Open AccessMultimaterial decomposition algorithm for quantification of fat in hepatocellular carcinoma using rapid kilovoltage-switching dual-energy CT
Author(s) -
Takashi Ota,
Masatoshi Hori,
Kosuke Sasaki,
Hiromitsu Onishi,
Atsushi Nakamoto,
Mitsuaki Tatsumi,
Hiroki Fukui,
Kôichi Ogawa,
Noriyuki Tomiyama
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000026109
Subject(s) - medicine , hepatocellular carcinoma , nuclear medicine , magnetic resonance imaging , dual energy , radiology , bone mineral , osteoporosis
Understanding intratumoral fat in hepatocellular carcinoma (HCC) is clinically important to elucidate prognosis. We sought to quantify HCC and liver fat with a multimaterial decomposition (MMD) algorithm with rapid kilovoltage-switching dual-energy computed tomography (DECT) relative to chemical-shift magnetic resonance imaging (CSI). In this retrospective study, 40 consecutive patients with HCC underwent non-contrast-enhanced (non-CE) and four-phases contrast-enhanced (four-CE) DECT (80 and 140 kVp) and abdominal MR imaging (including CSI) between April 2011 and December 2012. Fat volume fraction (FVF DECT ) maps were generated by MMD algorithm to quantify HCC and liver fat. Fat fraction measured by CSI (FF CSI ) was determined for HCC and liver on dual-echo sequence using 1.5- or 3-Tesla MR systems. The correlation between FVF DECT and FF CSI was evaluated using Pearson correlation test, while non-CE FVF DECT and four-CE FVF DECT were compared by one-way ANOVA and Bland–Altman analysis. Forty patients (mean age, 70.1 years ± 7.8; 25 males) were evaluated. FVF DECT and FF CSI exhibited weak to moderate correlations for HCC in non-CE and four-CE except in equilibrium phase ( r = 0.42, 0.44, 0.35, and 0.33; all P < .05), and very strong correlations for liver in all phases ( r = 0.86, 0.83, 0.85, 0.87, and 0.84; all P < .05). Those correlation coefficients were significantly higher for liver for each phase (all P < .05). FVF DECT did not differ significantly across scan phases regarding HCC or liver ( P = .076 and 0.56). Bland–Altman analysis showed fixed bias in all phases between non- and four-CE FVF DECT in HCC and liver. As compared with liver, correlations between FVF measured by DECT-based MMD and FF measured by CSI were weak in HCC in all phases. FVF is reproducible across all scan phases in HCC and liver. The MMD algorithm requires modification for HCC fat quantification given the heterogeneous components of HCC.