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  1. Article ; Online: Abdominal rapid-kVp-switching dual-energy MDCT with reduced IV contrast compared to conventional MDCT with standard weight-based IV contrast: an intra-patient comparison.

    Clark, Zachary E / Bolus, David N / Little, Mark D / Morgan, Desiree E

    Abdominal imaging

    2015  Volume 40, Issue 4, Page(s) 852–858

    Abstract: Purpose: Perform intra-patient comparison of attenuation values on lower keV dual-energy abdominal CT images using reduced IV contrast dose compared to conventional single energy polychromatic beam abdominal MDCT images using standard IV contrast dose.!# ...

    Abstract Purpose: Perform intra-patient comparison of attenuation values on lower keV dual-energy abdominal CT images using reduced IV contrast dose compared to conventional single energy polychromatic beam abdominal MDCT images using standard IV contrast dose.
    Methods: IRB approved retrospective evaluation of consecutive adults who had both standard IV contrast dosage conventional multiphasic MDCT (SECT) and reduced IV contrast dosage rapid kV-switching dual-energy multiphasic MDCT (rsDECT) of the abdomen. Arterial phase dual-energy 52, 70 and 78 keV simulated monoenergetic HU were compared (t test) to arterial phase SECT HU for: aorta, liver, pancreas, psoas, and hepatic/pancreatic tumors. Contrast to noise ratios (CNR), IV contrast dose reduction and dose-length product (DLP) were recorded. Two blinded independent readers evaluated the CT datasets for subjective image quality based on a five point scale.
    Results: Twenty-nine scan pairs in 24 subjects (13 M, mean age 64, weight 76.7 kg) were evaluated. Mean reduction in IV contrast dose was 37 %. Mean ± SD HU on 52 keV rsDECT vs. SECT were: aorta 534 ± 138 vs. 271 ± 69; liver 88 ± 24 vs. 67 ± 16; pancreas 140 ± 60 vs. 89 ± 40; psoas 63 ± 15 vs. 50 ± 12 (all p < 0.001). Noise was higher for 52 keV compared to SECT (p < 0.001); CNRs were not significantly different. Mean ± SD DLP for rsDECT was 1421 ± 563 and SECT 1335 ± 562 mGy·cm (p = 0.640). For tumor vs. nontumoral parenchyma, mean absolute contrast difference was 58.4 HU on 52 keV, and 29.0 HU on SECT. Nearly all images were rated as good or excellent and there were no statistically significant differences in image quality between the DECT and SECT images.
    Conclusion: Statistically significant gains in vascular and parenchymal enhancement without adverse effect on CNR or lesion contrast were observed in this intra-patient comparison using reduced IV contrast dose rsDECT compared to standard weight-based IV dose conventional SECT.
    MeSH term(s) Administration, Intravenous ; Aged ; Contrast Media/administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Radiographic Image Enhancement ; Radiographic Image Interpretation, Computer-Assisted ; Radiography, Abdominal ; Radiography, Dual-Energy Scanned Projection ; Reproducibility of Results ; Retrospective Studies
    Chemical Substances Contrast Media
    Language English
    Publishing date 2015-04
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 1144553-1
    ISSN 1432-0509 ; 0942-8925
    ISSN (online) 1432-0509
    ISSN 0942-8925
    DOI 10.1007/s00261-014-0253-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Epidemiology for the nuclear medicine technologist.

    Bolus, N E

    Journal of nuclear medicine technology

    2001  Volume 29, Issue 3, Page(s) 143–7; quiz 148–9

    Abstract: ... proper judgment of cause and effect relationships, e) definitions of epidemiologic terms, and f ...

    Abstract Objective: The purpose of this article is to introduce the nuclear medicine technologist to the field of epidemiology. There are many applications of epidemiology in nuclear medicine, including research studies that deal with the causes of disease or ways to prevent disease from occurring and investigating the possible effects of ionizing radiation on occupational workers and the general public. One use of an epidemiologic study is to suggest ways to reduce the occurrence of a disease. After reading this article, the nuclear medicine technologist will be familiar with: a) the history and underlying assumptions of epidemiology, b) types of epidemiologic studies, c) what is a valid statistical association for an epidemiologic study, d) proper judgment of cause and effect relationships, e) definitions of epidemiologic terms, and f) an example of a nuclear medicine research study.
    MeSH term(s) Epidemiologic Methods ; Epidemiologic Studies ; Humans ; Nuclear Medicine ; Technology, Radiologic
    Language English
    Publishing date 2001-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 189163-7
    ISSN 1535-5675 ; 0091-4916
    ISSN (online) 1535-5675
    ISSN 0091-4916
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Basic review of radiation biology and terminology.

