Evidence map›Paper›PMID 38811447›Full record

SynthesisAbdominal radiology (New York)2024

Dual-energy CT applications on liver imaging: what radiologists and radiographers should know? A systematic review.

Luigi Asmundo, Francesco Rizzetto, Shravya Srinivas Rao, Cristiano Sgrazzutti, Ilaria Vicentin, Avinash Kambadakone, Onofrio Antonio Catalano, Angelo Vanzulli

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Abdominal radiology (New York), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Luigi AsmundoPostgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milan, Italy.ORCID 0000-0002-1410-341X
Francesco RizzettoPostgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milan, Italy. francesco.rizzetto@unimi.it.ORCID 0000-0003-3451-9874
Shravya Srinivas RaoDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Cristiano SgrazzuttiDepartment of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
Ilaria VicentinDepartment of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
Avinash KambadakoneDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Onofrio Antonio CatalanoDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Angelo VanzulliDepartment of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.ORCID 0000-0002-2452-3370

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis review aims to provide a comprehensive summary of DECT techniques, acquisition workflows, and post-processing methods. By doing so, we aim to elucidate the advantages and disadvantages of DECT compared to conventional single-energy CT imaging.

methodsA systematic search was conducted on MEDLINE/EMBASE for DECT studies in liver imaging published between 1980 and 2024. Information regarding study design and endpoints, patient characteristics, DECT technical parameters, radiation dose, iodinated contrast agent (ICA) administration and postprocessing methods were extracted. Technical parameters, including DECT phase, field of view, pitch, collimation, rotation time, arterial phase timing (from injection), and venous timing (from injection) from the included studies were reported, along with formal narrative synthesis of main DECT applications for liver imaging.

resultsOut of the initially identified 234 articles, 153 met the inclusion criteria. Extensive variability in acquisition parameters was observed, except for tube voltage (80/140 kVp combination reported in 50% of articles) and ICA administration (1.5 mL/kg at 3-4 mL/s, reported in 91% of articles). Radiation dose information was provided in only 40% of articles (range: 6-80 mGy), and virtual non-contrast imaging (VNC) emerged as a common strategy to reduce the radiation dose. The primary application of DECT post-processed images was in detecting focal liver lesions (47% of articles), with predominance of study focusing on hepatocellular carcinoma (HCC) (27%). Furthermore, a significant proportion of the articles (16%) focused on enhancing DECT protocols, while 15% explored metastasis detection.

conclusionOur review recommends using 80/140 kVp tube voltage with 1.5 mL/kg ICA at 3-4 mL/s flow rate. Post-processing should include low keV-VMI for enhanced lesion detection, IMs for tumor iodine content evaluation, and VNC for dose reduction. However, heterogeneous literature hinders protocol standardization.

Indexed as

Radiography, Dual-Energy Scanned ProjectionTomography, X-Ray ComputedContrast MediaHumansLiverLiver DiseasesLiver NeoplasmsRadiation DosageContrast MediaComputed tomographyDual energyLiverSystematic review

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.