The patients underwent a contrast-enhanced CT examination using a 64-section SDCT system (IQon Spectral CT, Philips Healthcare, Amsterdam, The Netherlands). The scan covered the patient’s head, neck, chest, abdomen, and pelvis. The detailed acquisition parameters were as follows: tube voltage, 120 kVp; helical pitch, 0.8; rotation time, 0.5 s; and detector collimation at 64 × 0.625 mm2. The patients received an injection of a non-ionic iodinated contrast agent (350 mg/mL, iohexol, Accupaque 350, GE Healthcare, Boston, MA, USA) with a dose of 1.35 mL/kg at a rate of 3 mL/s followed by a 30 mL saline flush using a powered syringe (OptiVantage, Medtronic Covidien, Shanghai, China). The portal venous phase was acquired 60 s after contrast agent injection completion. The conventional images were reconstructed using the iDose algorithm, and the spectral images were reconstructed using the spectral reconstruction algorithm from the spectral-based imaging (SBI) data in a vendor-provided workstation (IntelliSpace Portal v9, Philips Healthcare) with a thickness of 1 mm, a section increment of 1 mm.
Intellispace portal v9
Manufactured by Philips
The IntelliSpace Portal v9 is an advanced integrated radiology platform that provides comprehensive and collaborative visualization, analysis, and reporting capabilities for medical imaging data. It is designed to streamline clinical workflows and enhance diagnostic decision-making.
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Lab products found in correlation
7 protocols using intellispace portal v9
1
Contrast-Enhanced SDCT Imaging Protocol
2
Acute Type B Aortic Dissection Protocol
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Acute type B aortic dissection was defined as occurring within 14 days of pain onset to the time of the intervention. Acute complicated type B dissection generally refers to the presence of a rupture or impending rupture, malperfusion, and/or refractory pain or hypertension.16) (link)Technical success was defined as successful deployment of the stent-graft device in the absence of a type I or type III endoleak, open surgical conversion, or death. An endoleak was defined as persistent blood flow outside the stent graft. RTAD was defined as ascending aortic dissection caused by a stent. True lumen rate (TLR) was defined as the ratio of the true lumen area to the actual lumen area. TLR was measured by Intellispace portal V9 (Philips Healthcare, Best, The Netherlands). TLR was assessed by two radiologists. Stent-graft-induced new entry was defined as a new aortic tear at the distal end of the stent graft.13) (link)
3
Quantitative CT Image Artifact Assessment
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Image assessment was conducted using regions of interest (ROI) with a consistent size of 50 mm2. First, ROI were placed in CI and then copied to MAR, VMI and VMIMAR using the vendor’s proprietary image viewer (IntelliSpace Portal v9, Philips Healthcare). ROI were placed in hypo- and hyperdense artifacts as well as corresponding artifact free reference tissue, e.g. when a hyperdense artifact impaired white matter parenchyma, artifact free contralateral white matter parenchyma was selected as a reference tissue; this method was used individually for each artifact. Mean and standard deviation within each ROI were recorded. Standard deviation in artifact impaired brain tissue was considered representative for artifact burden33 (link).
In addition, corrected attenuation for hypo- and hyperdense artifacts were calculated as the difference between attenuation in artifact impaired and non-affected artifact free reference tissue15 (link). This method accounts for general changes in attenuation along altering keV values of VMI to minimize any bias and detect real artifact reduction34 (link). Additionally, corrected image noise21 (link) was calculated as the difference between image noise in artifact impaired and artifact free reference tissue to correct for general lower image noise in higher keV VMI34 (link).
In addition, corrected attenuation for hypo- and hyperdense artifacts were calculated as the difference between attenuation in artifact impaired and non-affected artifact free reference tissue15 (link). This method accounts for general changes in attenuation along altering keV values of VMI to minimize any bias and detect real artifact reduction34 (link). Additionally, corrected image noise21 (link) was calculated as the difference between image noise in artifact impaired and artifact free reference tissue to correct for general lower image noise in higher keV VMI34 (link).
