Role of spectral-detector CT in reduction of artifacts from contrast media in axillary and subclavian veins: single institution study in 50 patients.

Laukamp, Kai Roman; Gupta, Amit; Große Hokamp, Nils; Obmann, Verena Carola; Graner, Frank Philipp; Ho, Vivian; Ros, Pablo; Ramaiya, Nikhil; Gilkeson, Robert (2020). Role of spectral-detector CT in reduction of artifacts from contrast media in axillary and subclavian veins: single institution study in 50 patients. Acta radiologica, 61(4), pp. 450-460. Sage 10.1177/0284185119868904

[img] Text
Role_Obmann.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

Background: In CT imaging, a high concentration of iodinated contrast media in axillary and subclavian veins after brachialapplication can cause perivenous artifacts impairing diagnostic assessment of local vascular structures and soft tissue. Purpose:To investigate reduction of perivenous hypo- and hyperattenuating artifacts of the axillary and subclavian veinsusing virtual monoenergetic images (VMI) in comparison to conventional CT images (CI), acquired on spectral-detector CT. Material and Methods:50 spectral-detector CT datasets of patients with perivenous artifacts from contrast mediawere included in this retrospective, institutional review board-approved study. CT images and virtual monoenergeticimages (range 40–200 keV, 10-keV increments) were reconstructed from the same scans. Quantitative analysis wasperformed by region of interest-based assessment of mean attenuation (HU) and standard deviation in most pro-nounced hypo- and hyperdense artifacts and artifact-impaired arteries as well as muscle. Visually, artifact reduction,assessment of vessels, and surrounding soft tissue were rated on 5-point Likert-scales by two radiologists. Results:In comparison to CT images, virtual monoenergetic images of ≥90 keV showed a significant reduction of hypo- and hyperattenuating artifacts (hypodense: CI -220.0±171.2 HU; VMI130keV -13.4±49.1 HU; hyperdense: CI 274.6±184.4 HU; VMI130keV 24.2±84.9 HU; P<0.001). Subjective analysis confirmed that virtual-monoenergetic images of ≥100 keV significantly reduced artifacts (hypodense: CI 2[1–3]; VMI130keV 5[4–5], hyperdense: CI 2[1–4]; VMI130keV 5[5–5], P<0.001) and improved diagnostic assessment. Best results for diagnostic assessment were noted for virtual monoenergetic images at 130 keV. Overcorrection of artifacts was observed at higher keV values. Interrater agreement was excellent for each evaluation and keV value (intraclass correlation coefficient 0.89). Conclusion:Higher keV virtual monoenergetic images yielded significant reduction of contrast media artifacts and ledto improved assessment of vessels and surrounding soft tissue. Recommended keV values for best diagnostic assessmentare in the range of 100–160 keV.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Obmann, Verena Carola


600 Technology > 610 Medicine & health








Maria de Fatima Henriques Bernardo

Date Deposited:

29 Aug 2019 13:31

Last Modified:

09 Apr 2020 01:30

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

X-ray computed tomography artifacts contrast media neoplasm staging, spectral-detector CT




Actions (login required)

Edit item Edit item
Provide Feedback