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Ogata, T., Ueguchi, T., Yagi, M., Yamada, S., Tanaka, C., Ogihara, R., Isohashi, F., Yoshioka, Y., Tomiyama, N., Ogawa, K. and Koizumi, M. (2013) Feasibility and Accuracy of Relative Electron Density Determined by Virtual Monochromatic CT Value Subtraction at Two Different Energies Using the Gemstone Spectral Imaging. Radiation Oncology, 8, 83.
http://ro-journal.biomedcentral.com/articles/10.1186/1748-717X-8-83
http://dx.doi.org/10.1186/1748-717x-8-83

has been cited by the following article:

• TITLE: Continued Diagnostic Difficulties in Preoperatively Differentiating Lipiodized Oil and Residual Metallic Material: A Case Report

  AUTHORS: Masashi Haraguchi, Shinichiro Ito, Kohei Kotera, Aya Fukushima, Toshio Fukuda, Hirotaka Tokai, Kazumasa Noda, Masataka Hirabaru, Toshiyuki Adachi, Nobuhiro Tada, Keiji Inoue, Shinya Onizuka, Shigeki Minami

  KEYWORDS: Lipiodized Oil, Hysterosalpingography, Residual Metallic Material

  JOURNAL NAME: Case Reports in Clinical Medicine, Vol.5 No.4, April 21, 2016

  ABSTRACT: Retained foreign objects in the abdomen and pelvis are serious clinical problems yet the imaging required can present difficulties. Prolonged retention of lipiodized oil used for hysterosalpingography over years is very rare. However, lipiodized oil had previously been misdiagnosed as residual metallic material. We are reporting a case in which the latest computed tomography (CT) equipment seemed inadequate for obtaining a clear pre-operative diagnosis. Here, we describe the case of a 33-year-old Japanese female whose pelvis had contained retained lipiodized oil that had been suspected as residual metallic material. The preoperative diagnosis was very difficult and included three-dimensional computed tomography (3D-CT) of unclear results despite expectations of resolution. By laparoscopic surgery, we removed a cyst of approximately 2 cm containing a yellowish oily fluid. Postoperatively, we demonstrated that the fluid was lipiodized oil. A postoperative experiment to attempt distinguishing lipiodized oil from metal through gemstone spectral CT imaging did not offer clarity either. Distinguishing between retained lipiodized oil and metallic material in the abdominal cavity may still present unexpected difficulties even with the latest medical equipments.