An experimental study on the diagnostic advantage of dual-energy computed tomography over single-energy scan to evaluate the treatment effect following transcatheter arterial chemoembolization

PLoS One. 2024 Nov 12;19(11):e0313543. doi: 10.1371/journal.pone.0313543. eCollection 2024.

Abstract

Objectives: We assessed the diagnostic advantage of dual-energy computed tomography (DECT) over single-energy computed tomography (SECT) to evaluate lipiodol accumulation in target lesions following transcatheter arterial chemoembolization (TACE).

Methods: TACE was performed in 10 rabbits in whom the VX2 tumor was implanted in their left liver lobes. The miriplatin-lipiodol mixture was injected into the common hepatic artery. All rabbits were sacrificed 2 days after TACE, and the liver was harvested. CT was performed using both single-energy and dual-energy scan modes. The specimen was stained with Oil Red O to evaluate lipiodol accumulation; this was considered the reference standard. Mutual information (MI) was used to evaluate the significance of radiological-pathological correlation. Estimated iodine content values on iodine material density images were compared with actual values obtained using mass spectroscopy.

Results: Mean MI values were 0.69, 0.32, 0.83, 0.72, 0.65, and 0.58 for single-energy scan; iodine density images; and virtual monoenergetic images for energy levels of 40, 60, 80, and 100 keV, respectively. The MI value of the monochromatic image (40 keV) was the highest among all sequences. However, this was not significant compared with the single-energy scan (p = 0.81). A significant correlation was observed between the estimated and actual values of iodine content (Pearson's product moment coefficient = 0.70, p = 0.023).

Conclusion: More accurate and quantitative lipiodol evaluation in targeted tumors after TACE can be achieved by applying DECT rather than SECT.

MeSH terms

  • Animals
  • Chemoembolization, Therapeutic* / methods
  • Ethiodized Oil* / administration & dosage
  • Hepatic Artery / diagnostic imaging
  • Liver / diagnostic imaging
  • Liver / metabolism
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / therapy
  • Male
  • Rabbits
  • Tomography, X-Ray Computed* / methods
  • Treatment Outcome

Substances

  • Ethiodized Oil

Grants and funding

DY 17K16489 Japan society for the promotion of science https://www.jsps.go.jp/jgrantsinaid/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.