Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms.
Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared.
Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p=0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p=0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p<0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p=0.22).
Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.
2009 The Royal College of Radiologists.