Reduced Intravenous Contrast Dose Portal Venous Phase Photon-Counting Computed Tomography Compared With Conventional Energy-Integrating Detector Portal Venous Phase Computed Tomography.

Objective: The aim of this study was to compare portal venous phase photon-counting CT (PCCT) using 20 cc less than weight-based contrast dosing with energy-integrating detector CT (EID-CT) using weight-based dosing by quantitative and qualitative analysis.

Methods: Fifty adult patients who underwent a reduced intravenous contrast dose portal venous phase PCCT from May 1, 2023, to August 10, 2023, and a prior portal-venous EID-CT with weight-based contrast dosing were retrospectively identified. Hounsfield units (HU) and noise (SD of HU) were obtained from region-of-interest measurements on 70-keV PCCT and EID-CT in 4 hepatic segments, the main and right portal vein, and both paraspinal muscles.

Pancreatic cyst prevalence and detection with photon counting CT compared with conventional energy integrating detector CT.

Purpose: To calculate the prevalence of pancreatic cysts on photon counting CT (PCCT) and compare with that of 128-slice conventional energy-integrating detector CT (EIDCT).

Method: A retrospective single institution database search identified all contrast-enhanced abdominal CT examinations performed at an outpatient facility that has both a PCCT and EIDCT between 4/11/2022 and 7/26/2022. The presence and size of pancreatic cysts were recorded.

Photon-Counting Computed Tomography Versus Energy-Integrating Dual-Energy Computed Tomography: Virtual Noncontrast Image Quality Comparison.

Purpose: This study aimed to compare the image quality of portal venous phase-derived virtual noncontrast (VNC) images from photon-counting computed tomography (PCCT) with energy-integrating dual-energy computed tomography (EI-DECT) in the same patient using quantitative and qualitative analyses.

Methods: Consecutive patients retrospectively identified with available portal venous phase-derived VNC images from both PCCT and EI-DECT were included. Patients without available VNC in picture archiving and communication system in PCCT or prior EI-DECT and non-portal venous phase acquisitions were excluded.

Photon-counting CT urogram: optimal acquisition potential (kV) determination for virtual noncontrast creation.

Purpose: To quantitatively and qualitatively compare the degree of iodine removal in the collecting system from PCCT urographic phase-derived virtual noncontrast (VNC) images obtained at 140 kV versus 120 kV.

Methods: A retrospective PACS search identified adult patients (>18 years) who underwent a PCCT urogram for hematuria from 4/2022 to 4/2023 with available urographic phase-derived VNC images in PACS. Tube voltage (120 kV, 140 kV), body mass index, CTDIvol, dose length product (DLP), and size-specific dose estimate (SSDE) were recorded.

Crohn's disease inflammation severity assessment with iodine density from photon counting CT enterography: comparison with endoscopic histopathology.

Purpose: To determine optimal iodine density thresholds for active inflammation in CD patients with PCCT enterography and determine if iodine density can be used to stratify CD activity severity.

Methods: A retrospective PACS search identified patients with CD imaged with PCCT enterography from 4/11/2022 to 10/30/2022 and with clinical notes, endoscopic/surgical pathology and available source PCCT data for iodine density analysis. Two abdominal radiologists with expertise in CD each drew two region of interest measurements within the visibly most affected region of terminal or neoterminal ileum wall on commercially available system (SyngoVia).

Pancreatic Cystic Lesions: Next Generation of Radiologic Assessment.

Pancreatic cystic lesions are frequently identified on cross-sectional imaging. As many of these are presumed branch-duct intraductal papillary mucinous neoplasms, these lesions generate much anxiety for the patients and clinicians, often necessitating long-term follow-up imaging and even unnecessary surgical resections. However, the incidence of pancreatic cancer is overall low for patients with incidental pancreatic cystic lesions.

Pancreatic Cysts: Radiology.

This article reviews the types of pancreatic cysts encountered in Radiologic practice. It summarizes the malignancy risk of each of the following: serous cystadenoma, mucinous cystic tumor, intraductal papillary mucinous neoplasm main duct and side branch, and some miscellaneous cysts such as neuroendocrine tumor and solid pseudopapillary epithelial neoplasm. Specific reporting recommendations are given.

Structured versus non-structured reporting of pelvic MRI for ileal pouch evaluation: clarity and effectiveness.

Purpose: Given that ileal pouch-anal anastomosis (IPAA) surgery is a technically challenging and high-morbidity procedure, there are numerous pertinent imaging findings that need to be clearly and efficiently communicated to the IBD surgeons for essential patient management and surgical planning. Structured reporting has been increasingly used over the past decade throughout various radiology subspecialties to improve reporting clarity and completeness. We compare structured versus non-structured reporting of pelvic MRI for ileal pouch to evaluate for clarity and effectiveness.

Crohn's disease active inflammation assessment with iodine density from dual-energy CT enterography: comparison with endoscopy and conventional interpretation.

Purpose: To compare terminal ileum (TI) mucosal iodine density obtained at dual-energy CT enterography (DECTE) with conventional CT interpretation and endoscopy in patients with Crohn's disease (CD).

Materials And Methods: Twenty-three CD patients (14 men; mean[SD] age:48.1[16.

Crohn Disease Active Inflammation Assessment with Iodine Density from Dual-Energy CT Enterography: Comparison with Histopathologic Analysis.

Background Dual-energy CT enterography (DECTE) has been shown to be useful in characterizing Crohn disease activity compared with clinical markers of inflammation but, to the knowledge of the authors, comparison has not been made with histopathologic specimens. Purpose To compare mucosal iodine density obtained at DECTE from Crohn disease-affected bowel with histopathologic specimens from surgically resected ileocolectomy bowel segments or terminal ileum colonoscopic biopsies in the same patients. Materials and Methods This was a retrospective study.

