Evaluation of lung transplant perfusion using iodine maps from novel spectral detector computed tomography

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Abstract

We report the case of a 51-year-old patient who underwent bilateral lung transplantation and presented with an unstable condition and sepsis 6 days after transplantation. The performed contrast enhanced spectral detector computed tomography (CT) using a dual-layer detector showed absence of perfusion in the left lung on iodine maps, although branches of the pulmonary artery were patent. This prompted retrospective evaluation of CT images and total venous occlusion of the left pulmonary veins was found. Here, iodine maps helped in raising conspicuity of loss of lung perfusion.

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

Cynthia McCollough, Shuai Leng, Lifeng Yu … (2015)

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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Effector mechanisms of rejection.

Ignacio Anegon, Maria Cristina Cuturi, Aurélie Moreau … (2013)

Organ transplantation appears today to be the best alternative to replace the loss of vital organs induced by various diseases. Transplants can, however, also be rejected by the recipient. In this review, we provide an overview of the mechanisms and the cells/molecules involved in acute and chronic rejections. T cells and B cells mainly control the antigen-specific rejection and act either as effector, regulatory, or memory cells. On the other hand, nonspecific cells such as endothelial cells, NK cells, macrophages, or polymorphonuclear cells are also crucial actors of transplant rejection. Last, beyond cells, the high contribution of antibodies, chemokines, and complement molecules in graft rejection is discussed in this article. The understanding of the different components involved in graft rejection is essential as some of them are used in the clinic as biomarkers to detect and quantify the level of rejection.

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Intermanufacturer Comparison of Dual-Energy CT Iodine Quantification and Monochromatic Attenuation: A Phantom Study.

Megan C Jacobsen, Dawid Schellingerhout, Cayla Wood … (2018)

Purpose To determine the accuracy of dual-energy computed tomographic (CT) quantitation in a phantom system comparing fast kilovolt peak-switching, dual-source, split-filter, sequential-scanning, and dual-layer detector systems. Materials and Methods A large elliptical phantom containing iodine (2, 5, and 15 mg/mL), simulated contrast material-enhanced blood, and soft-tissue inserts with known elemental compositions was scanned three to five times with seven dual-energy CT systems and a total of 10 kilovolt peak settings. Monochromatic images (50, 70, and 140 keV) and iodine concentration images were created. Mean iodine concentration and monochromatic attenuation for each insert and reconstruction energy level were recorded. Measurement bias was assessed by using the sum of the mean signed errors measured across relevant inserts for each monochromatic energy level and iodine concentration. Iodine and monochromatic errors were assessed by using the root sum of the squared error of all measurements. Results At least one acquisition paradigm per scanner had iodine biases (range, -2.6 to 1.5 mg/mL) with significant differences from zero. There were no significant differences in iodine error (range, 0.44-1.70 mg/mL) among the top five acquisition paradigms (one fast kilovolt peak switching, three dual source, and one sequential scanning). Monochromatic bias was smallest for 70 keV (-12.7 to 15.8 HU) and largest for 50 keV (-80.6 to 35.2 HU). There were no significant differences in monochromatic error (range, 11.4-52.0 HU) among the top three acquisition paradigms (one dual source and two fast kilovolt peak switching). The lowest accuracy for both measures was with a split-filter system. Conclusion Iodine and monochromatic accuracy varies among systems, but dual-source and fast kilovolt-switching generally provided the most accurate results in a large phantom. © RSNA, 2017 Online supplemental material is available for this article.

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Author and article information

Journal

Journal ID (nlm-ta): Indian J Radiol Imaging

Journal ID (iso-abbrev): Indian J Radiol Imaging

Journal ID (publisher-id): IJRI

Title: The Indian Journal of Radiology & Imaging

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0971-3026

ISSN (Electronic): 1998-3808

Publication date (Print): Oct-Dec 2018

Volume: 28

Issue: 4

Pages: 436-438

Affiliations

[1 ]Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA

[2 ]Department of Radiology, Case School of Medicine, Case Western Reserve University, Cleveland, OH, USA

Author notes

Correspondence: Dr. Nils Große Hokamp, Case Western Reserve University, Department of Radiology, 11000 Euclid Ave, Cleveland, OH, 44106, USA. E-mail: nils.grosse-hokamp@ 123456uk-koeln.de

Article

Publisher ID: IJRI-28-436

DOI: 10.4103/ijri.IJRI_35_18

PMC ID: 6319111

SO-VID: f2572540-d97b-42fd-b1c9-41198c2da017

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This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Evaluation of lung transplant perfusion using iodine maps from novel spectral detector computed tomography

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Most cited references 10

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

Effector mechanisms of rejection.

Intermanufacturer Comparison of Dual-Energy CT Iodine Quantification and Monochromatic Attenuation: A Phantom Study.

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