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Article

Virtual Non-Contrast Spectral CT in Renal Masses: Is It Time to Discard Conventional Unenhanced Phase?

by
Giuseppe M. Bucolo
1,*,
Velio Ascenti
2,
Simone Barbera
1,
Federico Fontana
3,
Francesco M. Aricò
1,
Filippo Piacentino
3,
Andrea Coppola
3,
Giuseppe Cicero
1,
Maria Adele Marino
1,
Christian Booz
4,
Thomas J. Vogl
4,
Tommaso D’Angelo
1,5,
Massimo Venturini
3 and
Giorgio Ascenti
1
1
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy
2
Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
3
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
4
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
5
Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(14), 4718; https://doi.org/10.3390/jcm12144718
Submission received: 29 May 2023 / Revised: 8 July 2023 / Accepted: 14 July 2023 / Published: 17 July 2023
(This article belongs to the Special Issue Technological Advancements and Clinical Innovations in Diagnostic and Interventional Radiology)
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Abstract

Dual-layer Dual-Energy CT (dl-DECT) allows one to create virtual non-contrast (VNC) reconstructions from contrast-enhanced CT scans, with a consequent decrease of the radiation dose. This study aims to assess the reliability of VNC for the diagnostic evaluation of renal masses in comparison with true non-contrast (TNC) images. The study cohort included 100 renal masses in 40 patients who underwent dl-DECT between June and December 2021. Attenuation values and standard deviations were assessed through the drawing of regions of interest on TNC and VNC images reconstructed from corticomedullary and nephrographic phases. A Wilcoxon signed-rank test was performed in order to assess equivalence of data and Spearman’s Rho correlation coefficient to evaluate correlations between each parameter. The diagnostic accuracy of VNC was estimated through the performance of receiver operating characteristic (ROC) curve analysis. Differences between attenuation values were, respectively, 74%, 18%, 5% and 3% (TNC-VNCcort), and 74%, 15%, 9% and 2% (TNC-VNCneph). The Wilcoxon signed-rank test demonstrated the equivalence of attenuation values between the TNC and VNC images. The diagnostic performance of VNC images in the depiction of kidney simple cysts remains high compared to TNC (VNCcort-AUC: 0.896; VNCneph-AUC: 0.901, TNC-AUC: 0.903). In conclusion, quantitative analysis of attenuation values showed a strong agreement between VNC and TNC images in the evaluation of renal masses.
Keywords: virtual non-contrast image; dual energy; computed tomography; findings incidental kidney virtual non-contrast image; dual energy; computed tomography; findings incidental kidney

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MDPI and ACS Style

Bucolo, G.M.; Ascenti, V.; Barbera, S.; Fontana, F.; Aricò, F.M.; Piacentino, F.; Coppola, A.; Cicero, G.; Marino, M.A.; Booz, C.; et al. Virtual Non-Contrast Spectral CT in Renal Masses: Is It Time to Discard Conventional Unenhanced Phase? J. Clin. Med. 2023, 12, 4718. https://doi.org/10.3390/jcm12144718

AMA Style

Bucolo GM, Ascenti V, Barbera S, Fontana F, Aricò FM, Piacentino F, Coppola A, Cicero G, Marino MA, Booz C, et al. Virtual Non-Contrast Spectral CT in Renal Masses: Is It Time to Discard Conventional Unenhanced Phase? Journal of Clinical Medicine. 2023; 12(14):4718. https://doi.org/10.3390/jcm12144718

Chicago/Turabian Style

Bucolo, Giuseppe M., Velio Ascenti, Simone Barbera, Federico Fontana, Francesco M. Aricò, Filippo Piacentino, Andrea Coppola, Giuseppe Cicero, Maria Adele Marino, Christian Booz, and et al. 2023. "Virtual Non-Contrast Spectral CT in Renal Masses: Is It Time to Discard Conventional Unenhanced Phase?" Journal of Clinical Medicine 12, no. 14: 4718. https://doi.org/10.3390/jcm12144718

APA Style

Bucolo, G. M., Ascenti, V., Barbera, S., Fontana, F., Aricò, F. M., Piacentino, F., Coppola, A., Cicero, G., Marino, M. A., Booz, C., Vogl, T. J., D’Angelo, T., Venturini, M., & Ascenti, G. (2023). Virtual Non-Contrast Spectral CT in Renal Masses: Is It Time to Discard Conventional Unenhanced Phase? Journal of Clinical Medicine, 12(14), 4718. https://doi.org/10.3390/jcm12144718

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