Split-bolus pancreas CTA protocol for local staging of pancreatic cancer and detection and characterization of liver lesions.

Purpose: To validate the use of a split-bolus pancreas CTA protocol for local staging of pancreatic cancer and to evaluate its ability to detect and characterize liver lesions.

Methods: Consecutive patients with pancreatic cancer who underwent split-bolus pancreas CTA between 12/2015 and 12/2016 were included in this IRB-approved HIPAA-compliant retrospective study. Objective evaluation of the abdominal vessels, the pancreas, the liver, and lesions, if present, was performed with attenuation measurements and tumor conspicuity and contrast-to-noise ratio (CNR) calculations.

Split-Bolus Injection Producing Simultaneous Late Arterial and Portal Venous Phases in CT Enterography: Preliminary Results.

Objective: The purpose of this article is to evaluate the image quality and added value of split-bolus contrast agent injection combining late arterial and portal venous phases compared with single-bolus contrast agent injection late arterial phase CT enterography.

Materials And Methods: Consecutive patients who underwent CT enterography before and after implementation of a single-bolus CT enterography protocol were included. Attenuation and contrast-to-noise ratio (CNR) were assessed by ROI measurements of the bowel wall and arterial and venous structures.

What Is the Optimal Abdominal Aortic Aneurysm Sac Measurement on CT Images during Follow-up after Endovascular Repair?

Purpose To develop a computed tomographic (CT) angiographic postprocessing protocol with two- and three-dimensional measurements for follow-up of patients who underwent endovascular aortic repair. Materials and Methods This HIPAA-compliant institutional review board-approved retrospective study included 159 patients (129 men, 30 women; mean age ± standard deviation, 74.9 years ± 8.

CT Intensity Distribution Curve (Histogram) Analysis of Patients Undergoing Antiangiogenic Therapy for Metastatic Renal Cell Carcinoma.

Objective: The purpose of this study was to evaluate the median versus mean attenuation obtained from histograms in the response assessment of renal cell carcinoma (RCC) target lesions in patients treated with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors.

Materials And Methods: Imaging findings of 19 patients with RCC and treated with a VEGFR tyrosine kinase inhibitor that included a baseline study and at least two follow-up studies were retrospectively analyzed. Histograms of target lesions were created from ROI measurements, and mean and median lesion attenuation were obtained.

Split-bolus intravenous contrast material injection vs. single-bolus injection in patients following endovascular abdominal aortic repair (EVAR).

Purpose: To investigate the feasibility and accuracy of a split-bolus contrast injection CTA (SB-CTA) compared to a single-bolus injection CTA (SI-CTA) protocol of post-EVAR patients.

Materials And Methods: In this IRB-approved study, patients who underwent SB-CTA and SI-CTA after EVAR were evaluated. Attenuation and contrast-to-noise ratio (CNR) of vessels and parenchymal organs were assessed.

Objective image analysis of real-time three-dimensional intraoperative ultrasound for intrinsic brain tumour surgery.

Background: There is growing evidence that maximal surgical resection of primary intrinsic brain tumours is beneficial, both by improving progression free and overall survival and also by facilitating postoperative chemotherapy and radiotherapy. Hence, there has been an increase in the popularity of real-time intraoperative imaging in brain tumour surgery. The complex theatre arrangements, prohibitive cost and prolonged theatre time of intraoperative MRI have restricted its application.

Metal implants on CT: comparison of iterative reconstruction algorithms for reduction of metal artifacts with single energy and spectral CT scanning in a phantom model.

Purpose: To assess single energy metal artifact reduction (SEMAR) and spectral energy metal artifact reduction (MARS) algorithms in reducing artifacts generated by different metal implants.

Materials And Method: Phantom was scanned with and without SEMAR (Aquilion One, Toshiba) and MARS (Discovery CT750 HD, GE), with various metal implants. Images were evaluated objectively by measuring standard deviation in regions of interests and subjectively by two independent reviewers grading on a scale of 0 (no artifact) to 4 (severe artifact).

Dual energy CT angiography: pros and cons of dual-energy metal artifact reduction algorithm in patients after endovascular aortic repair.

Purpose: To evaluate the value of metal artifact reduction (MAR) post-processing and iodine MD images in fast kV-switching dual-energy computed tomography (DECT) in patients after endovascular aortic repair (EVAR).