Prediction of Patient Height and Weight With a 3-Dimensional Camera.

Objective: The aim of this study was to determine accuracy of height and weight prediction by a 3-dimensional (3D) camera.

Methods: A total of 453 patients whose computed tomography imaging used a 3D camera from December 19, 2018 to March 19, 2019 were retrospectively identified. An image of each patient was taken before the computed tomography by a 3D camera mounted to the ceiling.

Society of Abdominal Radiology Disease Focused Panel Survey on Clinical Utilization of Incidental Pancreatic Cyst Management Recommendations and Template Reporting.

Objective: To assess current practice patterns with respect to protocols used for incidental pancreatic cyst follow-up, management guidelines, and template reporting.

Methods: The Society of Abdominal Radiology Disease Focused Panel on intraductal pancreatic neoplasms distributed an anonymous 14-question survey to its members in June 2018 that focused on current utilization of incidental pancreatic cyst guidelines, protocols, and template reporting.

Results: Among the 1,390 email invitations, 323 responded, and 94.

Crohn Disease Prognostication With Semiautomatic Dual-Energy Computed Tomography Enterography-Derived Iodine Density.

Objective: The objective of this study was to determine if dual-energy computed tomography enterography (DECTE)-obtained iodine density can predict medical management change or surgery in Crohn disease patients.

Methods: The most active-appearing bowel segment on DECTE in 21 Crohn disease patients was retrospectively interrogated with prototype software determining the percentage of bowel wall (I) in specified ranges. Patients were categorized into 3 groups after DECTE: (1) no management change, (2) outpatient medication change, and (3) inpatient admission or surgery.

Radiation dose reduction, improved isocenter accuracy and CT scan time savings with automatic patient positioning by a 3D camera.

Purpose: To compare CT isocenter accuracy, patient dose, and scan time in adults imaged with and without use of a 3D camera.

Method: 571 CT examinations utilizing a 3D camera for initial patient positioning (optional radiographer isocenter adjustment) and 504 examinations scanned without the camera between 10/1/2018 and 3/19/2019 were retrospectively identified. All exams were chest or abdominopelvic CTs.

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: recommendations for Standardized Imaging and Reporting from the Society of Abdominal Radiology IPMN disease focused panel.

There have been many publications detailing imaging features of malignant transformation of intraductal papillary mucinous neoplasms (IPMN), management and recommendations for imaging follow-up of diagnosed or presumed IPMN. However, there is no consensus on several practical aspects of imaging IPMN that could serve as a clinical guide for radiologists and enable future data mining for research. These aspects include how to measure IPMN, define reporting terminology, standardize reporting and unify guidelines for surveillance.

Novel Dual-Energy Computed Tomography Enterography Iodine Density Maps Provide Unique Depiction of Crohn Disease Activity.

Objective: To create a map of iodine densities within affected segments of small-bowel Crohn disease (CD) derived from contrast-enhanced dual-energy computed tomography enterography (DECTE) studies.

Methods: Twenty CD patients imaged with intravenous contrast-enhanced DECTE between June 2016 and December 2017 were retrospectively identified. Ten patients without clinical evidence of CD and 8 normal-appearing jejunal segments in CD patients were controls.

Reporting Templates for MRI and Water-Soluble Contrast Enema in Patients With Ileal Pouch-Anal Anastomosis: Experience From a Large Referral Center.

Ileal pouch-anal anastomosis (IPAA) surgery is the reference standard surgical procedure for treatment of ulcerative colitis and most patients with familial adenomatous polyposis. This procedure allows preservation of fecal continence and gastrointestinal continuity. However, it is associated with a wide variety of complications, which often have nonspecific and overlapping clinical presentations, making imaging an important part of workup for pouch dysfunction.

A clinical and radiographic model to predict surgery for acute small bowel obstruction in Crohn's disease.

Purpose: For more than half of Crohn's disease patients, strictures will cause bowel obstructions that require surgery within 10 years of their initial diagnosis. This study utilizes computed tomography imaging and clinical data obtained at the initial emergency room visit to create a prediction model for progression to surgery in Crohn's disease patients with acute small bowel obstructions.

Methods: A retrospective chart review was performed for patients who presented to the emergency room with an ICD-10 diagnosis for Crohn's disease and visit diagnosis of small bowel obstruction.

Crohn's Disease Activity Quantified by Iodine Density Obtained From Dual-Energy Computed Tomography Enterography.

Objective: The objective of this study was to assess if bowel wall iodine density obtained from dual-source, dual-energy computed tomography enterography (DECTE) could be a biomarker of Crohn's disease activity.

Methods: Twenty-two patients with Crohn's disease imaged with DECTE from February 2016 to May 2018 were retrospectively identified by departmental report search. Iodine maps were created with commercial software (Syngovia).

Clinical abdominal dual-energy CT: 15 years later.

Dual-energy CT (DECT) has been available for clinical use in the United States for close to 15 years. Although multiple applications in all areas of the body have been described that are only possible with DECT, the adoption into clinical practice has been slow. This paper will attempt to address many of the impediments the author has encountered from his discussions with radiologists across the country.

Testing for Verification Bias in Reported Malignancy Risks for Side-Branch Intraductal Papillary Mucinous Neoplasms: A Simulation Modeling Approach.

Objective: The objective of our study was to test for the possibility that published malignancy risks for side-branch intraductal papillary mucinous neoplasms (IPMNs) are overestimates, likely due to verification bias.

Materials And Methods: We tested for possible verification bias using simulation modeling techniques. First, in age-defined hypothetical cohorts of 10 million persons, we projected the frequency of pancreatic ductal adenocarcinoma (PDAC) arising from side-branch IPMNs over 5 years using published estimates of their prevalence (4.