OBJECTIVES: To evaluate the diagnostic efficacy of dual source-dual energy CT (DECT) in the detection of neoplasia in patients with polycystic kidney disease (PKD). METHODS: A total of 21 patients with PKD underwent DECT on a dual source system, using kVp settings of Sn140/100 or 140/80. Colour-coded iodine maps and virtual unenhanced images were used to determine enhancement within cysts and to differentiate haemorrhagic from simple cysts. A cut-off of 15 HU was used as a threshold for malignancy. In patients with malignancy, histopathology was the gold standard; otherwise, patients underwent follow-up imaging for 150-908 days. RESULTS: On the basis of measured enhancement, 13 enhancing masses were seen in 4 patients (12 renal cell cancers and 1 adenoma); follow-up imaging showed no malignancy in 18 patients. Cysts did not enhance by more than 15 HU, whereas masses showed a mean enhancement of 45 (25-123) HU. Average radiation exposure was 9.6 mSv for the biphasic protocol and 5.8 mSv for DECT only. CONCLUSION: DECT greatly facilitates the detection of malignancy in patients with polycystic kidney disease, at the same time reducing radiation exposure by omission of a true unenhanced phase. KEY POINTS : • Identification of tumours within polycystic kidneys can be difficult. • Dual energy computed tomography (DECT) provides two separate sets of images. • Iodine maps and virtual non-enhanced (VNE) images can then be calculated. • DECT facilitates screening for potential renal tumours in polycystic kidneys.
OBJECTIVES: To evaluate the diagnostic efficacy of dual source-dual energy CT (DECT) in the detection of neoplasia in patients with polycystic kidney disease (PKD). METHODS: A total of 21 patients with PKD underwent DECT on a dual source system, using kVp settings of Sn140/100 or 140/80. Colour-coded iodine maps and virtual unenhanced images were used to determine enhancement within cysts and to differentiate haemorrhagic from simple cysts. A cut-off of 15 HU was used as a threshold for malignancy. In patients with malignancy, histopathology was the gold standard; otherwise, patients underwent follow-up imaging for 150-908 days. RESULTS: On the basis of measured enhancement, 13 enhancing masses were seen in 4 patients (12 renal cell cancers and 1 adenoma); follow-up imaging showed no malignancy in 18 patients. Cysts did not enhance by more than 15 HU, whereas masses showed a mean enhancement of 45 (25-123) HU. Average radiation exposure was 9.6 mSv for the biphasic protocol and 5.8 mSv for DECT only. CONCLUSION: DECT greatly facilitates the detection of malignancy in patients with polycystic kidney disease, at the same time reducing radiation exposure by omission of a true unenhanced phase. KEY POINTS : • Identification of tumours within polycystic kidneys can be difficult. • Dual energy computed tomography (DECT) provides two separate sets of images. • Iodine maps and virtual non-enhanced (VNE) images can then be calculated. • DECT facilitates screening for potential renal tumours in polycystic kidneys.
Authors: Thorsten R C Johnson; Bernhard Krauss; Martin Sedlmair; Michael Grasruck; Herbert Bruder; Dominik Morhard; Christian Fink; Sabine Weckbach; Miriam Lenhard; Bernhard Schmidt; Thomas Flohr; Maximilian F Reiser; Christoph R Becker Journal: Eur Radiol Date: 2006-12-07 Impact factor: 5.315
Authors: Anno Graser; Christoph R Becker; Michael Staehler; Dirk A Clevert; Michael Macari; Niko Arndt; Konstantin Nikolaou; Wieland Sommer; Christian Stief; Maximilian F Reiser; Thorsten R C Johnson Journal: Invest Radiol Date: 2010-07 Impact factor: 6.016
Authors: N Hateboer; M A v Dijk; N Bogdanova; E Coto; A K Saggar-Malik; J L San Millan; R Torra; M Breuning; D Ravine Journal: Lancet Date: 1999-01-09 Impact factor: 79.321
Authors: Anno Graser; Thorsten R C Johnson; Elizabeth M Hecht; Christoph R Becker; Christianne Leidecker; Michael Staehler; Christian G Stief; Henriette Hildebrandt; Myrna C B Godoy; Myra E Finn; Flora Stepansky; Maximilian F Reiser; Michael Macari Journal: Radiology Date: 2009-06-01 Impact factor: 11.105