Trauma is a leading cause of death and disability in children ages 1-18, with blunt trauma causing the majority of abdominal injuries. For radiologists, cases of trauma elicit the necessity of timely reads to determine if a patient requires immediate surgical intervention, or is a candidate for conservative, non-operative management. Spectral Dual-Energy Computed Tomography (DECT) obtains raw data at two energy spectra which by virtue of material decomposition can identify, isolate and or quantify iodine, pure calcium, and uric acid. Multiple image sets can be generated from a single scan allowing both standard anatomic and material-specific analysis. This allows accurate demonstration and grading of solid organ injury, differentiation between acute hematoma from ongoing vascular extravasation, detection of subtle injuries and visualization of compromised vascular structures all of which are imperative in determining the proper course of treatment in the acute trauma setting. Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Williams Avery, Groth Nicholas, Southard Richard

Keywords: Spectral CT, Abdominal injury, Solid organ injury

PURPOSE: Trauma is a leading cause of death and disability in children ages 1-18, with abdominal trauma accounting for a significant patient population. Prompt identification of bowel and mesenteric injury in the setting of blunt trauma and penetrating injuries is important to avoid significant complications that may arise from delayed diagnosis. Spectral Dual-Energy Computed Tomography (DECT) obtains raw data at two energy spectra which by virtue of material decomposition can identify, isolate and or quantify iodine, pure calcium, and uric acid. Multiple image sets can be generated from a single scan allowing both anatomic and material-specific analysis. The use of DECT can improve detection and accurate grading of solid organ injury, aid in defining active hemorrhage, and increase visibility of altered bowel wall enhancement, ischemia, necrosis, and inflammation which provides critical information to inform the course of treatment in emergent settings. Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Groth Nicholas, Williams Avery, Southard Richard

Keywords: Dual Energy, Computed Tomography, Bowel Injury

As more pediatric patients are infected with severe acute respiratory syndrome coronavirus 2 during the coronavirus disease 2019 (COVID-19) pandemic, more have been diagnosed with multisystemic inflammatory syndrome in children (MIS-C). Early research investigations into MIS-C show cardiac involvement presenting as elevated troponins, ventricular dysfunction, electrical conduction abnormalities, and pericardial effusions. MIS-C may result in myocardial perfusion defects visualized with nuclear medicine imaging and magnetic resonance imaging (MRI), however these perfusion defects on contrast enhanced computed tomography (CT) have not yet been described. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Simmons Curtis, Goncalves Luis, Southard Richard, Bardo Dianna

Keywords: Cardiac, COVID

Spectral or multi-energy CT (MECT), obtains raw data at more than one energy spectra which allows the decomposition of materials into their constituent elements. As opposed to conventional CT which yields data based on linear attenuation, MECT yields both structural and material-specific information. Only limited experience and literature are available regarding use and applications of MECT in the pediatric patient population. Our institution has recently installed a spectral MECT scanner which uses a single x-ray source modified multilayered detector CT, in our emergency department (ED). It is currently the only such scanner used for routine clinical pediatric imaging in the US, and 4^th such unit in a children’s hospital in the world. In this educational exhibit we will review the basic physics of MECT, the benefits and limitations of the single-source multi-layered detector geometry, and clinical applications of MECT and our experience to date in the pediatric population. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Southard Richard, Chen Lingyun, Williams Carla, Bardo Dianna

Keywords: Spectral CT, Multi-energy CT, renal stones

Pediatric abdominal trauma can be challenging and often necessitates rapid and accurate identification of injuries for optimal patient care. This study aimed to assess the potential workflow improvements in diagnostic accuracy achieved with semi-automated analysis of Dual Energy CT (DECT) image reconstruction in the setting of abdominal solid organ injury, as compared to conventional Multi-Detector CT (MDCT) images. The data sets from dual energy reconstructions have superior tissue differentiation and can be used to train a simple artificial intelligence (AI) program to recognize these patterns and expedite care. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Griffin Walter, Simmons Curtis, Southard Richard, Jorgensen Scott, Van Tassel Dane

Keywords: Dual Energy, abdominal trauma

Spectral or multi-energy CT (MECT), obtains raw data at more than one energy spectra which allows the decomposition of materials into their constituent elements. As opposed to conventional CT which yields data based on linear attenuation, MECT yields both structural and material-specific information. Only limited experience and literature are available regarding use and applications of MECT in the pediatric patient population. Our institution has recently installed a spectral MECT scanner which uses a single x-ray source modified multilayered detector CT, in our emergency department (ED). It is currently the only such scanner used for routine clinical pediatric imaging in the US, and 4^th such unit in a children’s hospital in the world. In this educational exhibit we will review the basic physics of MECT, the benefits and limitations of the single-source multi-layered detector geometry, and clinical applications of MECT and our experience to date in the pediatric population. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Bardo Dianna, Southard Richard, Williams Carla, Augustyn Robyn, Thorkelson Marrit, Curran John, Miller Jeffrey, Chen Lingyun

Keywords: Spectral CT, Multi-Energy CT

Accurate tumor measurement is essential in initial assessment of solid tumors. Furthermore, it is vital when evaluating treatment response. Change in tumor size determines whether a treatment course is effective, if treatment should be prolonged, or whether a more aggressive treatment or chemotherapy drug should be administered. Currently endorsed and widely used guidelines for tumor volume measurement include response evaluation criteria in solid tumors (RECIST), a one dimensional measure (cm) of target lesions which is not routinely the longest axis; World Health Organization (WHO), a 2 dimensional measure of the long and one short tumor axis (cm2) but is not a measure of volume; and Childrens Oncology Group (COG), a 3 dimensional ‘volume’ (cm3) measurement but does not account for shape of the tumor. Pediatric oncology patients are almost exclusively cared for in major academic or community hospital settings where modern CT and MR scanners routinely produce direct or reconstructed multiplanar images. Therefore an evolution of tumor measurement, to determine tumor volume, must be forthcoming. Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Willard Scott, Barnes Craig, Augustyn Robyn, Thorkelson Marrit, Chatfield Paige, Hu Harry, Towbin Richard, Bardo Dianna, Pfeifer Cory, Dance Logan, Bailey Smita, Southard Richard, Jorgensen Scott, Biyyam Deepa, Patel Mittun, Cassell Ian

Keywords: RECIST, WHO, COG