Table Of ContentDual Source CT Imaging
Seidensticker
Hofmann
(Eds.)
Dual Source CT Imaging
Peter R. Seidensticker, MD
Lars K. Hofmann, MD
With 209 Figures and 52 Tables
ISBN 978-3-540-77601-7
Springer Medizin Verlag Heidelberg
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Content
Foreword 7
The Dual Source CT Expert Panel 9
Authors 13
Dual Source CT Technology
Bernhard Schmidt, Christiane Bredenhoeller, Thomas Flohr 19
Iodinated Contrast Media: New Perspectives with Dual Source CT
Matthias Braeutigam, Ute Huebner-Steiner, Hubertus Pietsch, Ulrich Speck 35
Cardiovascular and Body Radiology DSCT Applications
Cardiac: Coronary CT Angiography
Stephan Achenbach, Axel Kuettner, Dieter Ropers – Erlangen-Nuremberg 50
Cardiac: Coronary Stents
Stephan G. Ruehm, Cesar Arellano, Christoph Panknin – Los Angeles 60
Cardiac: Coronary CTA in Obese Patients
Kavitha M. Chinnaiyan, Ralph Gentry, Gilbert L. Raff – Royal Oak 70
Cardiac: Valvular Function
Hatem Alkadhi, Sebastian Leschka, Hans Scheffel, Paul Stolzmann – Zurich 80
Cardiac: Morphology
Scott Harris, Cynthia McCollough, Eric Williamson – Rochester 90
Cardiac: Left / Right Ventricular Function
Kai Uwe Juergens, Harald Seifarth, Michael Puesken, Roman Fischbach – Münster 100
Cardiac: Atrial Fibrillation / Arrhythmia
Nico R. Mollet, Filippo Cademartiri, Gabriel P. Krestin – Rotterdam 110
Cardiac: Bypass Grafts
Pal Suranyi, Christian Thilo, Heon Lee, U. Joseph Schoepf – Charleston 120
Vascular: Extended Chest Pain Protocol
Thorsten R. C. Johnson, Konstantin Nikolaou, Christoph R. Becker – Munich-Grosshadern 130
Vascular: Pulmonary Veins
Harald Brodoefel, Martin Heuschmid, Andreas F. Kopp – Tübingen 140
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Vascular: Aortic Runoff, Abdominal CTA
Andreas H. Mahnken, Joachim E. Wildberger, Marco Das – Aachen 150
Vascular: Renal CTA
Robert P. Hartman, Terri J. Vrtiska, Cynthia McCollough – Rochester 160
Vascular: Peripheral Runoff
Axel Kuettner, Katharina Anders, Michael Lell – Erlangen-Nuremberg 170
Vascular: Brain Perfusion
Harald Seifarth, Tobias Fischer, Roman Fischbach, Stephan P. Kloska – Münster 180
Body: Obese Mode
Elizabeth McDonald, Robert P. Hartman, Cynthia McCollough – Rochester 190
Dual Energy CT Applications
Dual Energy: CTA of Head and Neck
Dominik Morhard, Thorsten R. C. Johnson, Christoph R. Becker – Munich-Grosshadern 202
Dual Energy: CTA Aorta
Marco Das, Andreas H. Mahnken, Joachim E. Wildberger – Aachen 212
Dual Energy: CTA Runoff
Andrew Misselt, Cynthia McCollough, Eric Williamson – Rochester 222
Dual Energy: CTA Lung Perfusion (PE)
Thorsten R. C. Johnson, Christian Fink, Christoph R. Becker – Munich-Grosshadern 232
Dual Energy: Virtual Non-Contrast
Axel Kuettner, Katharina Anders, Michael Lell – Erlangen-Nuremberg 242
Dual Energy: Characterization of Kidney Stone Composition
Andrew Primak, Terri J. Vrtiska, Cynthia McCollough – Rochester 252
Dual Energy: Urography
Robert P. Hartman, Terri J. Vrtiska, Cynthia McCollough – Rochester 262
Dual Energy: Vascular Plaque Removal / Detection
Christoph Thomas, Harald Brodoefel, Martin Heuschmid, Andreas F. Kopp – Tübingen 272
Dual Energy: Tendons and Cartilage
Stephan G. Ruehm, Derek Lohan, Christoph Panknin – Los Angeles 282
Dual Energy: Gout
Thorsten R. C. Johnson, Sabine Weckbach, Christoph R. Becker – Munich-Grosshadern 292
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Abbreviations 301
Editors 303
CME Instructions inside back cover
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Dear Colleagues
The introduction of Dual Source Computed Tomography (DSCT) in 2005 represented a giant leap in the
evolution of sectional imaging comparable to the introduction of spiral and later multi-detector CT.
