title: Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT).
abstract: OBJECTIVE
  To assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR).
  
  
  METHODS
  Fifty patients referred for routine follow-up post-EVAR CT and a history of at least one post-EVAR follow-up CT examination using our standard biphasic (arterial and venous phase) routine protocol (which was used as the reference standard) were included in this prospective trial. An in-patient comparison and an analysis of the split-bolus protocol and the previously used double-phase protocol were performed with regard to differences in diagnostic accuracy, radiation dose, and image quality.
  
  
  RESULTS
  The analysis showed a significant reduction of radiation dose of up to 42 %, using the single-acquisition split-bolus protocol, while maintaining a comparable diagnostic accuracy (primary endoleak detection rate of 96 %). Image quality between the two protocols was comparable and only slightly inferior for the split-bolus scan (2.5 vs. 2.4).
  
  
  CONCLUSIONS
  Using the single-acquisition, split-bolus approach allows for a significant dose reduction while maintaining high image quality, resulting in effective endoleak identification.
  
  
  CONCLUSIONS
  • A single-acquisition, split-bolus approach allows for a significant dose reduction. • Endoleak development is the most common complication after endovascular aortic repair (EVAR). • CT angiography is the imaging modality of choice for aortic aneurysm evaluation.
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria. domagoj.javor@meduniwien.ac.at.
authors.forename: D
authors.initials: D
authors.lastname: Javor
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Wressnegger
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Unterhumer
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Kollndorfer
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Nolz
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Beitzke
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, A-1090, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Loewe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D003287:Contrast Media / Q000008:administration & dosage; D004334:Drug Administration Schedule; D057867:Endoleak / Q000000981:diagnostic imaging* / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Aneurysm; Angiography; Aorta; Computed tomography; Endoleak