Article
Evaluation of ultra-low-dose CT for the assessment of VP-shunt complications compared to radiographic shunt series: an experimental ex-vivo study in a swine model
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Published: | June 2, 2015 |
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Objective: Radiographic imaging of ventriculoperitoneal shunts (VP-shunts) is known to provide limited sensitivity for the detection of mechanical shunt complications and is associated with a radiation exposure of 1.57 mSv on the average In the present study we aimed to evaluate the feasibility of whole-body Ultra-Low-Dose-CT (ULD-CT) as an alternative for radiographic shunt series with special regards to diagnostic accuracy and radiation exposure.
Method: 14 VP-shunts were implanted in 7 swine cadavers (weight: 55 - 70 kg). In 9 VP-Shunts, 22 mechanical complications (i.e. extracranial/extraperitoneal malpositioning, breakage, disconnection) were induced. 10 different ULD-CT protocols (80-120 kV, 20-50 mAs, Pitch (P):1 and 1.5) as well as radiographic shunt series were acquired. Blinded readings of ULD-CTs and radiographic shunt series were performed.
Results: All ULD-CT protocols were superior to radiographic shunt series regarding sensitivity (.982 vs. .762) and specificity (.982 vs. .939). Estimated radiation doses for the ULD-CTs ranged from 0.44 to 2.55 mSv. 6 of the 10 ULD-CT protocols yielded lower radiation doses than reported for radiographic shunt series (1.57 mSv).
Conclusions: In this swine model, ULD-CT is superior to radiographic shunt series regarding the detection of VP-shunt complications at radiation doses similar or lower than reported for radiographic shunt series. The potential relevance of ultra-low-dose CT should be evaluated in prospective clinical series.