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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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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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  • Hussam Hamou - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • Ahmed Othman - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • Rastislav Pjontek - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • Saif Afat - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • Marc Alexander Brockmann - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • Martin Wiesmann - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • Hans Clusmann - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 169

doi: 10.3205/15dgnc567, urn:nbn:de:0183-15dgnc5672

Published: June 2, 2015

© 2015 Hamou et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.