Thrombus discrimination using quantitative assessment of late-enhancement iodine maps and low monoenergetic imaging

Abstract

In the past decade, spectral computed tomography (CT) has emerged as a useful means to improve tissue characterization. However, few studies have explored its potential usefulness for the detection of cardiac and aortic thrombi.1–3 Furthermore, although delayed-phase imaging typically provides the most valuable datasets aimed at ruling out thrombi, there are scarce reports regarding threshold values for thrombotic sources.4 With the advent of dual-layer scanners that enable spectral routine acquisitions without protocol modifications, and in the context of acute ischemic stroke imaging, there is an expected increase in the number of scans with incidental thrombi. These scanners enable the availability of simultaneous multiparametric data including conventional CT images, monoenergetic imaging ranging from low (40keV) to high (200 keV) energy levels, and iodine density maps among others. Accordingly, we sought to evaluate the incremental value of monoenergetic and iodine density maps over conventional CT for the discrimination of thrombi in patients with acute ischemic stroke (AIS)...