Bariatric CT Imaging: Challenges and Solutions.
Dzmitry M FursevichGary M LiMarziMatthew C O'DellManuel A HernandezWilliam F SensakovicPublished in: Radiographics : a review publication of the Radiological Society of North America, Inc (2016)
The obesity epidemic in the adult and pediatric populations affects all aspects of health care, including diagnostic imaging. With the increasing prevalence of obese and morbidly obese patients, bariatric computed tomographic (CT) imaging is becoming common in day-to-day radiology practice, and a basic understanding of the unique problems that bariatric patients pose to the imaging community is crucial in any setting. Because larger patients may not fit into conventional scanners, having a CT scanner with an adequate table load limit, a large gantry aperture, a large scan field of view, and a high-power generator is a prerequisite for bariatric imaging. Iterative reconstruction methods, high tube current, and high tube voltage can reduce the image noise that is frequently seen in bariatric CT images. Truncation artifacts, cropping artifacts, and ring artifacts frequently complicate the interpretation of CT images of larger patients. If recognized, these artifacts can be easily reduced by using the proper CT equipment, scan acquisition parameters, and postprocessing options. Lastly, because of complex contrast material dynamics, contrast material-enhanced studies of bariatric patients require special attention. Understanding how the rate of injection, the scan timing, and the total mass of iodine affect vascular and parenchymal enhancement will help to optimize contrast-enhanced studies in the bariatric population. This article familiarizes the reader with the challenges that are frequently encountered at CT imaging of bariatric patients, beginning with equipment selection and ending with a review of the most commonly encountered obesity-related artifacts and the technical considerations in the acquisition of contrast-enhanced images. (©)RSNA, 2016.
Keyphrases
- contrast enhanced
- computed tomography
- image quality
- weight loss
- dual energy
- end stage renal disease
- ejection fraction
- magnetic resonance imaging
- healthcare
- roux en y gastric bypass
- newly diagnosed
- obese patients
- magnetic resonance
- high resolution
- chronic kidney disease
- diffusion weighted
- bariatric surgery
- prognostic factors
- type diabetes
- deep learning
- gastric bypass
- peritoneal dialysis
- metabolic syndrome
- adipose tissue
- primary care
- positron emission tomography
- weight gain
- insulin resistance
- diffusion weighted imaging
- body mass index
- risk factors
- mental health
- patient reported outcomes
- mass spectrometry
- pet ct
- health information