%0 Journal Article
%T Usefulness of the Bolus-Tracking Baseline Scan for the Diagnosis of Hepatic Steatosis in Abdominal Computed Tomography: A Feasibility Study
%A J. Gossner
%A S. Sch£¿fer
%J ISRN Radiology
%D 2013
%R 10.5402/2013/147632
%X Nonalcoholic fatty liver disease (NAFLD) is a common pathology in western societies. Unenhanced computed tomography (CT) of the liver is a valuable tool in determining the presence of steatosis hepatis, but in most departments standard CT protocols of abdomen often do not include unenhanced scans anymore. In a small series of 22 patients the liver density was measured in the acquired low-dose baseline scan for bolus tracking and was compared to the measurement in a regular unenhanced CT scan of the upper abdomen. The mean difference between the unenhanced CT scan and the low-dose baseline scan was 3.4£¿HU (range 0.2¨C8.6£¿HU); the difference between these two scans was 5£¿HU or smaller in 82% of the patients. There was a significant difference between the two used CT scanners; this has to be kept in mind before implementing this approach into daily practice. All but one patient with fatty liver disease on unenhanced CT were diagnosed using the baseline scan. The baseline scan for bolus tracking may be useful for the diagnosis or in the followup of fatty liver disease. 1. Introduction Nonalcoholic fatty liver disease (NAFLD) is common in western societies and is reported to occur in 10¨C24% of the general population. Once believed to be a benign condition, it has been shown that the occurring inflammatory changes may lead to steatohepatitis, cirrhosis, liver failure, and hepatocellular carcinoma [1]. Unenhanced computed tomography (CT) of the liver is a valuable tool to determine the presence and to quantifiy the extent of steatosis hepatis. After the administration of contrast media the assessment of liver fat contant is problematic, and only severe cases of NAFLD may be recognised [2, 3]. In most departments standard CT protocols of abdomen often do not include unenhanced scans of the liver anymore; this is hindering the diagnosis of fatty liver disease. Modern CT scanners are using bolus tracking for the optimal timing of contrast media application. The baseline scan for this bolus-tracking technique is an unenhanced low-dose axial scan. If these planning images can be used to determine the density of the liver parenchyma has been studied in a small series of patients. 2. Material and Methods Retrospective Review of CT Datasets of 22 Patients. Patients were included if they had a multiphasic abdominal CT scan including unenhanced images of the upper abdomen and if the planning scan for bolus tracking included parts of the liver. Patients with focal liver disease were excluded. Patients were examined using a 16-slice CT scanner (Activion, Toshiba Medical
%U http://www.hindawi.com/journals/isrn.radiology/2013/147632/