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Evaluation of frequency-selective non-linear blending technique on brain CT in postoperative children with Moyamoya disease - 02/10/19

Doi : 10.1016/j.neurad.2019.07.006 
Seunghyun Lee a, Young Hun Choi a, b, , Yeon Jin Cho a, Jung-Eun Cheon a, b, c, Gayoung Choi a, Seul Bi Lee a, Woo Sun Kim a, b, c, In-One Kim a, b, c, Ji Eun Park d, Seong Yong Pak e
a Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea 
b Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea 
c Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea 
d Department of Radiology, Ajou University Medical Center, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea 
e Department of CT research collaborations, Siemens Healthcare Ltd., 23 Chungjeong-ro, Seodaemun-gu, Seoul, South Korea 

Corresponding author at: Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.Department of Radiology, Seoul National University Hospital101 Daehak-ro, Jongno-guSeoul03080Republic of Korea
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 02 October 2019
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Graphical abstract




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Highlights

The frequency-selective non-linear blending (BC) technique can improve tissue contrast between the gray matter and white matter with maintaining overall image quality (BC vs. non-enhanced brain CT; 3.9±1.0 vs. 1.8±0.6, P<0.001).
The diagnostic accuracy of the non-enhanced brain CT and post-processed brain CT images using BC techniques were 63.6% (21/33) and 69.7% (23/33) without significant diagnostic accuracy improvement (P=0.219).
However, the post-processed BC technique may be used to identify brain ischemic changes in a subcortical punctate lesion of postoperative pediatric moyamoya patients by improving contrast-to-noise of the infarct lesion.

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Abstract

Objective

To evaluate whether a frequency-selective non-linear blending (BC) technique can improve tissue contrast and infarct detection on non-enhanced brain CT (NECT) in postoperative Moyamoya (MMD) patients.

Materials and methods

From January 2010 to December 2017, 33 children (13boys and 20girls; mean age 9.1±3.4 years) with MMD postoperatively underwent NECT followed by diffusion MRI. We compared the contrast-to-noise ratio (CNR) between gray matter (GM) and white matter (WM) in NECT and BC images and the CNR between the infarct lesion and adjacent normal-appearing brain in NECT and BC images using a paired t-test. We assessed image noise, GM-WM differentiation, artifacts, and overall quality using a Wilcoxon signed rank test. A McNemar two-tailed test was conducted to compare the diagnostic accuracy of infarct detection.

Results

The CNR between GM and WM and the CNR of the infarct was better in BC images than in NECT images (3.9±1.0 vs. 1.8±0.6, P<0.001 and 3.6±0.3 vs. 1.9±0.2, P<0.001), with no difference in overall image quality observed. The sensitivity and specificity of infarct detection were 55.0% and 76.9% using NECT, and 70.0% and 69.2% using BC technique. The diagnostic accuracy of NECT and BC technique was 63.6% (21/33) and 69.7% (23/33), respectively.

Conclusion

This study showed that the BC technique improved CNR and maintained image quality. This technique may also be used to identify ischemic brain changes in postoperative MMD patients by improving the CNR of the infarct lesion.

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Keywords : Moyamoya, Frequency-selective non-linear blending, CT

Abbreviation : MMD, BC, NECT


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