Contrast thresholds for detection of various iodine concentrations in subtraction CT and dual-energy CT systems

Abstract

Objective: To estimate the minimum iodine concentrations detectable in simulated vessels of various diameters for both subtraction computed tomography (CT) and dual-energy CT systems. Methods: Fillable tubes (diameters: 1, 3, and 5 mm) were filled with a variety of iodine concentrations (range: 0–20 mg/ml), placed in the center of 28-mm cylindrical rods and surrounded with water. Rods with and without fillable tubes were placed in a 20-cm cylindrical solid-water phantom to simulate administration of iodine in blood vessels. The phantom was scanned with clinical subtraction CT (SCT) and dual-energy CT (DECT) head protocols to assess the detection of minimum iodine concentrations in both systems. The SCT and DECT images were evaluated quantitatively with a MATLAB script to extract regions of interest (ROIs) of each simulated vessel. ROI measurements were used to calculate the limit of detectability (LOD) and signal-to-noise ratio of Rose criteria for the assessment of the contrast thresholds. Results: Both SNRRose and LOD methods agreed and determined the minimum detectable iodine concentration to be 0.4 mg/ml in the 5-mm diameter vessel for SCT. However, the minimum detectable concentration in the 5-mm vessel with DECT was 1 mg/ml. The 3-mm vessel had a minimum detectable concentration of 0.8 mg/ml for SCT and 2 mg/ml for DECT. Lastly, the minimum detectable iodine concentration for the 1-mm vessel was 10 mg/ml for SCT and 10 mg/ml for DECT. Conclusion: In this phantom study, SCT showed the capability to detect lower iodine concentrations compared to DECT. Contrast thresholds varied for vessels of different diameters and the smaller vessels required a higher iodine concentration for detection. Based on this knowledge, radiologists can modify their protocols to increase contrast enhancement.