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Optimizing z-axis coverage of abdominal CT scans of the urinary tract: a proposed alternative proximal landmark for acquisition planning

Abstract : Objective: To evaluate an alternative method to reduce the acquisition coverage of urinary tract CT. Methods: This retrospective study included 365 abdominopelvic CT studies. Three radiographers simulated shortened acquisition coverages using three methods to determine the upper limit of the acquisition: Method 1 used the renal contours; Method 2 used the inferior margin of the 10th thoracic vertebra; and Method 3 used the point of intersection of the left diaphragmatic dome and the anterior margin of the vertebral bodies. Reductions in acquisition coverage and number of CT scans with a portion of the kidney excluded from the simulated reduced acquisition were compared between the three methods. Results: The mean ± standard deviation reduction of acquisition coverage for the three readers with Methods 1, 2 and 3 were 20.5 ± 4.8, 15.1 ± 6.5 and 18.2 ± 5.3%, respectively. Compared with Method 2, Method 3 allowed a mean scan length reduction of 3.6%. The proportions of CT scans with a portion of the kidney excluded from the simulated reduced acquisition with Methods 1, 2 and 3 and averaged over the three readers were 6.7, 0.7 and 1.4%, respectively, with no significant difference between Methods 2 and 3. Interreader and intrareader agreements were excellent with all methods, but interclass correlation coefficients were higher with Method 3. Conclusion: The method using the renal contours should not be used owing to its high proportion of kidneys with a portion excluded from the acquisition. Using the intersection of the left diaphragmatic dome and the anterior margin of the vertebral bodies for proximal landmark for urinary tract CT represents a new alternative method with a better reduction of scan length compared with the method using the inferior margin of T10 and with no significant increase in the number of kidneys with a portion excluded from the reduced acquisition. Advances in knowledge: A new method using the point of intersection of the left diaphragmatic dome and the anterior border of the vertebral bodies on the lateral scout radiograph is introduced to reduce the z-axis coverage of urinary tract CT scans.
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Submitted on : Thursday, May 20, 2021 - 3:22:12 PM
Last modification on : Monday, May 31, 2021 - 3:08:08 PM

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Alban Gervaise, Pedro Teixeira, Gabriela Hossu, Alain Blum, Marie Lapierre-Combes. Optimizing z-axis coverage of abdominal CT scans of the urinary tract: a proposed alternative proximal landmark for acquisition planning. British Journal of Radiology, British Institute of Radiology, 2016, 89 (1067), pp.20160197. ⟨10.1259/bjr.20160197⟩. ⟨hal-03231203⟩

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