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01.10.2014 | Computed Tomography

Dual-energy computed tomography after endovascular aortic aneurysm repair: The role of hard plaque imaging for endoleak detection

verfasst von: R. Müller-Wille, T. Borgmann, W. A. Wohlgemuth, F. Zeman, K. Pfister, E. M. Jung, P. Heiss, A. G. Schreyer, B. Krauss, C. Stroszczynski, C. Dornia

Erschienen in: European Radiology | Ausgabe 10/2014

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Abstract

Objectives

To assess the diagnostic accuracy of dual-energy computed tomography (DECT) for detection of endoleaks and aneurysm sac calcifications after endovascular aneurysm repair (EVAR) using hard plaque imaging algorithms.

Materials and methods

One hundred five patients received 108 triple-phase contrast-enhanced CT (non-contrast, arterial and delayed phase) after EVAR. The delayed phase was acquired in dual-energy and post-processed using the standard (HPI-S) and a modified (HPI-M) hard plaque imaging algorithm. The reference standard was determined using the triple-phase CT and contrast-enhanced ultrasound. All images were analysed separately for the presence of endoleaks and calcifications by two independent readers; sensitivity, specificity and interobserver agreement were calculated.

Results

Endoleaks and calcifications were present in 25.9 % (28/108) and 20.4 % (22/108) of images. The HPI-S images had a sensitivity/specificity of 54 %/100 % (reader 1) and 57 %/99 % (reader 2), the HPI-M images of 93 %/92 % (reader 1) and 96 %/92 % (reader 2) for detection of endoleaks. For detection of calcifications HPI-S had a sensitivity/specificity of 91 %/99 % (reader 1) and 95 %/97 % (reader 2), the HPI-M images of 91 %/99 % (reader 1) and 91 %/99 % (reader 2), respectively.

Conclusion

Using HPI-M, DECT enables an accurate diagnosis of endoleaks after EVAR and allows distinguishing between endoleaks and calcifications with high diagnostic accuracy.

Key Points

• Dual-energy computed tomography allows the diagnosis of aortic pathologies after EVAR.

• Hard plaque imaging algorithms can distinguish between endoleaks and aneurysm sac calcifications.

• The modified hard plaque imaging algorithm detects endoleaks with high diagnostic accuracy.

Prinssen M, Verhoeven EL, Buth J et al (2004) A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 351:1607–1618PubMedCrossRef

Keith CJ, Passman MA, Gaffud MJ et al (2013) Comparison of long-term outcomes following endovascular repair of abdominal aortic aneurysms based on size threshold. J Vasc Surg. doi:10.1016/j.jvs.2013.06.060 PubMed

Golzarian J, Valenti D (2006) Endoleakage after endovascular treatment of abdominal aortic aneurysms: Diagnosis, significance and treatment. Eur Radiol 16:2849–2857PubMedCrossRef

Jones JE, Atkins MD, Brewster DC et al (2007) Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg 46:1–8PubMedCrossRef

Stavropoulos SW, Charagundla SR (2007) Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair. Radiology 243:641–655PubMedCrossRef

Rozenblit AM, Patlas M, Rosenbaum AT et al (2003) Detection of endoleaks after endovascular repair of abdominal aortic aneurysm: value of unenhanced and delayed helical CT acquisitions. Radiology 227:426–433PubMedCrossRef

Stolzmann P, Frauenfelder T, Pfammatter T et al (2008) Endoleaks after endovascular abdominal aortic aneurysm repair: detection with dual-energy dual-source CT. Radiology 249:682–691PubMedCrossRef

Sommer WH, Graser A, Becker CR et al (2010) Image quality of virtual noncontrast images derived from dual-energy CT angiography after endovascular aneurysm repair. J Vasc Interv Radiol 21:315–321PubMedCrossRef

Genant HK, Boyd D (1977) Quantitative bone mineral analysis using dual energy computed tomography. Invest Radiol 12:545–551PubMedCrossRef

10.

Millner MR, McDavid WD, Waggener RG et al (1979) Extraction of information from CT scans at different energies. Med Phys 6:70–71PubMedCrossRef

11.

Buerke B, Wittkamp G, Seifarth H et al (2009) Dual-energy CTA with bone removal for transcranial arteries: intraindividual comparison with standard CTA without bone removal and TOF-MRA. Acad Radiol 16:1348–1355PubMedCrossRef

12.

Chae EJ, Kim N, Seo JB et al (2013) Prediction of postoperative lung function in patients undergoing lung resection: dual-energy perfusion computed tomography versus perfusion scintigraphy. Invest Radiol 48:622–627PubMedCrossRef

13.

Mangold S, Thomas C, Fenchel M et al (2012) Virtual nonenhanced dual-energy CT urography with tin-filter technology: determinants of detection of urinary calculi in the renal collecting system. Radiology 264:119–125PubMedCrossRef

14.

Glazebrook KN, Guimarães LS, Murthy NS et al (2011) Identification of intraarticular and periarticular uric acid crystals with dual-energy CT: initial evaluation. Radiology 261:516–524PubMedCrossRef

15.

Chandarana H, Godoy MC, Vlahos I et al (2008) Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms-initial observations. Radiology 249:692–700PubMedCrossRef

16.

Numburi UD, Schoenhagen P, Flamm SD et al (2010) Feasibility of dual-energy CT in the arterial phase: Imaging after endovascular aortic repair. Am J Roentgenol 195:486–493CrossRef

17.

Maturen KE, Kleaveland PA, Kaza RK et al (2011) Aortic endograft surveillance: use of fast-switch kVp dual-energy computed tomography with virtual noncontrast imaging. J Comput Assist Tomogr 35:742–746PubMedCrossRef

18.

Ascenti G, Mazziotti S, Lamberto S et al (2011) Dual-energy CT for detection of endoleaks after endovascular abdominal aneurysm repair: usefulness of colored iodine overlay. Am J Roentgenol 196:1408–1414CrossRef

Titel: Dual-energy computed tomography after endovascular aortic aneurysm repair: The role of hard plaque imaging for endoleak detection
verfasst von: R. Müller-Wille
T. Borgmann
W. A. Wohlgemuth
F. Zeman
K. Pfister
E. M. Jung
P. Heiss
A. G. Schreyer
B. Krauss
C. Stroszczynski
C. Dornia
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3266-y

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Dual-energy computed tomography after endovascular aortic aneurysm repair: The role of hard plaque imaging for endoleak detection