4
Liver Attenuation Imaging Protocol
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Circular ROIs of at least 500 mm2 were placed on axial images to measure the mean attenuation in HU by a radiologist with four years of experience in abdominal imaging. ROI were first drawn in CTA-Abdomen (because anatomical identification and delineation of structures was most accurate here) and subsequently were transferred to TNC and CTA-Chest as well as VNC-Chest and -Abdomen using the vendor’s proprietary image viewer (IntelliSpace Portal v9, Philips Healthcare). ROI positions could differ for image sets derived from different acquisitions due to respiratory motion. To minimize any mismeasurements from different ROI locations, screenshots of each ROI in CTA-Abdomen images were used to match placement in the other image sets. Two ROIs each were placed in the right and left liver lobe as well as in the spleen. The results of the four ROIs from the right and left liver lobes were averaged to obtain results for the entire liver. The two ROIs of the spleen were also averaged. The liver attenuation index was calculated as the difference of attenuation between liver and spleen13 (link),41 (link).
5
Automated Liver Segmentation and Fat Fraction
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On the post-processing platform (Intellispace portal v9.0, ISP v9.0, Philips Healthcare, Best, the Netherland), the software algorithm (multimodality tumor tracking, MMTT) could recognize the 3D margins of the liver on FF maps, and the whole liver was then semi-automatically traced with necessary manual corrections. The main portal vein, inferior vena cava, and the gallbladder were manually removed. After liver segmentation, the whole hepatic FF was automatically calculated (11 (link)).
6
Cardiac CT Imaging for Right Ventricular Function
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CCT studies are performed using at least a 64-slice scanner with retrospective electrocardiographic gating mode acquisition (ideally with modulation dose). CCT images are acquired from the level of the aortic arch to the dome of the diaphragm in a breath-hold mode. Nonionic iodinated contrast agent (approximately 80 ml) is injected at a rate of 5 ml/s with a power injector, followed by a saline 40 ml flush. A bolus tracking technique is used to trigger image acquisition once attenuation in a region of interest placed in the descending aorta has reached a pre-set threshold of 100 HU.
Axial images are reconstructed with an image matrix of 512 × 512 pixels and a slice thickness of 1.25 mm from 0% to 90% of the cardiac cycle to calculate RV function. Post-processing of CCT images will be performed on a dedicated workstation with specific RV function quantification package (IntelliSpacePortal v9.0, Philips) (Figures 2F and 2G ).
Axial images are reconstructed with an image matrix of 512 × 512 pixels and a slice thickness of 1.25 mm from 0% to 90% of the cardiac cycle to calculate RV function. Post-processing of CCT images will be performed on a dedicated workstation with specific RV function quantification package (IntelliSpacePortal v9.0, Philips) (
7
Chest CT Dose Optimization Protocol
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For every patient, the automatically generated dose protocol was extracted after the examination. Tube voltage (kVp), tube current (mA), volume-weighted CT dose index (CTDIvol) and dose length product (DLP) were collected. By multiplication of DLP by the chest conversion factor (0.0145), the effective dose (ED) could be calculated [37 (link)].
For SD-CT examinations, virtual monoenergetic images (VMI) with 40 keV, 60 keV and 70 keV were calculated using the commercially available spectral workstation (IntelliSpace Portal (v. 9.0), Philips Healthcare, The Netherlands). Thus, the following datasets were obtained:
1) 100 kVp using C-CT.
2) monoE-40 (VMI with 40 keV), monoE-50 (VMI with 50 keV), monoE-60 (VMI with 60 keV) and monoE-70 (VMI with 70 keV, approximately corresponding to 120 kVp and thus the standard clinical data) using SD-CT.
For SD-CT examinations, virtual monoenergetic images (VMI) with 40 keV, 60 keV and 70 keV were calculated using the commercially available spectral workstation (IntelliSpace Portal (v. 9.0), Philips Healthcare, The Netherlands). Thus, the following datasets were obtained:
1) 100 kVp using C-CT.
2) monoE-40 (VMI with 40 keV), monoE-50 (VMI with 50 keV), monoE-60 (VMI with 60 keV) and monoE-70 (VMI with 70 keV, approximately corresponding to 120 kVp and thus the standard clinical data) using SD-CT.
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