Radiography (London, England : 1995) · 2026
Whole-body reduced-dose dual-energy CT with deep learning image reconstruction for detection of osteolytic lesions in multiple myeloma.
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Li Y, Cheng Y, Ye Y, He R, Tang X, Hang C, Zhao R, Yu Y, Wang L, Li X
Аннотация
INTRODUCTION: Deep learning image reconstruction (DLIR) has been incorporated into dual-energy CT (DECT) to improve image quality. However, its applications in reduced-dose DECT for evaluating multiple myeloma remain unclear. This study aimed to evaluate image quality and osteolytic lesion detectability of reduced-dose DECT with DLIR, compared with routine-dose single-energy CT (SECT) with adaptive statistical iterative reconstruction-Veo (ASIR-V).
METHODS: This prospective study enrolled consecutive participants with known or precursor multiple myeloma from July 2023 to October 2024. Each participant underwent whole-body non-contrast SECT (120-kVp images; ASIR-V 40% [AR40]), followed by DECT (74- and 50-keV virtual monochromatic images [VMIs], material decomposition [MD] images; high-strength DLIR [DH]). Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and bone-to-lesion CNR (BLR) were calculated. Three radiologists assessed osteolytic lesion detectability and image quality. Lesion detection performance was analyzed using mixed-effects logistic regression.
RESULTS: A total of 43 participants (mean age, 68 ± 10 years; 31 men) with 121 osteolytic lesions were included. DECT reduced radiation dose by 53% versus SECT. Compared with AR40 120-kVp images, DH 74- and 50-keV VMIs exhibited lower and comparable image noise, respectively, and improved CNR, SNR, BLR, and overall image quality (p < 0.05). DH 50-keV VMIs and MD images demonstrated superior lesion conspicuity (p < 0.001), and DH MD images achieved higher sensitivity and specificity than AR40 120-kVp images (p < 0.05).
CONCLUSION: Whole-body reduced-dose multiparametric DECT with DLIR provides improved image quality and osteolytic lesion detectability compared with routine-dose SECT, with a 53% reduction in radiation dose.
IMPLICATIONS FOR PRACTICE: Multiparametric DECT with DLIR provides a more dose-efficient imaging method for visualizing osteolytic lesions in multiple myeloma compared with standard 120-kVp protocols.
METHODS: This prospective study enrolled consecutive participants with known or precursor multiple myeloma from July 2023 to October 2024. Each participant underwent whole-body non-contrast SECT (120-kVp images; ASIR-V 40% [AR40]), followed by DECT (74- and 50-keV virtual monochromatic images [VMIs], material decomposition [MD] images; high-strength DLIR [DH]). Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and bone-to-lesion CNR (BLR) were calculated. Three radiologists assessed osteolytic lesion detectability and image quality. Lesion detection performance was analyzed using mixed-effects logistic regression.
RESULTS: A total of 43 participants (mean age, 68 ± 10 years; 31 men) with 121 osteolytic lesions were included. DECT reduced radiation dose by 53% versus SECT. Compared with AR40 120-kVp images, DH 74- and 50-keV VMIs exhibited lower and comparable image noise, respectively, and improved CNR, SNR, BLR, and overall image quality (p < 0.05). DH 50-keV VMIs and MD images demonstrated superior lesion conspicuity (p < 0.001), and DH MD images achieved higher sensitivity and specificity than AR40 120-kVp images (p < 0.05).
CONCLUSION: Whole-body reduced-dose multiparametric DECT with DLIR provides improved image quality and osteolytic lesion detectability compared with routine-dose SECT, with a 53% reduction in radiation dose.
IMPLICATIONS FOR PRACTICE: Multiparametric DECT with DLIR provides a more dose-efficient imaging method for visualizing osteolytic lesions in multiple myeloma compared with standard 120-kVp protocols.