Virtual non-contrast of liver from dual energy CT: a clinical application

Objective: To assess the virtual non-contrast liver CT from dual-energy CT for the clinical application. Methods: In total, 51 patients were included in the study, and all patients underwent multi-phase liver CT on a dual-source CT. The True non-contrast liver CT (TNCT) was performed in a single-energy acquisition mode, but the arterial and portovenous liver CT (VNCT) were performed in a dual- energy mode of 110 kV and 140 kV respectively. The virtual non-contrast CT images were derived from the arterial data using liver virtual non-contrast software. Between the true non-contrast CT and the virtual non- contrast CT, the image quality, mean CT HU values in the liver and muscle, signal to noise (SNR), the radiation dose of volume CT dose index (CTDIvol) and dose length product (DLP) in a single phase and total examination were compared with t test. Results: There was no significant difference in the detection of' liver lesions between TNCT and VNCT. The CT Hu values of muscle on both TNCT and VNCT images were almost equal. The CT HU values of liver on VNCT images were higher than that on TNCT images and the difference was significant [61.32±6.04 vs. (56.85±4.80) HU, t=-3.927, P<0.01]. There was also significant difference of SNR between TNCT (11.28±2.78) and VNCT (8.65±1.56) images (t=-5.590, P<0.01). The CTDIvol and DLP of single phase were (7.07±0.85) mGy and (155.11± 22.52) mGy · cm respectively in TNCT, and (7.05±0.87) mGy and (154.48±23.12) mGy · cm in VNCT. The total CTDIvol and DLP in VNCT were (14.35±1.66) mGy and (313.91±45.08) mGy · cm respectively, but in TNCT the total CTDIvol and DLP reached (21.43±2.46) mGy and (469.02± 66.22) mGy · cm. The difference of CTDIvol and DLP in single phase between TNCT and VNCT showed no significance, but the total CTDIvol and DLP were significantly different (t=16.168 and 13.132, P< 0.01). Conclusion: With the consequent reduction in radiation dose, the VNCT can replace TNCT as an imaging protocol in multi-phase abdominal CT examination in clinic. (authors)