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<meta name="DC.Title" content="Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4223" />
<meta name="DC.Date" content="2015-05-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The virtual noncontrast images generated with iodine subtraction from dual-energy CTA images are expected to replace the true noncontrast images for radiation-dose reduction. This study assessed the feasibility of virtual noncontrast images for diagnosing SAH.

MATERIALS AND METHODS: Eighty-four patients with or without SAH underwent true noncontrast brain CT (the criterion standard for diagnosing SAH). Among them, 37 patients underwent an additional head dual-energy angiography, and the other patients underwent head and neck dual-energy angiography. Virtual noncontrast images were produced on a dedicated dual-energy postprocessing workstation and reconstructed in orientation and section width identical to those in true noncontrast images. The findings on the virtual noncontrast and true noncontrast images were compared at both the individual level and the lesion level. Image noise of the virtual noncontrast and true noncontrast images was also measured and compared. The volume CT dose index and dose-length product were recorded for the radiation-dose analysis.

RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of virtual noncontrast images at the individual level and the lesion level were 94.5%, 100%, 100%, 90.6% and 86.7%, 96.9%, 91.8%, 94.8%, respectively. The agreement in the diagnosis of SAH on true noncontrast and virtual noncontrast images reached 92.3% at the individual level and 85.1% at the lesion level. The virtual noncontrast images showed a higher image noise level. The volume CT dose index and dose-length product were obviously reduced without the true noncontrast brain CT scan.

CONCLUSIONS: Virtual noncontrast images are a reliable tool for diagnosing SAH, with the advantage of reducing the radiation dose.

TNC
:   true noncontrast
VNC
:   virtual noncontrast" />
<meta name="DC.Contributor" content="X.Y. Jiang" />
<meta name="DC.Contributor" content="S.H. Zhang" />
<meta name="DC.Contributor" content="Q.Z. Xie" />
<meta name="DC.Contributor" content="Z.J. Yin" />
<meta name="DC.Contributor" content="Q.Y. Liu" />
<meta name="DC.Contributor" content="M.D. Zhao" />
<meta name="DC.Contributor" content="X.L. Li" />
<meta name="DC.Contributor" content="X.J. Mao" />
<meta name="article:published_time" content="2015-05-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The virtual noncontrast images generated with iodine subtraction from dual-energy CTA images are expected to replace the true noncontrast images for radiation-dose reduction. This study assessed the feasibility of virtual noncontrast images for diagnosing SAH.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Eighty-four patients with or without SAH underwent true noncontrast brain CT (the criterion standard for diagnosing SAH). Among them, 37 patients underwent an additional head dual-energy angiography, and the other patients underwent head and neck dual-energy angiography. Virtual noncontrast images were produced on a dedicated dual-energy postprocessing workstation and reconstructed in orientation and section width identical to those in true noncontrast images. The findings on the virtual noncontrast and true noncontrast images were compared at both the individual level and the lesion level. Image noise of the virtual noncontrast and true noncontrast images was also measured and compared. The volume CT dose index and dose-length product were recorded for the radiation-dose analysis.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The sensitivity, specificity, positive predictive value, and negative predictive value of virtual noncontrast images at the individual level and the lesion level were 94.5%, 100%, 100%, 90.6% and 86.7%, 96.9%, 91.8%, 94.8%, respectively. The agreement in the diagnosis of SAH on true noncontrast and virtual noncontrast images reached 92.3% at the individual level and 85.1% at the lesion level. The virtual noncontrast images showed a higher image noise level. The volume CT dose index and dose-length product were obviously reduced without the true noncontrast brain CT scan.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Virtual noncontrast images are a reliable tool for diagnosing SAH, with the advantage of reducing the radiation dose.&lt;/p&gt;" />
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<meta name="twitter:title" content="Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage" />
<meta name="twitter:card" content="summary_large_image" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The virtual noncontrast images generated with iodine subtraction from dual-energy CTA images are expected to replace the true noncontrast images for radiation-dose reduction. This study assessed the feasibility of virtual noncontrast images for diagnosing SAH.

MATERIALS AND METHODS: Eighty-four patients with or without SAH underwent true noncontrast brain CT (the criterion standard for diagnosing SAH). Among them, 37 patients underwent an additional head dual-energy angiography, and the other patients underwent head and neck dual-energy angiography. Virtual noncontrast images were produced on a dedicated dual-energy postprocessing workstation and reconstructed in orientation and section width identical to those in true noncontrast images. The findings on the virtual noncontrast and true noncontrast images were compared at both the individual level and the lesion level. Image noise of the virtual noncontrast and true noncontrast images was also measured and compared. The volume CT dose index and dose-length product were recorded for the radiation-dose analysis.

RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of virtual noncontrast images at the individual level and the lesion level were 94.5%, 100%, 100%, 90.6% and 86.7%, 96.9%, 91.8%, 94.8%, respectively. The agreement in the diagnosis of SAH on true noncontrast and virtual noncontrast images reached 92.3% at the individual level and 85.1% at the lesion level. The virtual noncontrast images showed a higher image noise level. The volume CT dose index and dose-length product were obviously reduced without the true noncontrast brain CT scan.

CONCLUSIONS: Virtual noncontrast images are a reliable tool for diagnosing SAH, with the advantage of reducing the radiation dose.

TNC
:   true noncontrast
VNC
:   virtual noncontrast" />
<meta name="og-title" property="og:title" content="Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/36/5/855" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The virtual noncontrast images generated with iodine subtraction from dual-energy CTA images are expected to replace the true noncontrast images for radiation-dose reduction. This study assessed the feasibility of virtual noncontrast images for diagnosing SAH.

