Skip Navigation LinksHome > September/October 2012 - Volume 36 - Issue 5 > Toward Biphasic Computed Tomography (CT) Enteric Contrast:...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182606baf
Abdominal Imaging

Toward Biphasic Computed Tomography (CT) Enteric Contrast: Material Classification of Luminal Bismuth and Mural Iodine in a Small-Bowel Phantom Using Dual-Energy CT

Qu, Mingliang MD*; Ehman, Eric MD*; Fletcher, Joel G. MD*; Huprich, James E. MD*; Hara, Amy K. MD; Silva, Alvin C. MD; Farrugia, Gianrico MD; Limburg, Paul MD; McCollough, Cynthia H. PhD*

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Objective: To develop dual-energy computed tomography methods for identification of hyperenhancing, hypoenhancing, and nonenhancing small-bowel pathologies.

Methods: Small-bowel phantoms simulating varying patient sizes and polyp types (hyperenhancing, hypoenhancing, and nonenhancing) contained bismuth suspension in the lumen. Dual-energy CT was performed at 80/140 kV and 100/140 kV. Computed tomographic number ratios (CT numbers at low/high kilovoltage) were calculated. Two radiologists evaluated polyp detection and conspicuity using bismuth-only, iodine-only, iodine-overlay, and mixed-kilovoltage displays.

Results: Computed tomographic ratios for bismuth and iodine did not overlap. For hyperenhancing and nonenhancing polyps at 80/140 kV, iodine-overlay display yielded higher detection rate (96%, 94%) and conspicuity score (3.5, 3.1) than mixed-kilovoltage images (88%, 68%; 1.5, 2.7). Mixed-kV images performed slightly better for hypoenhancing polyps (92%, 3.4 vs. <80%, <2.9). Similar results were observed at 100/140kV.

Conclusions: Dual-energy CT and a bismuth-containing enteric contrast permitted simultaneous identification of hyperenhancing, hypoenhancing, and nonenhancing polyps over a range of patient sizes.

© 2012 Lippincott Williams & Wilkins, Inc.



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