    Bolus, N E

    Journal of nuclear medicine technology

    2001  Volume 29, Issue 2, Page(s) 67–73; test 76–7

    Abstract: ... dose radiation exposure; and (e) possible acute and chronic radiation exposure effects. ...

    Abstract Objective: The purpose of this paper is to review basic radiation biology and associated terminology to impart a better understanding of the importance of basic concepts of ionizing radiation interactions with living tissue. As health care workers in a field that utilizes ionizing radiation, nuclear medicine technologists are concerned about the possible acute and chronic effects of occupational radiation exposure. Technologists should have a clear understanding of what they are exposed to and how their safety could be affected. Furthermore, technologists should be knowledgeable about radiation effects so that they can adequately assuage possible patient fears about undergoing a nuclear medicine procedure. After reading this article, the nuclear medicine technologist will be familiar with: (a) basic radiation biology concepts; (b) types of interactions of radiation with living tissue, and possible effects from that exposure; (c) theoretical dose-response curves and how they are used in radiation biology; (d) stochastic versus nonstochastic effects of radiation exposure, and what these terms mean in relation to both high- and low-dose radiation exposure; and (e) possible acute and chronic radiation exposure effects.
    MeSH term(s) Dose-Response Relationship, Radiation ; Humans ; Radiobiology ; Technology, Radiologic ; Terminology as Topic
    Language English
    Publishing date 2001-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 189163-7
    ISSN 1535-5675 ; 0091-4916
    ISSN (online) 1535-5675
    ISSN 0091-4916
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Diffusion-weighted MRI as a screening tool for hepatocellular carcinoma in cirrhotic livers: correlation with explant data-a pilot study.

    McNamara, M M / Thomas, J V / Alexander, L F / Little, M D / Bolus, D N / Li, Yufeng E / Morgan, D E

    Abdominal radiology (New York)

    2018  Volume 43, Issue 10, Page(s) 2686–2692

    Abstract: Objective: The purpose of this study was to compare the sensitivity and specificity of diffusion-weighted liver MRI alone with complete, multiphasic gadoteridol-enhanced MRI for the detection of hepatocellular carcinoma in cirrhotic patients before ... ...

