title: Type 2 Endoleaks: The Diagnostic Performance of Non-Specialized Readers on Arterial and Venous Phase Multi-Slice CT Angiography.
abstract: OBJECTIVE
  To define the diagnostic precision of non-specialized readers in the detection of type 2 endoleaks (T2EL) in arterial versus venous phase acquisitions, and to evaluate an approach for radiation dose reduction.
  
  
  METHODS
  The pre-discharge and final follow-up multi-slice CT angiographies of 167 patients were retrospectively analyzed. Image data were separated into an arterial and a venous phase reading set. Two radiology residents assessed the reading sets for the presence of a T2EL, feeding vessels, and aneurysm sac size. Findings were compared with a standard of reference established by two experts in interventional radiology. The effective dose was calculated.
  
  
  RESULTS
  Overall, experts detected 131 T2ELs, and 331 feeding vessels in 334 examinations. Persistent T2ELs causing aneurysm sac growth > 5 mm were detected in 20 patients. Radiation in arterial and venous phases contributed to a mean of 58.6% and 39.0% of the total effective dose. Findings of reader 1 and 2 showed comparable sensitivities in arterial sets of 80.9 versus 85.5 (p = 0.09), and in venous sets of 73.3 versus 79.4 (p = 0.15), respectively. Reader 1 and 2 achieved a significant higher detection rate of feeding vessels with arterial compared to venous set (p = 0.04, p < 0.01). Both readers correctly identified T2ELs with growing aneurysm sac in all cases, independent of the acquisition phase.
  
  
  CONCLUSIONS
  Arterial acquisitions enable non-specialized readers an accurate detection of T2ELs, and a significant better identification of feeding vessels. Based on our results, it seems reasonable to eliminate venous phase acquisitions.
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Vienna, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Nolz
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of General Radiology, Vienna, Austria.
authors.forename: Asenbaum
authors.initials: A
authors.lastname: Ulrika
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Furtner
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of General Radiology, Vienna, Austria.
authors.forename: Ramona
authors.initials: R
authors.lastname: Woitek
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Vienna, Austria.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Unterhumer
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wibmer
authors.affiliation: Medical University of Vienna, Department of Surgery, Division of Vascular Surgery, Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Prusa
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Vienna, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000295:instrumentation / Q000379:methods*; D001158:Arteries / Q000473:pathology*; D057867:Endoleak / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D014680:Veins / Q000473:pathology*