Endoleaks after Endovascular Abdominal Aortic Aneurysm Repair: Detection with Dual-Energy Dual-Source CT

Stolzmann, Paul; Frauenfelder, Thomas; Pfammatter, Thomas; Peter, Nicole; Scheffel, Hans; Lachat, Mario; Schmidt, Bernhard; Marinček, Borut; Alkadhi, Hatem; Schertler, Thomas

doi:10.1148/radiol.2483080193

Cited by 208 publications

(125 citation statements)

References 29 publications

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…The recent introduction of dual-source CT (DSCT) systems has re-enlivened DECT for various clinical indications [9][10][11][12][13][14][15][16][17], owing to the simultaneous data acquisition of two X-ray tube-detector systems at two different X-ray spectra.…”

Section: Discussionmentioning

confidence: 99%

“…Common applications of DECT include the reconstruction of virtual unenhanced images to spare the (true) unenhanced CT acquisition and therefore reduce the total radiation dose [9][10][11][12], the detailed use of material decomposition techniques to characterise urinary stones of different compositions [9; 13-16], the separation of xenon from air [18], or blood from air [19; 20].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

Self Cite

View full text Add to dashboard Cite

PURPOSE: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). MATERIALS AND METHODS: 70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140 kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140 kV ratio was calculated. RESULTS: All intra-and interobserver agreements were excellent (r = 0.93-0.97; p < 0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p < 0.05; average increase, 12.5 +/-3.6HU), while the ratios remained similar (each, p > 0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p < 0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p < 0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p < 0.05). CONCLUSION: DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80 kV and 140 kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.Dual-Energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study 1 Abstract Purpose: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). Materials and Methods:70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140kV ratio was calculated.Results: All intra-and interobserver agreements were excellent (r=0.93-0.97; p<0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p<0.05; average increase, 12.5±3.6HU), while the ratios remained similar (each, p>0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p<0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p<0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p<0.05). Conclusion:DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80kV and 140kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several clinical applications for dual-energy imaging (using both dual-source and fast kVp switching) are emerging, including virtual unenhanced imaging, differentiating urinary stones, imaging of gout, and others [28][29][30][31][32].…”

Section: Dual-energy Ct Is As Old As Ct Itselfmentioning

confidence: 99%

Computed tomography—old ideas and new technology

2011

View full text Add to dashboard Cite

show abstract

“…Dual energy CT was originally designed for classification of the elementary chemical composition of tissues, which is of clinical value in applications such as automated bone removal [1], kidney stone characterization [2], gout detection [3], pulmonary embolism detection [4], endoleak detection [5] and iodine removal (or "virtual non-contrast") [1]. Relatively little attention has been paid to the potential for enhanced detection of hypervascular pathologies at dual energy CT [6], despite the predicted advantage of low kV imaging in phantom models [7,8].…”

Section: Introductionmentioning

confidence: 99%

Pilot multi-reader study demonstrating potential for dose reduction in dual energy hepatic CT using non-linear blending of mixed kV image datasets

et al. 2010

View full text Add to dashboard Cite

Objective To determine the potential for radiation dose reduction using sigmoidally-blended mixed-kV images from dual energy (DE) hepatic CT. Methods Multiple contrast-enhanced, DE (80 kV/140 kV) datasets were reconstructed from 34 patients undergoing clinically-indicated examinations using routine CTDI vol . Noise was inserted in projection-space to simulate six dose levels reflecting 25-100% of the original dose. Three radiologists, blinded to dose, evaluated image preference, image quality, and diagnostic confidence (scale 1 to 5) using sigmoidally-blended, mixed-kV images, identifying the lowest acceptable dose (both image quality and confidence scores ≥4). At this lowest acceptable dose, the sigmoidal, 0.5 and 0.3 linear blended images were ranked in order of preference.Results Radiation dose level correlated with image preference (correlation coefficients = 0.94, 0.81, 0.94). However, 82% (28/34) and 97% (33/34) of examinations corresponding to dose reductions of 45% and 30%, respectively, yielded acceptable image quality and confidence for all three radiologists. These frequencies were similar whether or not a lesion was present. Each radiologist had specific preferences between mixed-kV image display techniques (p≤0.006), with two most often preferring sigmoidally-blended images. Conclusions There is potential for further dose reduction utilizing DE hepatic CT. Radiologist visual preference for mixed-kV images is idiosyncratic.

show abstract

Endoleaks after Endovascular Abdominal Aortic Aneurysm Repair: Detection with Dual-Energy Dual-Source CT

Abstract: Compared with standard protocols, one dual-energy dual-source CT scan performed during the delayed phase with reconstruction of virtual nonenhanced images enables detection of endoleaks after endovascular AAA repair with high accuracy and a considerably lower radiation dose.

Cited by 208 publications

References 29 publications

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

Computed tomography—old ideas and new technology

Pilot multi-reader study demonstrating potential for dose reduction in dual energy hepatic CT using non-linear blending of mixed kV image datasets

Contact Info

Product

Resources

About