MATERIALS AND METHODS: Eighty-four patients with or without SAH underwent true noncontrast brain CT (the criterion standard for diagnosing SAH). Among them, 37 patients underwent an additional head dual-energy angiography, and the other patients underwent head and neck dual-energy angiography. Virtual noncontrast images were produced on a dedicated dual-energy postprocessing workstation and reconstructed in orientation and section width identical to those in true noncontrast images. The findings on the virtual noncontrast and true noncontrast images were compared at both the individual level and the lesion level. Image noise of the virtual noncontrast and true noncontrast images was also measured and compared. The volume CT dose index and dose-length product were recorded for the radiation-dose analysis.

RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of virtual noncontrast images at the individual level and the lesion level were 94.5%, 100%, 100%, 90.6% and 86.7%, 96.9%, 91.8%, 94.8%, respectively. The agreement in the diagnosis of SAH on true noncontrast and virtual noncontrast images reached 92.3% at the individual level and 85.1% at the lesion level. The virtual noncontrast images showed a higher image noise level. The volume CT dose index and dose-length product were obviously reduced without the true noncontrast brain CT scan.

CONCLUSIONS: Virtual noncontrast images are a reliable tool for diagnosing SAH, with the advantage of reducing the radiation dose.

TNC
:   true noncontrast
VNC
:   virtual noncontrast" />
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      <h1 class="highwire-cite-title" id="page-title">Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">X.Y. Jiang</span>, <span class="highwire-citation-author" data-delta="1">S.H. Zhang</span>, <span class="highwire-citation-author" data-delta="2">Q.Z. Xie</span>, <span class="highwire-citation-author" data-delta="3">Z.J. Yin</span>, <span class="highwire-citation-author" data-delta="4">Q.Y. Liu</span>, <span class="highwire-citation-author" data-delta="5">M.D. Zhao</span>, <span class="highwire-citation-author" data-delta="6">X.L. Li</span> and <span class="highwire-citation-author" data-delta="7">X.J. Mao</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">855-860; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4223 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-13900--61533539105" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">X.Y. Jiang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (X.Y.J., Z.J.Y., Q.Y.L., M.D.Z., X.L.L., X.J.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.Y.%2BJiang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jiang%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AX.Y.%2BJiang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">S.H. Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (S.H.Z.), Shandong Cancer Hospital and Institute, Shandong, P.R. China.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.H.%2BZhang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhang%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.H.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Q.Z. Xie </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Pediatrics (Q.Z.X.), Affiliated Hospital of Binzhou Medical University, Shandong, P.R. China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Q.Z.%2BXie%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Xie%20Q&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AQ.Z.%2BXie%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Z.J. Yin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (X.Y.J., Z.J.Y., Q.Y.L., M.D.Z., X.L.L., X.J.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.J.%2BYin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yin%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AZ.J.%2BYin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Q.Y. Liu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (X.Y.J., Z.J.Y., Q.Y.L., M.D.Z., X.L.L., X.J.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Q.Y.%2BLiu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Liu%20Q&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AQ.Y.%2BLiu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">M.D. Zhao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (X.Y.J., Z.J.Y., Q.Y.L., M.D.Z., X.L.L., X.J.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.D.%2BZhao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhao%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.D.%2BZhao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">X.L. Li </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (X.Y.J., Z.J.Y., Q.Y.L., M.D.Z., X.L.L., X.J.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.L.%2BLi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Li%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AX.L.%2BLi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">X.J. Mao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (X.Y.J., Z.J.Y., Q.Y.L., M.D.Z., X.L.L., X.J.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.J.%2BMao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mao%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AX.J.%2BMao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> The virtual noncontrast images generated with iodine subtraction from dual-energy CTA images are expected to replace the true noncontrast images for radiation-dose reduction. This study assessed the feasibility of virtual noncontrast images for diagnosing SAH.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Eighty-four patients with or without SAH underwent true noncontrast brain CT (the criterion standard for diagnosing SAH). Among them, 37 patients underwent an additional head dual-energy angiography, and the other patients underwent head and neck dual-energy angiography. Virtual noncontrast images were produced on a dedicated dual-energy postprocessing workstation and reconstructed in orientation and section width identical to those in true noncontrast images. The findings on the virtual noncontrast and true noncontrast images were compared at both the individual level and the lesion level. Image noise of the virtual noncontrast and true noncontrast images was also measured and compared. The volume CT dose index and dose-length product were recorded for the radiation-dose analysis.</p>
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<p id="p-4"><strong>RESULTS:</strong> The sensitivity, specificity, positive predictive value, and negative predictive value of virtual noncontrast images at the individual level and the lesion level were 94.5%, 100%, 100%, 90.6% and 86.7%, 96.9%, 91.8%, 94.8%, respectively. The agreement in the diagnosis of SAH on true noncontrast and virtual noncontrast images reached 92.3% at the individual level and 85.1% at the lesion level. The virtual noncontrast images showed a higher image noise level. The volume CT dose index and dose-length product were obviously reduced without the true noncontrast brain CT scan.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> Virtual noncontrast images are a reliable tool for diagnosing SAH, with the advantage of reducing the radiation dose.</p>
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<h2 class="">ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">TNC<span class="def-item-dt-sep"></span></dt><dd>true noncontrast<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">VNC<span class="def-item-dt-sep"></span></dt><dd>virtual noncontrast</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2015 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/36/5/855.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 36</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 5 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 May 2015 </div></div>
      
      
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      <div class="highwire-cite-title">Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">855-860; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4223 </span></div>
  
  
  
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      <div class="highwire-cite-title">Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">855-860; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4223 </span></div>
  
  
  
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