(2022) Decker | PCCT enables anemia detection from routine contrast-enhanced CT

Daniel Stromer

This proof-of-concept study demonstrates that spectral PCCT data from routine contrast-enhanced oncologic staging examinations can be used to detect and quantify anemia by measuring blood-pool attenuation on virtual non-contrast (VNC) images.

Mean blood-pool VNC attenuation showed a strong positive correlation with hemoglobin (R² = 0.81) and hematocrit (R² = 0.77), indicating that decreasing VNC attenuation closely reflects increasing anemia severity.

VNC attenuation progressively decreased from no anemia to mild, moderate, and severe anemia, demonstrating the potential for opportunistic identification of previously unknown or worsening anemia directly from routinely acquired contrast-enhanced PCCT examinations.

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Key Results

Parameter	Main finding
Study population	179 oncologic patients; mean age 68 ± 11 years; 77 women and 102 men
Hemoglobin correlation	Mean VNC blood-pool attenuation strongly correlated with hemoglobin: R² = 0.81 (95% CI: 0.76–0.86; P < .001)
Hematocrit correlation	Strong correlation with hematocrit: R² = 0.77 (95% CI: 0.70–0.82; P < .001)
Women – no anemia	Mean VNC attenuation 44.2 ± 3.6 HU
Women – mild anemia	40.6 ± 2.0 HU
Women – moderate anemia	35.2 ± 3.6 HU
Women – severe anemia	25.0 ± 3.5 HU
Men – no anemia	Mean VNC attenuation 46.4 ± 3.5 HU
Men – mild anemia	41.8 ± 2.5 HU
Men – moderate anemia	36.4 ± 3.6 HU
Men – severe anemia	33.3 ± 1.2 HU
Main implication	Spectral PCCT VNC imaging may provide an opportunistic quantitative marker of anemia from routine contrast-enhanced examinations without requiring a dedicated non-contrast acquisition.

Source:
Decker JA, Huber A, Senel F, Bette S, Braun F, Risch F, Woźnicki P, et al. Anemia Detection by Hemoglobin Quantification on Contrast-enhanced Photon-counting CT Data Sets. Radiology. 2022;305(3):650–652. doi: 10.1148/radiol.220063.