Bhavik N Patel1, Lauren Alexander2, Brian Allen3, Lincoln Berland4, Amir Borhani5, Achille Mileto3, Courtney Moreno2, Desiree Morgan4, Dushyant Sahani6, William Shuman7, Eric Tamm8, Mitchell Tublin5, Benjamin Yeh9, Daniele Marin3. 1. Division of Abdominal Imaging, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC, 27710, USA. bhavik.patel@dm.duke.edu. 2. Department of Radiology, Emory University, Atlanta, USA. 3. Division of Abdominal Imaging, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC, 27710, USA. 4. Department of Radiology, University of Alabama Birmingham, Birmingham, USA. 5. Department of Radiology, University of Pittsburgh, Pittsburgh, USA. 6. Department of Radiology, Massachusetts General Hospital, Boston, USA. 7. Department of Radiology, University of Washington, Seattle, USA. 8. Department of Radiology, MD Anderson, Houston, USA. 9. Department of Radiology, University of California San Francisco, San Francisco, USA.
Abstract
PURPOSE: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS: 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions. RESULTS: 5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00). CONCLUSIONS: DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.
PURPOSE: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS: 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions. RESULTS: 5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00). CONCLUSIONS: DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.
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