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Kidney tumor imaging with VNC Dual Energy
SOMATOM Definition Dual Energy Scanning
Authors: Jiri Ferda MD PhD, Boris Kreuzberg MD PhD
University Hospital Pilsen / Czech Republic
History
A 56-year-old male patient was referred to the University Hospital Pilsen with abdominal pressure pain near right kidney region. The patient also experienced fever and weight loss. A hematuria exists and has been proven by the general practitioner. The proximate ultrasound shows a right kidney infiltration.
Diagnosis
After the Dual Energy scan performed on the SOMATOM Definition Dual Source CT, the post processing of the images in VNC (Virtual non Contrast) displayed a color-coded iodine distribution map. The Dual Energy iodine assignment confirms a tumor infiltration of the right kidney, emphasizing by color-codery the hypervascularized tumor tissue with involvement of the renal vein. The same SOMATOM Definition DSCT scan verified metastases in retroperitoneal lymph nodes.
Comments
In the Dual Energy mode, two x-ray sources can be operated simultaneously at different KV levels. The results are two spiral data sets acquired in a single scan providing diverse information that allows one to differentiate, characterize, isolate, and distinguish the imaged tissue and material. Enhancement patterns of kidney regions can clearly be visualized with the Dual Energy VNC application.
Fig 1: Dual Energy scan virtual non contrast (VNC)
Fig 2: Dual Energy scan composed data with contrast
Fig 3: Mixed visualization of VNC and iodine concentration
Fig 4: Dual Energy application highlights iodine concentration
Fig 5: VRT with Bone Removal shows vascular status of the tumor
Fig 6: Coronal reformation of the right kidney using Optimum Contrast
Examination Protocol
| Scanner | SOMATOM Definition |
| Scan area | Abdomen CTA |
| Scan length | 500 mm |
| Scan time | 17s |
| Scan direction | Cranio-Caudal |
| kV | 140/80 |
| Effective mAs | 60/360 |
| Rotation time | 0.5 s |
| Slice collimation | 0.6 mm |
| Reconstructed slice thickness | 0.6 mm |
| Increment | 0.4 mm |
| Kernel | B20f |
The information presented in this case study is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their
own learning, training and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard.
The drugs and doses mentioned herein are consistent with the approval labeling for uses and/or indications of the drug. The treating physician bears the sole responsibility for the diagnosis and treatment of patients, including drugs and doses prescribed in connection with such use. The Operating Instructions must always be strictly followed when operating the CT System. The source for the technical data is the corresponding data sheets. Results may vary.
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SOMATOM Definition Dual Energy Scanning
Excellence in CT
SOMATOM Definition is the latest revolution in CT. Its new Dual Source CT technology promotes pioneering new clinical opportunities at the highest level, making it the ideal choice not only for bigger hospitals and research facilities but also for community hospitals, emergency departments and imaging centers.
