Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT)
D Javor1, A Wressnegger2, S Unterhumer2
1Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria. domagoj.javor@meduniwien.ac.at.
Objectives:
To assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR).
Methods:
Fifty patients referred for routine follow-up post-EVAR CT and a history of at least one post-EVAR follow-up CT examination using our standard biphasic (arterial and venous phase) routine protocol (which was used as the reference standard) were included in this prospective trial. An in-patient comparison and an analysis of the split-bolus protocol and the previously used double-phase protocol were performed with regard to differences in diagnostic accuracy, radiation dose, and image quality.
Results:
The analysis showed a significant reduction of radiation dose of up to 42 %, using the single-acquisition split-bolus protocol, while maintaining a comparable diagnostic accuracy (primary endoleak detection rate of 96 %). Image quality between the two protocols was comparable and only slightly inferior for the split-bolus scan (2.5 vs. 2.4).
Conclusions:
Using the single-acquisition, split-bolus approach allows for a significant dose reduction while maintaining high image quality, resulting in effective endoleak identification.
Key Points:
• A single-acquisition, split-bolus approach allows for a significant dose reduction. • Endoleak development is the most common complication after endovascular aortic repair (EVAR). • CT angiography is the imaging modality of choice for aortic aneurysm evaluation.
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