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Abdominal Aorta: Evaluation with Dual-Source Dual-Energy Multidetector CT after Endovascular Repair of Aneurysms—Initial Observations¹

¹ From the Department of Radiology, New York University Medical Center, Tisch Hospital, Suite HW 202, 560 First Ave, New York, NY 10016 (H.C., M.C.B.G., I.V., J.B., M.M.); Department of Radiology, Grosshadern University, Munich, Germany (A.G.); and Siemens Medical Solutions, Malvern, Pa (C.L.). Received February 22, 2008; revision requested April 21; revision received May 3; accepted May 20; final version accepted May 30. Address correspondence to M.M. (e-mail: Michael.macari{at}nyumc.org).

Purpose: To evaluate the possible radiation dose reduction facilitated by using dual-energy (DE) multidetector computed tomography (CT) after endovascular repair of abdominal aortic aneurysms (AAAs).

Materials and Methods: This prospective study was HIPAA compliant and institutional review board approved. Twenty-two patients who previously had undergone endovascular repair of AAAs underwent 24 DE multidetector CT examinations, which were performed with a 64-detector scanner. Initial nonenhanced CT was followed by arterial phase and venous phase acquisitions. Virtual nonenhanced, pure 80-kVp, and weighted-average peak voltage CT data sets were generated from the venous acquisition. Two independent readers interpreted the virtual nonenhanced and DE weighted-average CT data for the presence or absence of endoleaks. These interpretations were compared with the clinical interpretations of the data performed by a different radiologist by using true nonenhanced, arterial phase, and venous phase data. Region-of-interest measurements of the abdominal aorta and of the region of the endoleaks were obtained. Effective radiation dose was calculated.

Results: Both independent readers' interpretations of the virtual nonenhanced and weighted-average venous CT data revealed six type II endoleaks. There were no false-positive or false-negative findings. Aortic attenuation during the arterial, 80-kVp venous, and weighted-average data acquisitions were 288, 213, and 150 HU, respectively. The attenuation of the endoleaks was higher during the 80-kVp acquisition (P < .03) than during the arterial phase and weighted-average venous phase acquisitions. The mean effective dose for DE venous phase CT was 11.1 mSv compared with 27.8 mSv for standard triple-phase CT with a single-source configuration.

Conclusion: Preliminary observations suggest that obtaining DE multidetector CT data by using a single 60-second contrast material–enhanced acquisition may be all that is required for surveillance after endovascular repair of AAA.

© RSNA, 2008

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Endoleaks after Endovascular Abdominal Aortic Aneurysm Repair: Detection with Dual-Energy Dual-Source CT

Paul Stolzmann, Thomas Frauenfelder, Thomas Pfammatter, Nicole Peter, Hans Scheffel, Mario Lachat, Bernhard Schmidt, Borut Marincek, Hatem Alkadhi, and Thomas Schertler
Radiology 2008 249: 682-691. [Abstract] [Full Text] [PDF]