title: Dual-energy CT workflow: multi-institutional consensus on standardization of abdominopelvic MDCT protocols.
abstract: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols.
  
  
  
  9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions.
  
  
  
  5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00).
  
  
  
  DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.
authors.affiliation: Division of Abdominal Imaging, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC, 27710, USA. bhavik.patel@dm.duke.edu.
authors.forename: Bhavik N
authors.initials: BN
authors.lastname: Patel
authors.affiliation: Department of Radiology, Emory University, Atlanta, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Alexander
authors.affiliation: Division of Abdominal Imaging, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC, 27710, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Allen
authors.affiliation: Department of Radiology, University of Alabama Birmingham, Birmingham, USA.
authors.forename: Lincoln
authors.initials: L
authors.lastname: Berland
authors.affiliation: Department of Radiology, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Borhani
authors.affiliation: Division of Abdominal Imaging, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC, 27710, USA.
authors.forename: Achille
authors.initials: A
authors.lastname: Mileto
authors.affiliation: Department of Radiology, Emory University, Atlanta, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Department of Radiology, University of Alabama Birmingham, Birmingham, USA.
authors.forename: Desiree
authors.initials: D
authors.lastname: Morgan
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, USA.
authors.forename: Dushyant
authors.initials: D
authors.lastname: Sahani
authors.affiliation: Department of Radiology, University of Washington, Seattle, USA.
authors.forename: William
authors.initials: W
authors.lastname: Shuman
authors.affiliation: Department of Radiology, MD Anderson, Houston, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Tamm
authors.affiliation: Department of Radiology, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Tublin
authors.affiliation: Department of Radiology, University of California San Francisco, San Francisco, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Yeh
authors.affiliation: Division of Abdominal Imaging, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC, 27710, USA.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marin
mesh_terms: D002985:Clinical Protocols / Q000592:standards*; D006801:Humans; D061330:Multidetector Computed Tomography / Q000379:methods*; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011857:Radiographic Image Interpretation, Computer-Assisted; D011860:Radiography, Abdominal / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D011795:Surveys and Questionnaires; D057188:Workflow
keywords: Consensus; Dual-energy CT; Workflow