    Abstract Objective: The purpose of this study was to compare the sensitivity and specificity of diffusion-weighted liver MRI alone with complete, multiphasic gadoteridol-enhanced MRI for the detection of hepatocellular carcinoma in cirrhotic patients before liver transplant.
    Materials and methods: This single institution retrospective study was performed after IRB approval and was HIPAA compliant. MRI scans of 37 patients who underwent liver transplant were evaluated and findings correlated with liver explant (36) or biopsy (1). All MRI scans were obtained within six months of explant. MRI from 17 patients with liver lesions by report at imaging subsequently proven to be HCC at pathology and 20 controls without liver lesions by imaging and pathology were reviewed in random order on the radiology PACS by three independent readers blinded to the MRI reports and pathology reports in two separate sittings. First, only the diffusion-weighted images (DWI) were interpreted. Second, the complete multiphasic MRI exam with DWI was reviewed. A consensus read was obtained by two separate radiologists who had access to the patients' explant data in order to map lesions. Reader-specific and pooled classification was assessed using sensitivity, specificity, positive predictive value, and negative predictive values and corresponding 95% confidence intervals (CI) for both DWI and complete MRI examination readings compared to pathology. McNemar's test and Kappa coefficient were used to assess differences (agreement) in DWI and complete examination readings.
    Results: A total of 37 patients have been studied (25M 12F age range 21-70). Averaged results of the three independent readers demonstrated a sensitivity of 78% (95% CI 65-89%) and specificity of 88% (95% CI 77-95%) for DWI alone for detection of liver lesions, with a positive predictive value of 85% (95% CI 72-94%) and a negative predictive value of 83% (95% CI 71-91%). Review of the complete MRI exam showed a sensitivity of 90% (95% CI 76-97%) and a specificity of 82% (95% CI 66-92%) with a positive predictive value of 83% (95% CI 69-93%) and a negative predictive value of 89% (95% CI 74-97%). McNemar's agreement test revealed no significant difference between the DWI and complete multiphasic interpretations (p = 0.3458), with simple Kappa coefficient of 0.6716 (95% CI 0.5332-0.8110). Lesions identified on DWI ranged in size from 1.5 to 5 cm. Detection of lesions was decreased in the presence of artifact from motion, large ascites, and technical issues.
    Conclusion: Diffusion-weighted MRI has NPV and PPV comparable to complete multiphasic MRI examination for liver lesion detection in cirrhotic patients and may have a role in screening.
    MeSH term(s) Adult ; Aged ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Contrast Media ; Diffusion Magnetic Resonance Imaging/methods ; Female ; Humans ; Liver Cirrhosis/diagnostic imaging ; Liver Cirrhosis/pathology ; Liver Cirrhosis/surgery ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Liver Transplantation ; Male ; Middle Aged ; Pilot Projects ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/pathology ; Predictive Value of Tests ; Sensitivity and Specificity
    Chemical Substances Contrast Media
    Language English
    Publishing date 2018-02-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2839786-1
    ISSN 2366-0058 ; 2366-004X
    ISSN (online) 2366-0058
    ISSN 2366-004X
    DOI 10.1007/s00261-018-1535-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Effect of Anticoagulation Medication on the Thyroid Fine-Needle Aspiration Pathologic Diagnostic Sufficiency Rate.

    Denham, S LeeAnn Wilson / Ismail, Aimen / Bolus, David N / Lockhart, Mark E

    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

    2016  Volume 35, Issue 1, Page(s) 43–48

    Abstract: Objectives: This study examined whether ultrasound-guided thyroid fine-needle aspiration (FNA) biopsy performed on patients taking anticoagulation medication results in a greater number of nondiagnostic pathologic samples due to a higher propensity to ... ...

    Abstract Objectives: This study examined whether ultrasound-guided thyroid fine-needle aspiration (FNA) biopsy performed on patients taking anticoagulation medication results in a greater number of nondiagnostic pathologic samples due to a higher propensity to bleed, and thus fill the needle with blood rather than cellular material, compared to patients not taking anticoagulation medication.
    Methods: In this retrospective review, data were collected on 1100 patients who underwent ultrasound-guided thyroid FNA over a 4-year period. Of these patients, 438 were included. Each thyroid FNA was performed by a board-certified radiologist using a 6-pass capillary fill technique. Data including patient age, sex, nodule size, nodule consistency, and whether the patient was or was not taking anticoagulation medication (and, if they were, which medication) were recorded from the electronic medical record, and the nodule characteristics were confirmed on imaging by a senior radiology resident (postgraduate year 5).
    Results: Of the 438 patients included, 12 (2.7%) had an FNA aspirate that was deemed insufficient for diagnostic evaluation. Nondiagnostic pathologic yields were seen in 7 of the 309 patients (2.3%) who were not taking anticoagulation medication and 5 of 129 patients (3.9%) who were taking aspirin, warfarin, or clopidogrel, resulting in no statistically significant difference in the rates of nondiagnostic pathologic yields between the two groups (P = .35).
    Conclusions: Based on these data, cessation of anticoagulation medication before thyroid FNA is not necessary to obtain sufficient cellular material for diagnosis, thus eliminating the need for procedural delays, patient inconvenience, and risks associated with anticoagulation medication cessation.
    MeSH term(s) Alabama/epidemiology ; Anticoagulants/administration & dosage ; Artifacts ; Diagnostic Errors/prevention & control ; Diagnostic Errors/statistics & numerical data ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/utilization ; Female ; Humans ; Male ; Prevalence ; Reproducibility of Results ; Sensitivity and Specificity ; Thyroid Nodule/epidemiology ; Thyroid Nodule/pathology
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2016-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 604829-8
    ISSN 1550-9613 ; 0278-4297
    ISSN (online) 1550-9613
    ISSN 0278-4297
    DOI 10.7863/ultra.15.03044
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Gadoxetate Disodium enhanced spectral dual-energy CT for evaluation of cholangiocarcinoma: Preliminary data.

