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      Utility of virtual monoenergetic images from spectral detector computed tomography in improving image segmentation for purposes of 3D printing and modeling.

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          Abstract

          One of the key steps in generating three-dimensional (3D) printed models in medicine is segmentation of radiologic imaging. The software tools used for segmentation may be automated, semi-automated, or manual which rely on differences in material density, attenuation characteristics, and/or advanced software algorithms. Spectral Detector Computed Tomography (SDCT) is a form of dual energy computed tomography that works at the detector level to generate virtual monoenergetic images (VMI) at different energies/ kilo-electron volts (keV). These VMI have varying contrast and attenuation characteristics relative to material density. The purpose of this pilot project is to explore the use of VMI in segmentation for medical 3D printing in four separate clinical scenarios. Cases were retrospectively selected based on varying complexity, value of spectral data, and across multiple clinical disciplines (Vascular, Cardiology, Oncology, and Orthopedic).

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          Most cited references15

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          Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications.

          In x-ray computed tomography (CT), materials having different elemental compositions can be represented by identical pixel values on a CT image (ie, CT numbers), depending on the mass density of the material. Thus, the differentiation and classification of different tissue types and contrast agents can be extremely challenging. In dual-energy CT, an additional attenuation measurement is obtained with a second x-ray spectrum (ie, a second "energy"), allowing the differentiation of multiple materials. Alternatively, this allows quantification of the mass density of two or three materials in a mixture with known elemental composition. Recent advances in the use of energy-resolving, photon-counting detectors for CT imaging suggest the ability to acquire data in multiple energy bins, which is expected to further improve the signal-to-noise ratio for material-specific imaging. In this review, the underlying motivation and physical principles of dual- or multi-energy CT are reviewed and each of the current technical approaches is described. In addition, current and evolving clinical applications are introduced.
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            Medical 3D Printing for the Radiologist.

            While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article.
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              • Record: found
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              Dual-energy CT: general principles.

              In dual-energy CT (DECT), two CT datasets are acquired with different x-ray spectra. These spectra are generated using different tube potentials, partially also with additional filtration at 140 kVp. Spectral information can also be resolved by layer detectors or quantum-counting detectors. Several technical approaches-that is, sequential acquisition, rapid voltage switching, dual-source CT (DSCT), layer detector, quantum-counting detector-offer different spectral contrast and dose efficiency. Various postprocessing algorithms readily provide clinically relevant spectral information.
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                Author and article information

                Journal
                3D Print Med
                3D printing in medicine
                Springer Science and Business Media LLC
                2365-6271
                2365-6271
                Jan 18 2019
                : 5
                : 1
                Affiliations
                [1 ] Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA. egk8@case.edu.
                [2 ] Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
                [3 ] Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany.
                Article
                10.1186/s41205-019-0038-y
                10.1186/s41205-019-0038-y
                6505638
                30659415
                6678707b-bebf-4796-a781-7fca42bebd0a
                History

                3D printing,Dual layer CT,Dual-energy CT,Segmentation,Spectral detector CT

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