Tracy Anne Jaffe MD, Presenter: Nothing to Disclose

Lucie C. Martin MD, Abstract Co-Author: Nothing to Disclose

Kendra Marshae Franklin MD, Abstract Co-Author: Nothing to Disclose

Elmar Max Merkle MD, Abstract Co-Author: Nothing to Disclose

William Moreau Thompson MD, Abstract Co-Author: Nothing to Disclose

David Delong PhD, Abstract Co-Author: Nothing to Disclose

Erik Karl Paulson MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To test the hypothesis that coronal reformations obtained with isotropic MDCT data sets are equivalent to the axial data sets for interpretation of the abdomen and pelvis.

29 consecutive patients with unexplained abdominal pain underwent 16-slice MDCT (Lightspeed 16, GE Healthcare) with coronal reformations. Protocol: oral contrast; 150 mL iopamidol at 3mL/second; 16x0.625mm, pitch 1.75, 17.5mm/rotation, 0.5 seconds. Axial images were reconstructed at 5mm x 5mm intervals and at 06.25mm x 0.5 mm intervals, and reformatted coronally at 3 mm x 5 mm intervals. On a workstation (AW, GE Healthcare), six independent blinded readers reviewed a randomized set of scans (axials and coronals) and identified pathology in multiple organ systems including: lung bases/cardiac, liver, spleen, biliary tree/gallbladder, pancreas, adrenals, kidneys, small and large bowel, vasculature and lymph nodes. Timing for each interpretation was recorded. One month later readers reviewed the scan obtained in the other imaging plane for the same findings. Interpretations of the axial scans were considered the gold standard. Agreement between axial and coronals was tested using Cohen's Kappa coefficient.

Mean axial interpretation time was 4.97 minutes (2.93-6.45 minutes); mean coronal time was 5.13 minutes (3.34-6.72 minutes). For each reader, there was no statistically significance difference in interpretation time between axials and coronals (p=0.33). There was good agreement between axial and coronal interpretations for gallbladder, biliary and pancreatic anatomy and pathology (Kappa = 0.8-0.93, 0.65-1.0, and 0.59-0.73, respectively) as well as for small bowel, colon, and arterial anatomy (Kappa = 0.83-0.87, 0.59-0.66, and 0.71-0.82, respectively). Agreement for liver, renal, and splenic pathology was also noted (Kappa = 0.53, 0.51, and 0.55, respectively). Axial interpretations noted more thoracic pathology and coronal interpretations noted more lymphadenopathy.

Coronal reformations from isotropic voxels are similar to axials in terms of interpretation time and reader agreement regarding the presence of intraabdominal pathology. Coronal reformations may replace axial scans.

Jaffe, T, Martin, L, Franklin, K, Merkle, E, Thompson, W, Delong, D, Paulson, E, et al, , Coronal Reformations from Isotropic Voxels Using 16-Slice MDCT in the Evaluation of the Abdomen and Pelvis: Can They Replace the Axials?.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417560.html