    Thomas, John V / Bolus, David N / Jackson, Bradford E / Berland, Lincoln L / Yester, Michael / Morgan, Desiree E

    Annals of medicine and surgery (2012)

    2016  Volume 6, Page(s) 17–22

    Abstract: Purpose: Evaluate Gadoxetate Disodium enhanced dual-energy CT for visualization of perihilar cholangiocarcinoma by exploiting the hepatobiliary uptake of Gadoxetate Disodium and viewing images at the k-edge of gadolinium on the spectrum of simulated ... ...

    Abstract Purpose: Evaluate Gadoxetate Disodium enhanced dual-energy CT for visualization of perihilar cholangiocarcinoma by exploiting the hepatobiliary uptake of Gadoxetate Disodium and viewing images at the k-edge of gadolinium on the spectrum of simulated monoenergetic energies available with Dual Energy CT.
    Material and methods: In this prospective, IRB-approved study in patients with suspected cholangiocarcinoma, subjects who underwent a clinically indicated Gadoxetate Disodium liver MRI were immediately scanned without further IV contrast administration using rapid kVp-switching dual energy CT (rsDECT). Initial Gadoxetate Disodium dose was the FDA approved clinical dose, 0.025 mmol/kg; after additional IRB/FDA approval, 10 subjects were scanned with 0.05 mmol/kg. Both 50 keV and 70 keV simulated monoenergetic images as well as gadolinium(-water) material density images were viewed qualitatively and measured quantitatively for gadolinium uptake in the hepatic parenchyma and any focal lesions identified.
    Results: Of 18 subjects (mean age 55 years, 10M, 8F, weight 84 kg), eight were scanned with 0.025 mmol/kg (Group 1) and 10 with 0.05 mmol/kg Gadoxetate Disodium (Group 2). Five patients had cholangiocarcinoma (all in Group 1). On synthetic monoenergetic images using standard and double Gadoxetate Disodium dose, the liver parenchyma did not appear enhanced qualitatively. Comparison of mean hepatic parenchymal HU at 50 and 70 keV showed a measurable increase in attenuation at the lower viewing energy, which corresponded to the k-edge of gadolinium. No statistically significant difference was observed on quantitative gadolinium measurement of hepatic parenchyma for single versus double Gadoxetate Disodium dose using rsDECT gadolinium material density images. Of the five cholangiocarcinomas, the tumor to nontumoral hepatic tissue HU differences were 51.1 (32.2) (mean and std dev) and 49.0(26.5) at 50 and 70 keV, respectively.
    Conclusion: In this small pilot population, evaluation of potential hilar/perihilar cholangiocarcinoma using dual energy CT at both the single FDA-approved dose and double dose of gadolinium demonstrated observed differences in attenuation between the hepatic parenchyma and lesions. However, small sample size and heterogeneity of lesions warrants further investigation.
    Language English
    Publishing date 2016-01-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2016.01.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Radiological emergency preparedness: a survey of nuclear medicine technologists in the United States.

    Van Dyke, Miriam E / McCormick, Lisa C / Bolus, Norman E / Pevear, Jesse / Kazzi, Ziad N

    Journal of nuclear medicine technology

    2013  Volume 41, Issue 3, Page(s) 223–230

    Abstract: Unlabelled: Because of the increasing risk of radiological emergencies, public health agencies and first-response organizations are working to increase their capability of responding. Nuclear medicine technologists (NMTs) have expertise in certain areas, ...

