Comparing dual energy CT and subtraction CT on a phantom: which one provides the best contrast in iodine maps for sub-centimetre details?

E. Baerends, L.J. Oostveen, C.T. Smit, M. Das, I. Sechopoulos, M. Brink, F. de Lange and M. Prokop

European radiology 2018;28:5051-5059



To compare contrast-to-noise ratios (CNRs) and iodine discrimination thresholds on iodine maps derived from dual energy CT (DECT) and subtraction CT (SCT). A contrast-detail phantom experiment was performed with 2 to 15 mm diameter tubes containing water or iodinated contrast concentrations ranging from 0.5 mg/mL to 20 mg/mL. DECT scans were acquired at 100 kVp and at 140 kVp+Sn filtration. SCT scans were acquired at 100 kVp. Iodine maps were created by material decomposition (DECT) or by subtraction of water scans from iodine scans (SCT). Matched exposure levels varied from 8 to 15 mGy. Iodine discrimination thresholds (C ) and response times were determined by eight observers. The adjusted mean CNR was 1.9 times higher for SCT than for DECT. Exposure level had no effect on CNR. All observers discriminated all details ≥10 mm at 12 and 15 mGy. For sub-centimetre details, the lowest calculated C was ≤ 0.50 mg/mL for SCT and 0.64 mg/mL for DECT. The smallest detail was discriminated at ≥4.4 mg/mL with SCT and at ≥7.4 mg/mL with DECT. Response times were lower for SCT than DECT. SCT results in higher CNR and reduced iodine discrimination thresholds compared to DECT for sub-centimetre details. • Subtraction CT iodine maps exhibit higher CNR than dual-energy iodine maps • Lower iodine concentrations can be discriminated for sub-cm details with SCT • Response times are lower using SCT compared to dual-energy CT.