Materials And Methods: Twenty-four consecutive EVAR patients (age 76 ± 9 years, 7/24 (29%) with coils, 9/24 (37.5%) with 10 endoleaks) who underwent DECT angiography were included in this HIPAA-compliant, IRB-approved retrospective study.

Diagnostic yield and clinical impact of microbiologic diagnosis from CT-guided drainage in patients previously treated with empiric antibiotics.

Purpose: The purpose of the study was to evaluate diagnostic yield and the added value of culture results on the clinical management of patients empirically treated with antibiotics prior to CT-guided drainage.

Methods: This retrospective, HIPAA-compliant, IRB-approved study reviewed records of 300 consecutive patients who underwent CT-guided aspiration or drainage for suspected infected fluid collection while on empiric antibiotics (11/2011 to 9/2013) at a single institution. Patient imaging and clinical characteristics were evaluated by an abdominal imaging fellow and culture results, and patient management were evaluated by an infectious diseases fellow.

MDCT vs. MRI for incidental pancreatic cysts: measurement variability and impact on clinical management.

Purpose: To investigate incidental pancreatic cysts (IPCs) size discrepancy in a cohort of patients receiving both computed tomography (CT) and magnetic resonance imaging (MRI) and its impact on clinical management based on the 2010 American College of Radiology (ACR) guidelines.

Methods: This was a HIPAA-compliant, retrospective, IRB-approved study. Informed consent was waived.

Localizing Acute Lower Gastrointestinal Hemorrhage: CT Angiography Versus Tagged RBC Scintigraphy.

Objective: Lower gastrointestinal hemorrhage is a common cause of hospitalization and has substantial associated morbidity and financial cost. CT angiography (CTA) is emerging as an alternative to (99m)Tc-labeled RBC scintigraphy (RBC scintigraphy) for the localization of acute lower gastrointestinal bleeding (LGIB); however, data on comparative efficacy are scant. The aim of this study was to assess the utility of CTA compared with RBC scintigraphy in the overall evaluation and management of acute LGIB.

CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors.

Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods.

Limited added utility of performing follow-up contrast-enhanced CT in patients undergoing initial non-enhanced CT for evaluation of flank pain in the emergency department.

In our emergency department (ED), patients with flank pain often undergo non-enhanced computed tomography (NECT) to assess for nephroureteral (NU) stone. After immediate image review, decision is made regarding need for subsequent contrast-enhanced CT (CECT) to help assess for other causes of pain. This study aimed to review the experience of a single institution with this protocol and to assess the utility of CECT.

Assessment of liver fat in an obese patient population using noncontrast CT fat percent index.

Objective: To develop a simplified method to quantify liver fat using computed tomography (CT) fat % index (CTFPI) compared to liver spleen method (CTL/S, CTL-S).

Methods: Noncontrast CT of the liver was performed in 89 patients (overweight, obese, severely obese) to quantify fat, using the following: CTFPI=[(65-patient HU)/65]×100, normal live r=65 HU.

Results: There was a strong linear correlation between CTFPI and the standard method of assessing liver fat using CTL/S (r=-0.

Split-bolus spectral multidetector CT of the pancreas: assessment of radiation dose and tumor conspicuity.

Purpose: To assess tumor conspicuity and radiation dose with a new multidetector computed tomography (CT) protocol for pancreatic imaging that combines spectral CT and split-bolus injection.

Materials And Methods: This study was approved by the institutional review board and compliant with HIPAA. The requirement for informed consent was waived.

Spectral CT with metal artifacts reduction software for improvement of tumor visibility in the vicinity of gold fiducial markers.

Purpose: To evaluate spectral computed tomography (CT) with metal artifacts reduction software (MARS) for reduction of metal artifacts associated with gold fiducial seeds.

Materials And Methods: Thirteen consecutive patients with 37 fiducial seeds implanted for radiation therapy of abdominal lesions were included in this HIPAA-compliant, institutional review board-approved prospective study. Six patients were women (46%) and seven were men (54%).

Standardisation of liver MDCT by tracking liver parenchyma enhancement to trigger imaging.

Objective: To assess parenchymal bolus-triggering in terms of liver enhancement, lesion-to-liver conspicuity and inter-image variability across serial follow-up MDCTs.

