Patient-tailored scan delay for multiphase liver CT: Improved scan quality and lesion conspicuity with a novel timing bolus method

J. Gabriel Schneider, Zhen J. Wang, Wilbur Wang, Judy Yee, Yanjun Fu, Benjamin M. Yeh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to compare scan quality and lesion conspicuity for late arterial and portal venous phase liver CT scans using fixed versus patient-tailored scan delay derived with an evidence-based timing bolus method. MATERIALS AND METHODS. We retrospectively identified the cases of 73 patients who underwent both multiphase liver CT with fixed late arterial and portal venous phase scan delay times of 45 and 80 seconds and subsequent multiphase liver CT with patient-tailored scan delay determined with a timing bolus and a previously reported relation between the time to peak aortic and liver enhancement. Both late arterial and portal venous phase scans were graded in terms of scan quality. Hepatic lesion conspicuity (difference in attenuation between lesion and liver parenchyma) for hypervascular lesions (late arterial phase) and hypovascular lesions (portal venous phase) was recorded. RESULTS. Patient-tailored scan delay reflected a wide range of times to peak aortic enhancement (mean, 24 seconds; range, 18-32 seconds) and yielded a greater proportion of optimal scans compared with fixed scan delay for both late arterial phase (92% versus 74%, p < 0.01) and portal venous phase (86% versus 70%, p < 0.05) scans. Mean hypervascular lesion conspicuity was greater for lesions imaged with patient-tailored scan delay rather than fixed scan delay (84.0 versus 57.0 HU, p < 0.01). CONCLUSION. Compared with examinations with fixed scan delay, multiphase liver CT that incorporates patient-tailored scan delay produces more optimally timed late arterial and portal venous phase CT scans with greater lesion conspicuity.

Original languageEnglish (US)
Pages (from-to)318-323
Number of pages6
JournalAmerican Journal of Roentgenology
Volume202
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

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Liver

Keywords

  • Abdomen
  • Aorta
  • CT
  • Flow dynamics
  • Gastrointestinal
  • Hemodynamics
  • Liver
  • Technical aspects

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Patient-tailored scan delay for multiphase liver CT : Improved scan quality and lesion conspicuity with a novel timing bolus method. / Schneider, J. Gabriel; Wang, Zhen J.; Wang, Wilbur; Yee, Judy; Fu, Yanjun; Yeh, Benjamin M.

In: American Journal of Roentgenology, Vol. 202, No. 2, 01.02.2014, p. 318-323.

Research output: Contribution to journalArticle

Schneider, J. Gabriel ; Wang, Zhen J. ; Wang, Wilbur ; Yee, Judy ; Fu, Yanjun ; Yeh, Benjamin M. / Patient-tailored scan delay for multiphase liver CT : Improved scan quality and lesion conspicuity with a novel timing bolus method. In: American Journal of Roentgenology. 2014 ; Vol. 202, No. 2. pp. 318-323.
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abstract = "OBJECTIVE. The purpose of this study was to compare scan quality and lesion conspicuity for late arterial and portal venous phase liver CT scans using fixed versus patient-tailored scan delay derived with an evidence-based timing bolus method. MATERIALS AND METHODS. We retrospectively identified the cases of 73 patients who underwent both multiphase liver CT with fixed late arterial and portal venous phase scan delay times of 45 and 80 seconds and subsequent multiphase liver CT with patient-tailored scan delay determined with a timing bolus and a previously reported relation between the time to peak aortic and liver enhancement. Both late arterial and portal venous phase scans were graded in terms of scan quality. Hepatic lesion conspicuity (difference in attenuation between lesion and liver parenchyma) for hypervascular lesions (late arterial phase) and hypovascular lesions (portal venous phase) was recorded. RESULTS. Patient-tailored scan delay reflected a wide range of times to peak aortic enhancement (mean, 24 seconds; range, 18-32 seconds) and yielded a greater proportion of optimal scans compared with fixed scan delay for both late arterial phase (92{\%} versus 74{\%}, p < 0.01) and portal venous phase (86{\%} versus 70{\%}, p < 0.05) scans. Mean hypervascular lesion conspicuity was greater for lesions imaged with patient-tailored scan delay rather than fixed scan delay (84.0 versus 57.0 HU, p < 0.01). CONCLUSION. Compared with examinations with fixed scan delay, multiphase liver CT that incorporates patient-tailored scan delay produces more optimally timed late arterial and portal venous phase CT scans with greater lesion conspicuity.",
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AB - OBJECTIVE. The purpose of this study was to compare scan quality and lesion conspicuity for late arterial and portal venous phase liver CT scans using fixed versus patient-tailored scan delay derived with an evidence-based timing bolus method. MATERIALS AND METHODS. We retrospectively identified the cases of 73 patients who underwent both multiphase liver CT with fixed late arterial and portal venous phase scan delay times of 45 and 80 seconds and subsequent multiphase liver CT with patient-tailored scan delay determined with a timing bolus and a previously reported relation between the time to peak aortic and liver enhancement. Both late arterial and portal venous phase scans were graded in terms of scan quality. Hepatic lesion conspicuity (difference in attenuation between lesion and liver parenchyma) for hypervascular lesions (late arterial phase) and hypovascular lesions (portal venous phase) was recorded. RESULTS. Patient-tailored scan delay reflected a wide range of times to peak aortic enhancement (mean, 24 seconds; range, 18-32 seconds) and yielded a greater proportion of optimal scans compared with fixed scan delay for both late arterial phase (92% versus 74%, p < 0.01) and portal venous phase (86% versus 70%, p < 0.05) scans. Mean hypervascular lesion conspicuity was greater for lesions imaged with patient-tailored scan delay rather than fixed scan delay (84.0 versus 57.0 HU, p < 0.01). CONCLUSION. Compared with examinations with fixed scan delay, multiphase liver CT that incorporates patient-tailored scan delay produces more optimally timed late arterial and portal venous phase CT scans with greater lesion conspicuity.

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