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04:26 CET
VoE 97 - CT
Radiographers
Thursday, March 1, 10:00 - 11:00
Moderator: L. Ribeiro (Parchal/PT)


C-0761
10:00
Dual-energy CT venography of the lower extremity as part of presurgical evaluation in complicated cases before coronary artery bypass graft.
R. Gohmann, F. Hardt, J. Schmöe, K. Fehrenbacher, T. Dirrichs, C. Kuhl, M. Schmidt, S. Reinartz; Aachen/DE

Aims and objectives:
The aim of the study was to evaluate the suitability and image quality of dual-source dual-energy indirect CT venography (CTV) of the lower extremity for presurgical evaluation in complicated cases before coronary artery bypass graft (CABG).
Methods and materials:
Patient Cohort: Retrospective study 15 consecutive DECT 10 male, 5 female Age 52 ± 17 years Acquisition protocol: Dual energy dual source CT 80 kV and sn140 kV current modulation (ref. 150 mAs and 58 mAs) from pubic symphysis to ankles Fig. 1 Contrast protocol: 100 ml iodinated contrast ([...]
Results:
All Veins HU Superficial Veins HU Deep Veins HU Muscle HU Adipose Tissue SD CNR sn140 kV 74,1 75,6 71,8 57,5 12,6 1,3 Non-linearblending 114,0 115,8 111,3 62,6 18,5 2,8 80 kV 119,8 119,7 119,9 66,3 21,3 2,5 40 kV (VMC+) 201,2 197,5 206,7 82,6 32,6 3,6 Vascular attenuation was 74[...]
Conclusion:
Post processing with asynchronous virtual monochromatic images Improves visibility of peripheral lower extremity veins only moderately increasing image noise and thereby raises CNR.
Personal information:
References:
none

C-0967
10:14
The advantages of using Dual Energy CT scanning: a retrospective dose audit.
H. R. Bergman1, V. T. Major1, P. Merry1, A. Shah1, A. Gogbashian2; 1Northwood/UK 2Middlesex/UK

Learning objectives:
Learning objectives: The main objective was to perform a retrospective Computed Tomography (CT) dose audit to compare Dual Energy to 120 kV conventional protocols. The second objective was to discuss the advantages of using Dual Energy scanning on image quality.
Background:
Background: CT scanning is fast, fairly inexpensive and readily available in most Radiology departments. The Radiation dose from X-ray and CT scanning accounts for the highest proportion of Radiation exposures to the EU population every year (see figure 1), [1]. Auditing of Radiation doses and rev[...]
Findings and procedure details:
Findings and procedure details: A retrospective dose audit on patients scanned between May 2016 and December 2016 using the Dual Energy Chest, Abdomen and Pelvis protocol were audited. The average doses for 50 patients between 60-80 kg were included. The Computed Tomography Dose Index (CTDI) and[...]
Conclusion:
This audit demonstrates the inherent value of using Dual Energy CT scanning in order to keep CT doses as low as reasonably practicable while enhancing image quality.
Personal information:
H.Bergman BSc Address: Paul Strickland Scanner Center, Mount Vernon Hospital, Rickmansworth Road, Middlesex, England,HA6 2RN. Phone: +44 (0) 1923 844630 Email: hannah.bergman@stricklandscanner.org.uk
References:
1. https://www.phe-protectionservices.org.uk/radiationandyou/ Public Health England Radiation Protection Services Information taken from Ionising Radiation Exposure of the UK Population: 2010 Review Published April 2016. PHE publications gateway number: 2016015 2. De Cecco, C. N., Da[...]

C-1718
10:21
Exploring the Pros and Cons of Post-Processing in Contrast-Enhanced Dual-Energy Neck CT Scans.
J. J. de Groen1, R. Booij2, M. Dijkshoorn2, A. van den berg2; 1Spijkenisse/NL 2Rotterdam/NL