Methods: We reviewed MDCTs of 50 patients with hepatic metastases who had a baseline CT and two follow-up examinations. In 25 consecutive patients CT data acquisition was initiated by liver parenchyma triggering at a 50-HU enhancement threshold.

Female breast, lung, and pelvic organ radiation from dose-reduced 64-MDCT thoracic examination protocols: a phantom study.

Objective: We compared phantom organ doses delivered to breast, lung, and pelvis by five protocols using current dose reduction methods for routine chest CT and pulmonary CT angiography.

Materials And Methods: We measured the radiation dose to an anthropomorphic phantom using 64-MDCT with metal oxide semiconductor field effect transistor (MOSFET) detectors in the breast (skin and parenchyma), the lungs, and the pelvis (upper and lower). We compared the following five protocols: protocol 1, 120 kVp, automatic dose modulation, 120-320 mA; protocol 2, 120 kVp, automatic dose modulation, 60-200 mA; protocol 3, 100 kVp and fixed dose of 200 mA; protocol 4, 120 kVp, automatic dose modulation, 200-394 mA; and protocol 5, 80 kVp and fixed dose of 120 mA.

Incidence of contrast-induced nephropathy in patients with multiple myeloma undergoing contrast-enhanced CT.

Objective: The purpose of this article is to evaluate the incidence of contrast-induced nephropathy (CIN) and the effects of associated risk factors in patients with multiple myeloma undergoing contrast-enhanced CT (CECT) with IV administration of nonionic iodinated contrast agent.

Materials And Methods: This retrospective review of medical records identified patients with a diagnosis of myeloma who underwent a CECT examination of the chest, abdomen, or pelvis between January 1, 2005, and December 1, 2008. Analysis for CIN, as defined by an increase in creatinine level after the CECT examination of 25% or more, or of 0.

Absorbed radiation dose in radiosensitive organs during coronary CT angiography using 320-MDCT: effect of maximum tube voltage and heart rate variations.

Objective: The purpose of this article is to estimate the absorbed radiation dose in radiosensitive organs during coronary MDCT angiography using 320-MDCT and to determine the effects of tube voltage variation and heart rate (HR) control on absorbed radiation dose.

Materials And Methods: Semiconductor field effect transistor detectors were used to measure absorbed radiation doses for the thyroid, midbreast, breast, and midlung in an anthropomorphic phantom at 100, 120, and 135 kVp at two different HRs of 60 and 75 beats per minute (bpm) with a scan field of view of 320 mm, 400 mA, 320 × 0.5 mm detectors, and 160 mm collimator width (160 mm range).

Escalating computed tomography angiogram (CTA) grade predicts unresectability and margin status for pancreaticobiliary neoplasms.

Background And Aims: The Raptopoulos computed tomography (CT) grading system of pancreaticobiliary cancers was conceived to predict resectability based on tumour involvement of critical vasculature. The aim of the present study was to investigate the relationship between CT grade, resectability, margin status and survival after pancreatic resection.

Methods: Patients with presumed pancreaticobiliary malignancy and a pancreas protocol computed tomography angiogram (CTA) who underwent attempted curative resection from October 2001 and August 2008 were identified.

CT enterography.

Conventional radiologic and endoscopic evaluations of the small bowel are often limited by the length, caliber, and motility of the small bowel loops. The development of new multidetector-row CT scanners, with faster scan times and isotropic spatial resolution, allows high-resolution multiphasic and multiplanar assessment of the bowel, bowel wall, and lumen. CT Enterography (CTE) is a variant of routine abdominal scanning, geared toward more sustained bowel filling with oral contrast material, and the use of multiplanar images, that can enhance gastrointestinal (GI) tract imaging.

Combined vascular-excretory phase MDCT angiography in the preoperative evaluation of renal donors.

Objective: The objective of our study was to test a dose reduction protocol that uses combined vascular-excretory phase scanning achieved by split IV contrast injection and compare it with conventional multiphase MDCT angiography (MDCTA) in evaluating potential renal donors.

Materials And Methods: This study is a review of MDCTA examinations of 54 potential renal donors scanned on 16- and 64-MDCT. The IV bolus was split: 50 mL was administered 3 minutes before scanning and a second injection of 70-100 mL was administered at a rate of 4-6 mL/s, with CT angiography started by bolus tracking.