Potential of gadolinium as contrast material in second generation dual energy computed tomography - An ex vivo phantom study

Purpose: To evaluate the potential of gadolinium (Gd) as contrast material (CM) in second generation dual energy computed tomography (DECT). Material and methods: In a phantom model, DECT post-processing was used to increase Gd attenuation using advanced monoenergetic extrapolation (MEI), to create virtual non-contrast images (Gd-VNC) and Gd maps and to quantify Gd content. Dilutions of Gd and iodinated CM (7-296 HU) were filled in syringes, placed in an attenuation phantom and scanned with standard DECT protocols (80 &100/Sn140 kV). MEI (40-190 keV) and VNC images as well as Gd maps were computed. The amount of Gd Was quantified and the accuracy was compared to iodine images. Linear regression models were calculated to evaluate Gd attenuation of equivolume CM doses and clinical MRI doses. Results: Applying monoenergetic reconstructions and using Gd as contrast agent (Gd MEI 40 keV) doubled Hounsfield-Units (HU) and 90% of the SNR (averaged: 225 HU, SNR3.1) are achievable, as compared to iodinated CM at 120 kV (averaged:110 HU, SNR3.5), at Gd doses of 1.0 mmol/kg BW. The accuracies of Gd-VNC (deviation, 6 12 HU) images and Gd quantification (measurement error, 17%) were not significantly different to those of iodine enhanced images (VNC:deviation, 2 11 HU; measurement error,14%). Conclusion: Using monoenergetic extrapolation at 40 keV, it is possible to increase Gd-CM attenuation significantly. Thus, equivalent HU and half the SNR in comparison to a standard dose of ICM at 120 kV can be expected at a Gd-CM dose of 0.5 mmol/kg BW. Post-processing features of iodine based DECT like monoenergetic or VNC images, iodine maps or quantification of CM are feasible with the use of Gd-CM. (C) 2017 Elsevier Inc. All rights reserved.