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01.11.2014 | Hepatobiliary-Pancreas

Single-portal-phase low-tube-voltage dual-energy CT for short-term follow-up of acute pancreatitis: evaluation of CT severity index, interobserver agreement and radiation dose

verfasst von: Julian L. Wichmann, Pawel Majenka, Martin Beeres, Wolfgang Kromen, Boris Schulz, Stefan Wesarg, Ralf W. Bauer, J. Matthias Kerl, Tatjana Gruber-Rouh, Renate Hammerstingl, Thomas J. Vogl, Thomas Lehnert

Erschienen in: European Radiology | Ausgabe 11/2014

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Abstract

Objectives

To intra-individually compare single-portal-phase low-tube-voltage (100-kVp) computed tomography (CT) with 120-kVp images for short-term follow-up assessment of CT severity index (CTSI) of acute pancreatitis, interobserver agreement and radiation dose.

Methods

We retrospectively analysed 66 patients with acute pancreatitis who underwent initial dual-contrast-phase CT (unenhanced, arterial, portal phase) at admission and short-term (mean interval 11.4 days) follow-up dual-contrast-phase dual-energy CT. The 100-kVp and linearly blended images representing 120-kVp acquisition follow-up CT images were independently evaluated by three radiologists using a modified CTSI assessing pancreatic inflammation, necrosis and extrapancreatic complications. Scores were compared with paired t test and interobserver agreement was evaluated using intraclass correlation coefficients (ICC).

Results

Mean CTSI scores on unenhanced, portal- and dual-contrast-phase images were 4.9, 6.1 and 6.2 (120 kVp) and 5.0, 6.0 and 6.1 (100 kVp), respectively. Contrast-enhanced series showed a higher CTSI compared to unenhanced images (P < 0.05) but no significant differences between single- and dual-contrast-phase series (P > 0.7). CTSI scores were comparable for 100-kVp and 120-kVp images (P > 0.05). Interobserver agreement was substantial for all evaluated series and subcategories (ICC 0.67–0.93). DLP of single-portal-phase 100-kVp images was reduced by 41 % compared to 120-kVp images (363.8 versus 615.9 mGy cm).

Conclusions

Low-tube-voltage single-phase 100-kVp CT provides sufficient information for follow-up evaluation of acute pancreatitis and significantly reduces radiation exposure.

Key Points

• Single-portal-phase CT provides sufficient evaluation for follow-up of acute pancreatitis.

• Follow-up CT does not benefit from unenhanced or arterial-phase acquisition.

• CT severity index scores are equal for dual-contrast-phase 100-/120-kVp acquisition (P > 0.05).

• 100-kVp single-portal-phase follow-up CT of acute pancreatitis significantly reduces radiation exposure.

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Titel: Single-portal-phase low-tube-voltage dual-energy CT for short-term follow-up of acute pancreatitis: evaluation of CT severity index, interobserver agreement and radiation dose
verfasst von: Julian L. Wichmann
Pawel Majenka
Martin Beeres
Wolfgang Kromen
Boris Schulz
Stefan Wesarg
Ralf W. Bauer
J. Matthias Kerl
Tatjana Gruber-Rouh
Renate Hammerstingl
Thomas J. Vogl
Thomas Lehnert
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3300-0

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Single-portal-phase low-tube-voltage dual-energy CT for short-term follow-up of acute pancreatitis: evaluation of CT severity index, interobserver agreement and radiation dose