Aquilion one

All patients underwent a low-dose dual-energy CT scan of both wrists (one patient had only one wrist examined) in a 320-row CT scanner (Canon Aquilion One and Canon Aquilion One Vision, Canon Medical Systems, Otawara, Japan), using a standardized scan protocol. Tube settings were as follows: 80 kVp with 90 to 170 mA and 135 kVp with 15 to 30 mA. We used the volume mode with a z-axis coverage of 16 cm without table movement and with the fastest tube rotation time. To establish a conventional CT image visualization, virtual blended 120 kVp equivalent images were computed as well as collagen maps using a vendor software (Canon Medical Systems, Otawara, Japan) on the CT console and applying a dual-energy gradient of 1.1 for collagen on the three-material decomposition software. Readers were blinded to all patient data, which was ensured by pseudonymization with dedicated software (Horos v.2.2.0, The Horos Project).

Vernier calipers were used to measure the following indicators on the 3D printed model of knee joint: anterior and posterior diameter and the left and right diameter of the internal and external condyles of the femur (APDLF: Anterior and posterior diameter of lateral femoral condyle; APDFC: Anterior and posterior diameter of the femoral medial condyle; LRDMLFC: Left and right diameters of medial and lateral femoral condyles). Left and right diameters and anteroposterior diameters of tibial plateau (LRTP: Left and right diameters of tibial plateau; APTP: anterior and posterior diameters of tibial plateau). The upper and lower meridian and left and right diameters of the patella (ULP: Upper and lower meridian of the patella, LRDP: Left and right diameters of the patella). The anteroposterior diameter, left and right diameter of the femur, the anteroposterior diameter of the tibial plateau, the left and right diameter, the distance from the intercondylar ridge to the tibial tuberosity, the lower femur angle, and the upper tibial angle were measured on the CT images of the knee joint (Canon Workstation, Canon Aquilion One, Japan). The above parameters play an important role in the selection of the internal fixation model. Three measurements were taken, and the average value was used for analysis.

All patients received CTP of the liver one day before initial planned liver surgery with the use of a 320-slice CT scanner (Aquilion ONE, Canon Medical Systems). Dynamic imaging was only performed within the 16 cm detector range of the scanner. A non-contrast helical CT was performed of all patients in order to ensure the coverage of the metastases within the 16 cm scan range for further dynamic imaging. A scanning protocol was chosen combined with a diagnostic venous phase liver CT and perfusion imaging in one session, e.g., diagnostic images were acquired between the dynamic time points. The CT had an X-Ray tube voltage of 100 kV. The milliampere-seconds was set at 50 mAs or Automatic Exposure Control for respectively the dynamic and diagnostic imaging. Rotation time was 0.5 seconds with a pitch of 0. Patients received 150 ml of iodine contrast at a concentration of 300 mg/ml at an injection rate of 5 ml/s (Iomeron® Bracco UK Ltd.) followed by a saline flush (Mallinckrodt /Covidien OptiVantage Power Injector). Imaging was performed during 110 seconds with 22 time points starting 7 seconds after contrast injection. Median DLP was 775 mGy.cm (range 347–1367).

A 320-detector row CT scanner (Aquilion ONE, Canon Medical Systems, Tochigi, Japan) was used. Scans were performed using 1.0-mm thick sections of contiguous images from the apex to the lung base. Images were obtained at a window setting of –600 (level) and 1500 (width). If the patient underwent a CT scan before referral to our hospital, the CT scan features were evaluated using the images obtained from the referring institutions. The finding of calcification on chest X-ray (lung field or pleura) or chest CT (lung field, mediastinal lymph node, or pleura) were determined at the mediastinal window. Fibrotic lesions were not assessed in this study because fibrotic change is more frequently observed on chest CT than on chest X-ray in various types of lung diseases including interstitial pneumonia, smoking-related lung diseases, and age-related interstitial changes, and this would be less specific for previous TB infection in elderly people. Chest images were independently evaluated by respiratory medicine specialists (IY and KK) who were blinded to the clinical information. Any disagreement between the presence of these findings in each case was resolved by a review conducted by the same two physicians in order to reach a consensus.