64-MDCT imaging of the pancreas: Scan protocol optimisation by different scan delay regimes

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1 64-MDCT imaging of the pancreas: Scan protocol optimisation by different scan delay regimes Poster No.: C-051 Congress: ECR 2009 Type: Scientific Exhibit Topic: Abdominal and Gastrointestinal Authors: M. S. Juchems, A. S. Ernst, H.-J. Brambs, A. J. Aschoff; Ulm/DE Keywords: MDCT protocol, scan delay, imaging optimization, Hounsfield units DOI: /ecr2009/C-051 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 5

2 Purpose With the new generation of 64-slice Multidetector-CT (MDCT) scanners, acquisition time for the scan has been shortened to a few seconds. To fully exploit the advantages of MDCT scanners in pancreasimaging, the examination protocols have to be optimized with regard to the scan delay. The purpose of this study was to compare different 64-slice MDCT protocols to optimize pancreatic contrast enhancement. Methods and Materials A total of 40 patients (18 male, 22 female; mean age years) underwent biphasic abdominal CT in arterial and portal venous phase. Examinations were performed on a 64-slice MDCT (Brilliance 64, Philips Medical Systems) after the injection of 1.2 ml/kg bodyweight of Iomeron 400 (Bracco) at rate of 4 ml/s. In 20 patients the scan protocol was adapted from a previously used 40x CT scanner (Brilliance 40) with arterial phase scanning initiated 11.1s after a threshold of 150HU was reached in thedescending aorta using automatic bolus tracking (protocol 1). This 11.1s delay was changed to 15s in the other 20 patients to reflect the shorter scanning times on the 64-channel CT compared to the previous 40x system (protocol 2). Hounsfield units (HU) weremeasured in the head and the tail of the pancreas in the arterial and portal venous phase. Results In the arterial phase average HU value of the pancreatic head was 74.2 HU using a 11.1s scan delay (protocol 1), while HU was measured using a15s delay (protocol 2) (p=0.0001) (Fig. 1). The average HU value of the pancreatic tail was HU using a 11.1s scan delay and HU using a 15s delay in the arterial phase (p=0.0002) (Fig. 2; Fig. 3). HU values were also significantly higher in the portal venous phase when using a 15s scan delay: pancreatic head: 67.5 HU (11.1s) and 84.0 HU (15s), p=0.0014; pancreatic tail: 69.4 HU (11.1s) and 99.9 HU (15s), p= Images for this section: Page 2 of 5

3 Fig. 1: HU-Values of the pancreatic tail: measurement arterial phase: 51 HU; measurement portal venous phase: 81 HU Fig. 2: HU-Values of the pancreatic tail: measurement arterial phase: 122 HU; measurement portal venous phase: 84 HU Page 3 of 5

4 Fig. 3: Average HU values of the pancreatic head and the pancreatic tail in the arterial and portal venous phase using a 64-slice MDCT. Comparison of different MDCT protocols with 11,1s scan delay and 15s scan delay. Page 4 of 5

5 Conclusion In this study, we were able to demonstrate that the concept that longer scan delays are required for faster CT scanners can be used to optimizeimaging of the pancreas. Page 5 of 5

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