Purpose
Pancreatic CTA is widely used for screening,
detection,
staging and follow up of the pancreatic cancer.
The standard protocol used in our institution involves non contrast study,
followed by pancreatic phase and portal venous phase.
This combination of contrast phases provides perfect conspicuity of pancreatic tumor,
proximity to vessels and detection of metastases.
Nevertheless,
multiple phases also cause very high levels of radiation exposure to the patients.
Our goal as radiologists is to reduce the radiation exposure,
due to the known risks of radiation exposure,...
Methods and Materials
The study was conducted with the approval of institutional review board and was compliant with Health Insurance Portability and Accountability Act regulations.
Informed consent was waived by the Institutional Review Board.
In our institution,
patients with high suspicion for pancreatic adenocarcinoma are referred to for pancreatic MDCT Angiography asfirst CTstudy. This study includes 144 consecutive patients referred for pancreatic CTA for suspected pancreatic neoplasm.
These patients were assigned to either standard or split bolus spectral MDCT protocol accordingly to scanner availability.
Of those,
69 scans...
Conclusion
In a single combined phase,
split-bolus spectral imaging resulted in vascular,
liver and pancreatic attenuation values and pancreatic tumor conspicuity equal or higher than those from a combination of two phase pancreatic imaging.
References
Kent TS,
Raptopoulos V,
Callery MP,
Gautam S,
Vollmer CM. Escalating computed tomography angiogram (CTA) grade predicts unresectability and margin status for pancreaticobiliary neoplasms.
HPB (Oxford) 2010; 12:115-122
Ichikawa T,
Erturk SM,
Sou H,
Nakajima H,
Tsukamoto T,
Motosugi U,
Araki T.MDCT of pancreatic adenocarcinoma: optimal imaging phases and multiplanar reformatted imaging.
Am J Roentgenol 2006;187(6):1513-1520
Kondo H,
Kanematsu M,
Goshima S,
Miyoshi T,
Shiratori Y,
Onozuka M,
Moriyama N,
Bae KT.
MDCT of the pancreas: optimizing scanning delay with a bolus-tracking technique for pancreatic,...
Personal Information
O.
R.
Brook,
A.
Brook,
C.
Wilcox,
B.
Siewert,
V.
Raptopoulos
Department of Radiology,
Beth Israel Deaconess Medical Center,
Boston,
MA
S.
Gourtsoyianni
Athens,
Greece