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European Radiology
Published in: European Radiology 4/2017

Open Access 01-04-2017 | Computed Tomography

Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT)

Authors: D. Javor, A. Wressnegger, S. Unterhumer, K. Kollndorfer, R. Nolz, D. Beitzke, C. Loewe

Published in: European Radiology | Issue 4/2017

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Abstract

Objectives

To assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR).

Methods

Fifty patients referred for routine follow-up post-EVAR CT and a history of at least one post-EVAR follow-up CT examination using our standard biphasic (arterial and venous phase) routine protocol (which was used as the reference standard) were included in this prospective trial. An in-patient comparison and an analysis of the split-bolus protocol and the previously used double-phase protocol were performed with regard to differences in diagnostic accuracy, radiation dose, and image quality.

Results

The analysis showed a significant reduction of radiation dose of up to 42 %, using the single-acquisition split-bolus protocol, while maintaining a comparable diagnostic accuracy (primary endoleak detection rate of 96 %). Image quality between the two protocols was comparable and only slightly inferior for the split-bolus scan (2.5 vs. 2.4).

Conclusions

Using the single-acquisition, split-bolus approach allows for a significant dose reduction while maintaining high image quality, resulting in effective endoleak identification.

Key Points

• A single-acquisition, split-bolus approach allows for a significant dose reduction.
• Endoleak development is the most common complication after endovascular aortic repair (EVAR).
• CT angiography is the imaging modality of choice for aortic aneurysm evaluation.
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Metadata
Title
Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT)
Authors
D. Javor
A. Wressnegger
S. Unterhumer
K. Kollndorfer
R. Nolz
D. Beitzke
C. Loewe
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4480-6

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