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MDCT of the Pancreas: Optimizing Scanning Delay with a Bolus-Tracking Technique for Pancreatic, Peripancreatic Vascular, and Hepatic Contrast Enhancement

Hiroshi Kondo1, Masayuki Kanematsu1,2,3, Satoshi Goshima1, Toshiharu Miyoshi2, Yoshimune Shiratori4, Minoru Onozuka5, Noriyuki Moriyama6 and Kyongtae T. Bae7

1 Departments of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
2 Departments of Radiology Services, Gifu University School of Medicine, Gifu 501-1194, Japan.
3 Center of Brain and Oral Science, Kanawaga Dental College, Yokosuka 238-8580, Japan.
4 Department of Medical Informatics, Gifu University School of Medicine, Gifu 501-1193, Japan.
5 Department of Physiology and Neuroscience, Kanagawa Dental College, Yokosuka 238-8580, Japan.
6 Research Center for Cancer Prevention and Screening, National Cancer Center Hospital, Tsukiji, Japan.
7 Radiology and Biomedical Engineering University of Pittsburgh, Pittsburgh, PA 15261.


Figure 1
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  		Fig. 1 —Graph shows curves of scanning delay versus mean change in attenuation. Mean change in attenuation of aorta (327 H) and of superior mesenteric artery (307 H) peaked 10 (p < 0.05) and 5 seconds (p < 0.01), respectively, after bolus tracking was triggered and then decreased with time. Mean change in attenuation of splenic vein (183 H) and main portal veins (148 H) peaked at 25 seconds (both p < 0.05). Mean change in attenuation of superior mesenteric vein (158 H) peaked at 30 seconds (p < 0.001). Scanning delay is defined as time after bolus-tracking program detected threshold enhancement of 50 H in aorta.

 

Figure 2
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  		Fig. 2 —Graph shows curves of scanning delay versus mean change in attenuation for pancreatic and liver parenchyma. Mean change in attenuation of pancreatic parenchyma increased constantly at 5-15 seconds, peaked at 15-20 seconds (84-85 H, respectively), and then decreased with time. Mean change in attenuation of pancreatic parenchyma in first phase was significantly higher (p < 0.001) 15 seconds than it was 5-10 seconds after bolus tracking was triggered and in second phase was significantly higher (p < 0.005) 20 seconds than it was 30 seconds after bolus tracking was triggered. Mean change in attenuation of liver parenchyma gradually increased at 5-30 seconds, reached 61 H at 45 seconds, and then reached plateau. Scanning delay is defined as time after bolus-tracking program detected threshold enhancement of 50 H in aorta.

 

Figure 3
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  		Fig. 3 —70-year-old man with malignant melanoma. Amount of contrast material administered was 126 mL. CT image obtained 15 seconds after triggering of bolus tracking shows intense enhancement in pancreatic parenchyma (arrowhead). Common hepatic artery (solid arrow) and splenic vein (open arrow) are also intensely enhanced.

 

Figure 4
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  		Fig. 4 —Graph shows scanning delay versus mean qualitative contrast enhancement of superior mesenteric artery and vein, main portal veins, and pancreatic and liver parenchyma. Mean degree of superior mesenteric venous enhancement was significantly higher at 25-30 seconds than it was at 20 seconds (p < 0.001). Mean degree of main portal venous enhancement was significantly higher at 25-30 seconds than it was at 20 seconds (p < 0.001). Mean degree of pancreatic parenchyma was significantly higher at 15 seconds than it was at 5-10 seconds (p < 0.001) and at 20 seconds than it was 25-30 seconds (p < 0.05). Scanning delay is defined as time after bolus-tracking program detected threshold enhancement of 50 H in aorta.

 

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