Soft tissue discrimination ex vivo by dual energy computed tomography

Purpose

Dual Energy Computed Tomography (DECT) may provide additional information about the chemical composition of tissues compared to examination with a single X-ray energy. The aim of this in vitro study was to test whether combining two energies may significantly improve the detection of soft tissue components commonly present in arterial plaques.

Methods

Tissue samples of myocardial and psoas muscle, venous and arterial thrombus as well as fat from different locations were scanned using a SOMATOM Definition Dual Source CT system (Siemens AG, Medical Solutions, Forchheim, Germany) with simultaneous tube voltages of 140 and 80 kV. The attenuation (Hounsfield units, HU) at 80 and 140 kV was measured in representative regions of interest, and the association between measured HU values and tissue types was tested with logistic regression.

Results

The combination of two energy levels (80 and 140 kV) significantly improved (p < 0.001) the ability to correctly classify venous thrombus vs arterial thrombus, myocardium or psoas; arterial thrombus vs myocardium or psoas; myocardium vs psoas; as well as the differentiation between fat tissue from various locations. Single energy alone was sufficient for distinguishing fat from other tissues.

Conclusion

DECT offers significantly improved in vitro differentiation between soft tissues occurring in plaques. If this corresponds to better tissue discrimination in vivo needs to be clarified in future studies.