The scientific community has responded with great interest and DSCT has opened entirely new clinical
fields to CT applications. Equipped with two x-ray sources and detectors mounted in one gantry, DSCT
enables many new applications ranging from heart rate independent coronary CT angiography
examinations to complete chest pain evaluation in one single scan. Because it is able to run both x-ray
sources simultaneously at different energy settings, DSCT is also the first scanner generation to enable
routine spiral dual energy imaging.
As today’s scanners become faster and more robust, contrast media delivery has become an
increasingly critical element of the contrast enhanced CT procedure. It has been necessary over the
years to significantly adapt injection protocols with each new scanner generation. This is particularly
relevant in the case of DSCT.
Siemens AG and Bayer Schering Pharma joined forces in early 2006 to provide you with a comprehensive
overview of DSCT’s capabilities together with reliable protocol recommendations for scanner use and
optimized contrast media injection parameters.
Based on their extensive experience in CT imaging, physicians from 12 global luminary sites were
selected to form the Dual Source CT Expert Panel. Over the course of 18 months and four panel
meetings, 25 clinical scan and contrast media injection protocols were developed. All protocols were
based on intense discussions among the panel members. To ensure the highest quality, the selected
protocols were tested by numerous sites, individually adapted and finally approved during a panel
consensus meeting.
This book will provide an introduction into DSCT technology as well as into the basics of contrast
media administration. You will find consensus protocols as well as individual considerations, such as
tricks and pitfalls, complemented by clinical examples from several of the world’s best radiologists
and cardiologists. We are confident it can help you to achieve consistently high image quality, optimal
patient care, and perhaps a solid starting point for the development of your own unique protocols.
Peter R. Seidensticker, MD Lars K. Hofmann, MD
Berlin / Germany Erlangen / Germany
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The Dual Source CT Expert Panel
Stephan Achenbach, MD, FESC, FACC Roman Fischbach, MD
Professor of Cardiology Associate Professor of Radiology
University of Erlangen-Nuremberg University of Münster
Departments of Cardiology and Radiology Department of Clinical Radiology
Ulmenweg 18 Albert-Schweitzer-Str. 33
91054 Erlangen, Germany 48149 Münster, Germany
Hatem Alkadhi, MD Martin Heuschmid, MD
University Hospital Zurich Associate Professor
Institute of Diagnostic Radiology Eberhard-Karls-University Tübingen
Raemistr. 100 Department of Diagnostic and
8091 Zurich, Switzerland Interventional Radiology
Hoppe-Seyler-Str. 3
Christoph R. Becker, MD 72076 Tübingen, Germany
Associate Professor
University of Munich-Grosshadern Thorsten R. C. Johnson, MD
Department of Clinical Radiology University of Munich-Grosshadern
Marchioninistr. 15 Department of Clinical Radiology
81377 Munich, Germany Marchioninistr. 15
81377 Munich, Germany
Harald Brodoefel, MD
Eberhard-Karls-University Tübingen Kai Uwe Juergens, MD
Department of Diagnostic and Assistant Professor
Interventional Radiology University of Münster
Hoppe-Seyler-Str. 3 Department of Clinical Radiology
72076 Tübingen, Germany Albert-Schweitzer-Str. 33
48149 Münster, Germany
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Andreas F. Kopp, MD Gilbert L. Raff, MD
Professor of Radiology William Beaumont Hospital
Eberhard-Karls-University Tübingen Department of Cardiology
Department of Diagnostic and 3601 West Thirteen Mile Road
Interventional Radiology Royal Oak, MI 48073, USA
Hoppe-Seyler-Str. 3
72076 Tübingen, Germany Dieter Ropers, MD, FESC
Professor of Cardiology
Axel Kuettner, MD University of Erlangen-Nuremberg
University of Erlangen-Nuremberg Departments of Cardiology and Radiology
Department of Radiology Ulmenweg 18
Maximiliansplatz 1 91054 Erlangen, Germany
91054 Erlangen, Germany
Stephan G. Ruehm, MD, PhD
Andreas H. Mahnken, MD, MBA David Geffen School of Medicine at UCLA
University Hospital, RWTH Aachen University Department of Radiology
Department of Diagnostic Radiology Peter V Ueberroth Bldg., Suite 3371
Pauwelsstr. 30 10945 LeConte Avenue
52074 Aachen, Germany Los Angeles, CA 90095-7206, USA
Cynthia McCollough, PhD U. Joseph Schoepf, MD
Mayo Clinic College of Medicine Medical University of South Carolina
Department of Radiology Departments of Radiology and Medicine
200 First Street SW 169 Ashley Ave., PO Box 250322
Rochester, MN 55905, USA 29425 Charleston, USA
Nico R. Mollet, MD, PhD Harald Seifarth, MD
Erasmus Medical Center Rotterdam University of Münster
Department of Radiology Department of Clinical Radiology
Room HS-207, Department of Radiology Albert-Schweitzer-Str. 33
PO Box 2040 48149 Münster, Germany
3000 CA Rotterdam, Netherlands
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