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Single-portal-phase low-tube-voltage dual-energy CT for short-term follow-up of acute pancreatitis: evaluation of CT severity index, interobserver agreement and radiation dose
Ist Teil von
European radiology, 2014-11, Vol.24 (11), p.2927-2935
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2014
Quelle
MEDLINE
Beschreibungen/Notizen
Objectives
To intra-individually compare single-portal-phase low-tube-voltage (100-kVp) computed tomography (CT) with 120-kVp images for short-term follow-up assessment of CT severity index (CTSI) of acute pancreatitis, interobserver agreement and radiation dose.
Methods
We retrospectively analysed 66 patients with acute pancreatitis who underwent initial dual-contrast-phase CT (unenhanced, arterial, portal phase) at admission and short-term (mean interval 11.4 days) follow-up dual-contrast-phase dual-energy CT. The 100-kVp and linearly blended images representing 120-kVp acquisition follow-up CT images were independently evaluated by three radiologists using a modified CTSI assessing pancreatic inflammation, necrosis and extrapancreatic complications. Scores were compared with paired
t
test and interobserver agreement was evaluated using intraclass correlation coefficients (ICC).
Results
Mean CTSI scores on unenhanced, portal- and dual-contrast-phase images were 4.9, 6.1 and 6.2 (120 kVp) and 5.0, 6.0 and 6.1 (100 kVp), respectively. Contrast-enhanced series showed a higher CTSI compared to unenhanced images (
P
< 0.05) but no significant differences between single- and dual-contrast-phase series (
P
> 0.7). CTSI scores were comparable for 100-kVp and 120-kVp images (
P
> 0.05). Interobserver agreement was substantial for all evaluated series and subcategories (ICC 0.67–0.93). DLP of single-portal-phase 100-kVp images was reduced by 41 % compared to 120-kVp images (363.8 versus 615.9 mGy cm).
Conclusions
Low-tube-voltage single-phase 100-kVp CT provides sufficient information for follow-up evaluation of acute pancreatitis and significantly reduces radiation exposure.
Key Points
• Single-portal-phase CT provides sufficient evaluation for follow-up of acute pancreatitis.
• Follow-up CT does not benefit from unenhanced or arterial-phase acquisition.
• CT severity index scores are equal for dual-contrast-phase 100-/120-kVp acquisition (P > 0.05).
• 100-kVp single-portal-phase follow-up CT of acute pancreatitis significantly reduces radiation exposure.