Evaluating anemia using contrast-enhanced spectral detector CT of the chest in a large cohort of 522 patients.
Anemia
Hemoglobin
Tomography, X-ray computed
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
22
06
2020
accepted:
10
11
2020
revised:
21
09
2020
pubmed:
27
11
2020
medline:
21
5
2021
entrez:
26
11
2020
Statut:
ppublish
Résumé
The blood of patients with anemia demonstrates distinctly lower attenuation in unenhanced CT images. However, the frequent usage of intravenous contrast hampers evaluation of anemia. Spectral detector computed tomography (SDCT) allows for reconstruction of virtual non-contrast images (VNC) from contrast-enhanced data (CE). The purpose of this study was to evaluate whether VNC allow for prediction of anemia. Five hundred twenty-two patients with CE-SDCT of the chest and accessible serum hemoglobin (HbS) were retrospectively included. Patients were assigned to three groups (severe anemia, moderate/mild anemia, and healthy) based on recent lab tests (≤ 7 days) for HbS following gender and the WHO definition of anemia. CT attenuation was determined using two ROI in the left ventricular lumen and one ROI in the descending thoracic aorta. ROI were placed on CE and copied to VNC. ANOVA, linear regression, and receiver operating characteristics were used for statistic evaluation. Average HbS was 11.6 ± 2.4 g/dl. Attenuation on VNC showed significant differences between healthy patients, patients with mild/moderate anemia, and severely anemic patients (all p ≤ 0.05). Applying cutoffs of 39.2/37.6 HU and 33.6/32.7 HU allowed to differentiate between healthy, mild/moderately, and severely anemic men/women (AUC 0.857/0.833 and 0.879/0.932). A linear relationship between HbS and attenuation on VNC was established (r An approximation of HbS and presence of anemia can be conducted based on simple attenuation measurements in contrast-enhanced SDCT examinations enabled by VNC imaging. • While the attenuation of blood is a previously described biomarker for anemia in non-contrast images, virtual non-contrast images from spectral detector CT circumvent this limitation and allow for diagnosis of anemia in contrast-enhanced scans. • Attenuation of blood in virtual non-contrast images derived from spectral detector CT shows a moderate correlation to serum hemoglobin levels. • Presence of anemia be estimated in virtual non-contrast images using proposed cutoffs of 39.2 HU and 37.6 HU for men and women, respectively, to differentiate between healthy and anemic patients.
Identifiants
pubmed: 33241515
doi: 10.1007/s00330-020-07497-y
pii: 10.1007/s00330-020-07497-y
pmc: PMC8128794
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4350-4357Subventions
Organisme : Else Kröner-Fresenius-Stiftung
ID : 2018_EKMS.34
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