    Abstract Unlabelled: Because of the increasing risk of radiological emergencies, public health agencies and first-response organizations are working to increase their capability of responding. Nuclear medicine technologists (NMTs) have expertise in certain areas, such as radiation safety, radiobiology, decontamination, and the use of radiation detection and monitoring equipment, that could be useful during the response to events that involve radiological materials.
    Methods: To better understand the potential role that NMTs may have in response efforts, a cross-sectional survey was conducted. The survey was sent electronically to the 7,000 members of the Technology Section of the Society of Nuclear Medicine and Molecular Imaging. Eight hundred fifty NMTs responded to the survey, for a response rate of 12.14%. The study queried NMTs across the United States on their knowledge of using radiation detection and monitoring equipment, such as a scintillation γ-cameras, Geiger counters, thyroid probes, well counters, and portal monitors; willingness to participate in response efforts during a nuclear reactor accident, nuclear weapon detonation, or dirty bomb detonation; access to radiation detection and monitoring equipment within their work setting; familiarity with current preparedness guidance and tools provided by the Centers for Disease Control and Prevention and U.S. Department of Health and Human Services; and registration in volunteer initiatives such as the Emergency System for Advance Registration of Volunteer Health Professionals, Metropolitan Medical Response System, and Medical Reserve Corps.
    Results: Survey results suggest that NMTs are knowledgeable and willing to respond to radiological emergencies, regardless of number of years of work experience. Radiological preparedness training within the last 5 y significantly increases NMTs' willingness to respond and familiarity with current guidance and tools provided by the Centers for Disease Control and Prevention and Department of Health and Human Services. Respondents reported a low participation level in volunteer programs, and most agreed that continuing education should include radiological emergency preparedness.
    Conclusion: NMTs should be considered an untapped resource and should be strategically recruited for involvement in radiological emergency preparedness planning and training. NMTs should also consider becoming involved in local volunteer initiatives because they have the knowledge and willingness to provide assistance during a radiological emergency.
    MeSH term(s) Civil Defense/statistics & numerical data ; Humans ; Medical Laboratory Personnel/statistics & numerical data ; Nuclear Medicine ; Radiation ; Surveys and Questionnaires ; United States
    Language English
    Publishing date 2013-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 189163-7
    ISSN 1535-5675 ; 0091-4916
    ISSN (online) 1535-5675
    ISSN 0091-4916
    DOI 10.2967/jnmt.113.124677
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Stress resulting from change and restructuring: A cognitive approach

    Bolus, N. E.

    Family and Community Health

    1998  Volume 21, Issue 2, Page(s) 70–78

    Abstract: Restructuring of the health care system has brought about stress in health care workers who are attempting to adapt to change. Although most stress-reduction approaches utilize affective solutions, this article argues that instituting a new way of ... ...

    Institution USA-Birmingham AL University of Alabama at Birmingham
    Abstract Restructuring of the health care system has brought about stress in health care workers who are attempting to adapt to change. Although most stress-reduction approaches utilize affective solutions, this article argues that instituting a new way of thinking is needed for health care workers to survive and thrive under restructuring. There are a number of fallacies of thinking that individuals use in the face of change, including dichotomous thinking and weak-sense critical thinking. Adaptation and survival in today's health care environment requires complex ways of thinking that go beyond an innate resistance to change, shown in this article as dialectical thinking.
    Keywords Gesundheitswesen ; Struktur ; Veraenderung ; Beruf d. Gesundheitswesens ; Stress ; Anpassung ; USA
    Language English
    Document type Article
    Database Social Medicine (SOMED)

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  9. Article ; Online: Assessment of adverse reaction rates during gadoteridol-enhanced MR imaging in 28,078 patients.

    Morgan, Desiree E / Spann, J Stephen / Lockhart, Mark E / Winningham, Beth / Bolus, David N

    Radiology

    2011  Volume 259, Issue 1, Page(s) 109–116

    Abstract: Purpose: To determine adverse reaction rates in a tertiary care clinical setting after adoption of gadoteridol as the institutional routine magnetic resonance (MR) imaging contrast agent.: Materials and methods: With institutional review board ... ...

