Initial Evaluation of Virtual Un-Enhanced Imaging derived from Fast kVp-Switching Dual Energy Contrast Enhanced CT for the Abdomen

The feasibility and utility of creating virtual un-enhanced images from contrast enhanced data acquired using a fast switching dual energy CT acquisition, is explored. Utilizing projection based material decomposition data, monochromatic images are generated and a Multi-material decomposition technique is applied. Quantitative and qualitative evaluation is performed to assess the equivalence of Virtual Un-Enhanced (VUE) and True Un-enhanced (TUE) for multiple tissue types and different organs in the abdomen. Ten patient cases were analyzed where a TUE and a subsequent Contrast Enhanced (CE) acquisition were obtained using fast kVp-switching dual energy CT utilizing Gemstone Spectral Imaging. Quantitative measurements were made by placing multiple Regions of Interest on the different tissues and organs in both the TUE and the VUE images. The absolute Hounsfield Unit (HU) differences in the mean values between TUE & VUE were calculated as well as the differences of the standard deviations. Qualitative analysis was done by two radiologists for overall image quality, presence of residual contrast, appearance of pathology, appearance and contrast of normal tissues and organs in comparison to the TUE. There is a very strong correlation between the TUE and VUE images.