Abstract | PURPOSE: METHOD: Study participants were consecutive patients referred for CT at 1-month post-EVAR. CT imaging acquisition included a dual-energy CT angiography (DECTA) and a delayed single-energy CT (SECT) imaging. Patients diagnosed with T2EL were re-examined at 6-months post-EVAR to assess the aneurysm sac growth (ASG). Upon ASG recorded, patients were categorized as having low- (group A) or high- risk (group B) T2EL. DECTA image data were employed to calculate the normalized effective atomic number (NZeff), the normalized iodine concentration, the slope of HUendoleak/HUaorta against monochromatic energy, the dual-energy index and an improvised endoleak index (EI) for each T2EL. Statistical analysis was employed to compare all above parameters regarding their ability to differentiate low- from high- risk T2EL. RESULTS: Among 40 patients examined at 1-month post-EVAR, 14 patients were diagnosed with T2EL. NZeff and EI were found to be significantly lower in group A. NZeff was found to have the highest power to discriminate high-risk T2EL with an area-under-curve of 86.7%, showing100% specificity and 60% sensitivity. The optimal contrast-to-noise ratio for T2EL demonstrated a median peak conspicuity level at 54-keV. The mean effective dose from DECTA and SECT scans was 27.8% lower compared to the sum of three SECT acquisitions. CONCLUSIONS: NZeff and EI were found to have a significant power in predicting the aggressiveness of T2EL lesions. Virtual monochromatic images at 54-keV may enhance T2EL detection efficiency.
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Authors | Stavros Charalambous, Kostas Perisinakis, Nikolaos Kontopodis, Antonios E Papadakis, Thomas G Maris, Christos V Ioannou, Apostolos Karantanas, Dimitrios Tsetis |
Journal | European journal of radiology
(Eur J Radiol)
Vol. 148
Pg. 110165
(Mar 2022)
ISSN: 1872-7727 [Electronic] Ireland |
PMID | 35081491
(Publication Type: Journal Article)
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Copyright | Copyright © 2022 Elsevier B.V. All rights reserved. |
Topics |
- Aortic Aneurysm, Abdominal
(surgery)
- Blood Vessel Prosthesis Implantation
- Computed Tomography Angiography
- Embolization, Therapeutic
- Endoleak
(diagnostic imaging)
- Endovascular Procedures
- Humans
- Retrospective Studies
- Time Factors
- Treatment Outcome
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