyk, Pedro
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv DUAL ENERGY
COMPUTED TOMOGRAPHY
SPECTRAL
TISSUE CHARACTERIZATION
topic DUAL ENERGY
COMPUTED TOMOGRAPHY
SPECTRAL
TISSUE CHARACTERIZATION
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv The potential clinical usefulness of electron density (ED) imaging, that can be directly estimated using dual-layer spectral computed tomography (CT), has been poorly investigated. We explored whether ED imaging might improve thrombus identification compared to conventional imaging in vitro. We evaluated mechanical thrombectomy material obtained from patients with acute ischemic stroke (AIS) treated in a tertiary level stroke center and immediately fixed in 10% neutral buffered formalin and stored in polystyrene test tubes. The test tubes were immersed in a bucket of water for evaluation by spectral CT, along with scattered control tubes. All images were obtained using a dual-layer detector CT scanner. Each tube was assessed using multiparametric side-by-side view of conventional CT (120 kVp), low monoenergetic imaging (40 keV), and ED images. Fifty-eight polystyrene tubes were analyzed, comprising 52 tubes with thrombectomy material of at least 1 mm2 size obtained from 52 AIS patients, and six control tubes filled with formalin. ED imaging identified accurately the presence of material in all tubes, whereas 2 (3%) of the tubes containing thrombus were not identified by conventional CT, leading to a very good agreement between observers for the presence of material using conventional CT and ED imaging (kappa =0.84, P<0.001). Using ED imaging, thrombus material showed a mean density of 108.8±2.9 percent ED relative to water (%EDW), water had a mean density of 100.0±0.3 %EDW, and formalin a mean density of 103.5±1.2 %EDW. Compared to conventional imaging and 40 keV monoenergetic, ED imaging had a significantly higher signal-to-noise ratio (conventional 10.4±7.0, vs. 40 keV 11.5±8.4, vs. ED 490.0±304.5, P<0.001) and contrast-to-noise ratio (CNR) (conventional 4.3±4.3, vs. 40 keV 5.7±11.2, vs. ED 37.8±29.1, P<0.001). In this in-vitro study, we demonstrated improved visualization of thrombus with ED imaging compared to conventional imaging and low monoenergetic imaging, with a significant increase in CNR.
Fil: Rodriguez Granillo, Gaston Alfredo. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Cirio, Juan. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Morales, Celina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiopatología Cardiovascular; Argentina
Fil: Safady, Jorge. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Fontana, Lucia. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Fernandez, Martin. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Diluca, Pablo. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
Fil: Lylyk, Pedro. Clinica la Sagrada Familia. Instituto Medico Eneri; Argentina
description The potential clinical usefulness of electron density (ED) imaging, that can be directly estimated using dual-layer spectral computed tomography (CT), has been poorly investigated. We explored whether ED imaging might improve thrombus identification compared to conventional imaging in vitro. We evaluated mechanical thrombectomy material obtained from patients with acute ischemic stroke (AIS) treated in a tertiary level stroke center and immediately fixed in 10% neutral buffered formalin and stored in polystyrene test tubes. The test tubes were immersed in a bucket of water for evaluation by spectral CT, along with scattered control tubes. All images were obtained using a dual-layer detector CT scanner. Each tube was assessed using multiparametric side-by-side view of conventional CT (120 kVp), low monoenergetic imaging (40 keV), and ED images. Fifty-eight polystyrene tubes were analyzed, comprising 52 tubes with thrombectomy material of at least 1 mm2 size obtained from 52 AIS patients, and six control tubes filled with formalin. ED imaging identified accurately the presence of material in all tubes, whereas 2 (3%) of the tubes containing thrombus were not identified by conventional CT, leading to a very good agreement between observers for the presence of material using conventional CT and ED imaging (kappa =0.84, P<0.001). Using ED imaging, thrombus material showed a mean density of 108.8±2.9 percent ED relative to water (%EDW), water had a mean density of 100.0±0.3 %EDW, and formalin a mean density of 103.5±1.2 %EDW. Compared to conventional imaging and 40 keV monoenergetic, ED imaging had a significantly higher signal-to-noise ratio (conventional 10.4±7.0, vs. 40 keV 11.5±8.4, vs. ED 490.0±304.5, P<0.001) and contrast-to-noise ratio (CNR) (conventional 4.3±4.3, vs. 40 keV 5.7±11.2, vs. ED 37.8±29.1, P<0.001). In this in-vitro study, we demonstrated improved visualization of thrombus with ED imaging compared to conventional imaging and low monoenergetic imaging, with a significant increase in CNR.
publishDate 2024
dc.date.none.fl_str_mv 2024-04
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/260798
Rodriguez Granillo, Gaston Alfredo; Cirio, Juan; Morales, Celina; Safady, Jorge; Fontana, Lucia; et al.; Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging; AME Publishing Company; Cardiovascular Diagnosis and Therapy; 14; 2; 4-2024; 304-310
2223-3652
2223-3660
CONICET Digital
CONICET
url http://hdl.handle.net/11336/260798
identifier_str_mv Rodriguez Granillo, Gaston Alfredo; Cirio, Juan; Morales, Celina; Safady, Jorge; Fontana, Lucia; et al.; Thrombus discrimination with electron density: Potential implications for non-contrast computed tomography imaging; AME Publishing Company; Cardiovascular Diagnosis and Therapy; 14; 2; 4-2024; 304-310
2223-3652
2223-3660
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://cdt.amegroups.org/article/view/123793/html
info:eu-repo/semantics/altIdentifier/doi/10.21037/cdt-24-28
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv AME Publishing Company
publisher.none.fl_str_mv AME Publishing Company
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.13397

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