Learning objectives:
To learn the pros and cons of dual-energy post-processing techniques in contrast-enhanced CT-scans of the neck. To understand the background how Perfused Blood Volume (PBV), Virtual Non-Contrast (VNC) and mono-energetic reconstructions are made. To demonstrate the benefits of the several post-proces[...]
Background:
Since the introduction of dual-energy with a dual source CT scanner (Figure 1), new ways of receiving extra information came available beyond just the gathered scans and mixed datasets. By post-processing these dual-energy scans on a workstation, with help of a post-processing client, we are able[...]
Findings and procedure details:
Twenty-four neck cases from 2017 which were scanned with dual-energy in our clinical practice were observed by a radiologist with years of experience with head and neck CT. These cases were examined for the pros and cons of using the extra reconstruction techniques in the form of PBV 75% overlay and[...]
Conclusion:
Dual-energy provides extra information and can reduce metal artifacts which can lead to better diagnosis or therapy decision making. Dose efficiency, workflow, quality and motion suitability may vary with different patients and protocols. Therefore the use of dual-energy over a standard CT should [...]
Personal information:
Contact details: J.J. de Groen, Department of Radiology, Erasmus University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, Netherlands. Email: j.degroen@erasmusmc.nl R. Booij, Department of Radiology, Erasmus University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE[...]
References:
Siemens Healthineers M.L. Dijkshoorn, Department of Radiology, Erasmus University Medical Center Rotterdam/ Netherlands 2018.

C-2962
10:28
Effect of the injected contrast media ratio on contrast of intraabdominal structures during pediatric CT examination with the method of splitted bolus injection
L. Sembele, I. Apine; Riga/LV

Learning objectives:
The aim of the study is to determine the best proportion of splitting the iodine contrast medium to achieve the best possible parenchymal and excretory phase pattern in paediatric politrauma patients at Children University Hospital of Riga, Latvia.
Background:
Due to increased sensitivity of paediatric pacients to ionizing radiation in paediatric CT imaging it is important to reduce the radiation dose avoiding multiple scanning phases. This creates a problem in assessment of abdominal organs in politrauma patients where damage of parenchymal organs and ur[...]
Findings and procedure details:
21 paediatric multitrauma patient was examined using split-bolus technique at Children Clinical University hospital of Riga, Latvia, from February 14, 2017 to April 14, 2017. CT exams were performed with 4 different proportion of i/v contrast medium. The patients were examined splitting the non-ion[...]
Conclusion:
The results of all 4 used proportions shows variability of contrast patterns of structure of abdominal organs depending on the volume and proportions of injected contrast media. The optimum proportion of contrast medium for imaging paediatric patients with politrauma is 1/4+3/4 because it depicts al[...]
Personal information:
1. Liga Sembele, radiographer, Department of Diagnostic Radiology Children`s Clinical University Hospital, Riga, Latvia, 45. Vienibas gatve LV-1004 e-mail: ligasaviesi@inbox.lv, Cell +371 29 191 779 2. Ilze Apine, Head of Department of Diagnostic Radiology, Children`s Clinical University Hospita[...]
References:
1.Split bolus technique[ online – 29.04.2017.] https://radiopaedia.org/articles/split-bolus-technique 2. Paediatric trauma protocols, The Royal College of Radiologists, 2014. [online -20.06.2017.] https://www.rcr.ac.uk/system/files/publication/field_publication_files/BFCR(14)8_paeds_trauma.pdf 3.Yon[...]

C-3174
10:35
There is metal in my scan volume, what should I do with my CT scan protocol? A practical guide to cope with metal in dual source CT scans.
M. Dijkshoorn, R. Booij, M. straten; Rotterdam/NL

Learning objectives:
To describe the cause and appearance of artifacts from metal on CT images. To learn how tin filtered CT or dual energy CT can reduce metal artifacts. To understand the potential and limitations of extended CT-scale and iterative metal artifact reduction reconstructions. To clarify in which clinical [...]
Background:
Often patients with metal implants are referred for a CT-scan. When scanning these patients artifacts, caused by the metal make it difficult to interpret the scans. The intensity of the artifacts are dependent on the metal composition, size, location, scan-, and reconstruction parameters. Dual s[...]
Findings and procedure details:
Tin filtered scanning Recent dual source CT systems of the second and third generation are equipped with a movable tin filter. Atearly systems this was only available on the second tube for the purpose of dual energy CT, but recently this filter has come available on the primary tube as well. Thi[...]
Conclusion:
Summarizing you can derivate a number of general imaging guidelines. When NOT to use: Tin filtration only Large metal or very high density metal Soft tissue scans or CTA with iodinated contrast Bone studies with advanced bone density loss Dual energy high mono-energetic High ri[...]
Personal information:
Marcel L. Dijkshoorn: Department of radiology and nuclear medicine, Erasmus Medical Center, Rotterdam, The Netherlands (m.l.dijkshoorn@erasmusmc.nl) Ronald Booij MSc: Department of radiology and nuclear medicine, Erasmus Medical Center, Rotterdam, The Netherlands Marcel van Straten PhD: Depa[...]
References:

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