    Abstract Purpose: To determine adverse reaction rates in a tertiary care clinical setting after adoption of gadoteridol as the institutional routine magnetic resonance (MR) imaging contrast agent.
    Materials and methods: With institutional review board approval, informed consent waiver, and HIPAA compliance, a prospective observational study of 28 078 patients who underwent intravenous gadoteridol-enhanced MR imaging from July 2007 to December 2009 was performed. Reactions were recorded by technologists who noted types of reactions, method of injection, and treatment. Reactions were classified as mild, moderate, or severe per American College of Radiology definitions. Comparisons of reaction rates with dose and method of injection were analyzed with the Fisher exact and χ(2) tests.
    Results: Overall reaction rate was 0.666% (187 patients), including 177 mild, six moderate, and four severe reactions. Treatment was given in 27 patients (14.4%). The most frequent reaction was nausea (and/or vomiting) in 149 patients (79.7% of patients with any adverse reaction, 0.530% of overall population). Method of injection did not affect reaction rate or severity. There was no difference in type or severity of reactions in comparison of patients receiving half the dose versus patients receiving the standard dose (P = .33-.75).
    Conclusion: The observed adverse reaction rate to gadoteridol was lower than previously reported. Specifically, the rate of nausea (0.530%) was less than half the rate (1.4%) in clinical trials of 1251 patients, leading to FDA approval in 1992. Rates of adverse reactions for this macrocyclic contrast agent are comparable to those published for linear gadolinium-based contrast agents.
    MeSH term(s) Alabama/epidemiology ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Female ; Gadolinium ; Heterocyclic Compounds ; Humans ; Incidence ; Magnetic Resonance Imaging/statistics & numerical data ; Male ; Organometallic Compounds ; Risk Assessment ; Risk Factors
    Chemical Substances Heterocyclic Compounds ; Organometallic Compounds ; gadoteridol (0199MV609F) ; Gadolinium (AU0V1LM3JT)
    Language English
    Publishing date 2011-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.10100906
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Gadoxetate Disodium enhanced spectral dual-energy CT for evaluation of cholangiocarcinoma

    John V. Thomas / David N. Bolus / Bradford E. Jackson / Lincoln L. Berland / Michael Yester / Desiree E. Morgan

    Annals of Medicine and Surgery, Vol 6, Iss C, Pp 17-

    Preliminary data

    2016  Volume 22

    Abstract: Purpose: Evaluate Gadoxetate Disodium enhanced dual-energy CT for visualization of perihilar cholangiocarcinoma by exploiting the hepatobiliary uptake of Gadoxetate Disodium and viewing images at the k-edge of gadolinium on the spectrum of simulated ... ...

    Abstract Purpose: Evaluate Gadoxetate Disodium enhanced dual-energy CT for visualization of perihilar cholangiocarcinoma by exploiting the hepatobiliary uptake of Gadoxetate Disodium and viewing images at the k-edge of gadolinium on the spectrum of simulated monoenergetic energies available with Dual Energy CT. Material and methods: In this prospective, IRB-approved study in patients with suspected cholangiocarcinoma, subjects who underwent a clinically indicated Gadoxetate Disodium liver MRI were immediately scanned without further IV contrast administration using rapid kVp-switching dual energy CT (rsDECT). Initial Gadoxetate Disodium dose was the FDA approved clinical dose, 0.025 mmol/kg; after additional IRB/FDA approval, 10 subjects were scanned with 0.05 mmol/kg. Both 50 keV and 70 keV simulated monoenergetic images as well as gadolinium(-water) material density images were viewed qualitatively and measured quantitatively for gadolinium uptake in the hepatic parenchyma and any focal lesions identified. Results: Of 18 subjects (mean age 55 years, 10M, 8F, weight 84 kg), eight were scanned with 0.025 mmol/kg (Group 1) and 10 with 0.05 mmol/kg Gadoxetate Disodium (Group 2). Five patients had cholangiocarcinoma (all in Group 1). On synthetic monoenergetic images using standard and double Gadoxetate Disodium dose, the liver parenchyma did not appear enhanced qualitatively. Comparison of mean hepatic parenchymal HU at 50 and 70 keV showed a measurable increase in attenuation at the lower viewing energy, which corresponded to the k-edge of gadolinium. No statistically significant difference was observed on quantitative gadolinium measurement of hepatic parenchyma for single versus double Gadoxetate Disodium dose using rsDECT gadolinium material density images. Of the five cholangiocarcinomas, the tumor to nontumoral hepatic tissue HU differences were 51.1 (32.2) (mean and std dev) and 49.0(26.5) at 50 and 70 keV, respectively. Conclusion: In this small pilot population, evaluation of potential hilar/perihilar cholangiocarcinoma using dual energy CT at both the single FDA-approved dose and double dose of gadolinium demonstrated observed differences in attenuation between the hepatic parenchyma and lesions. However, small sample size and heterogeneity of lesions warrants further investigation.
    Keywords Gadoxetate Disodium ; Dual-energy CT ; Cholangiocarcinoma ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2016-03-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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