Erschienen in:
25.11.2016
Dual-energy CT workflow: multi-institutional consensus on standardization of abdominopelvic MDCT protocols
verfasst von:
Bhavik N. Patel, Lauren Alexander, Brian Allen, Lincoln Berland, Amir Borhani, Achille Mileto, Courtney Moreno, Desiree Morgan, Dushyant Sahani, William Shuman, Eric Tamm, Mitchell Tublin, Benjamin Yeh, Daniele Marin
Erschienen in:
Abdominal Radiology
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Ausgabe 3/2017
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Abstract
Purpose
To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols.
Materials and methods
9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1–35) and 4.6 (1–14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4—contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0—not performing and shouldn’t; 1—performing but not clinically useful; 2—performing but not sure if clinically useful; 3—not performing it but would like to; 4—performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions.
Results
5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00).
Conclusions
DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.