Post-EVAR split-bolus CT angiography using dual-energy CT: all you need in a single scan!

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0021

Type:

EuroSafe Imaging

Keywords:

Diagnostic procedure, Computer Applications-Detection, diagnosis, CT-Angiography, Vascular, Radioprotection / Radiation dose, Action 2 - Clinical diagnostic reference levels (DRLs), Action 3 - Optimisation, diagnostic reference levels, image quality, Aneurysms

Authors:

R. Iezzi, F. Carchesio, A. Posa, C. Colosimo, L. Bonomo

DOI:

10.1594/esi2017/ESI-0021

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0021

Fig. 1: T.R. Male 74-year-old patient at 1 year post-EVAR follow-up....

Fig. 2: T.R. Male 74-year-old patient at 1 year post-EVAR follow-up....

Fig. 3: T.R. Male 74-year-old patient at 1 year post-EVAR follow-up. Combined...

Background/Introduction

To evaluate the diagnostic potential of virtual-unenhanced images plus combined arterial-delayed phase images obtained with a single acquisition by using a dual-energy split-bolus CT-angiography acquisition protocol in patients undergoing post-endovascular aortic repair (EVAR) follow-up.

Description of activity and work performed

Thirty consecutive patients older than 75 years with previous EVAR were enrolled and underwent a quadruple phase dual-energy CT examination using a split bolus injection protocol, in order to obtain a dual-energy combined Arterial-Delayed-Enhanced-Phase as well as a triple-phase (Real-Unenhanced-Phase plus Arterial-Enhanced-Phase plus Delayed-Enhanced-Phase). After Real-Unenhanced-Phase acquisition, a test-bolus technique with 20mL CM was performed to determine the aortic bolus-arrival-time. Two separate boli of CM (40mL@4mL/s) were injected. Arterial-Enhanced-Phase was acquired one bolus-arrival-time after injection of the first bolus, whereas Arterial-Delayed-Enhanced-Phase was acquired one bolus-arrival-time...

Conclusion and Recommendations

This study depicts an accurate "all-in-one" approach to endoleak detection in post-EVAR follow-up, with critical radiation dose saving, without affecting diagnostic information and patient management.

Personal/Organisational information

The authors have no conflicts of interest.

References

Takeuchi M, Kawai T, Ito M, et al. Split-bolus CT-urography using dual-energy CT: feasibility, image quality and dose reduction. Eur J Radiol. 2012;81:3160-5. Halpern EJ. Triple-rule-out CT angiography for evaluation of acute chest pain and possible acute coronary syndrome. Radiology. 2009;252:332-45. Iezzi R, Cotroneo AR, Filippone A, et al. Multidetector CT in abdominal aortic aneurysm treated with endovascular repair: are unenhanced and delayed phase enhanced images effective for endoleak detection? Radiology. 2006;241:915-21.