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Gadolinium Enhances Dual-energy Computed Tomography Scan of Pulmonary Artery. Curr Med Sci 2022; 42:1310-1318. [PMID: 36190598 DOI: 10.1007/s11596-022-2621-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/06/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the feasibility of using gadopentetate dimeglumine (Gd-DTPA) for dual-energy computed tomography pulmonary angiography (CTPA). METHODS Sixty-six patients were randomly divided into three groups and underwent CTPA. Group A had a turbo flash scan using an iohexol injection, Group B had a turbo flash scan using Gd-DTPA, and Group C had a dual-energy scan using Gd-DTPA. The original images of Group C were linearly blended with a blending factor of 0.5 or reconstructed at 40, 50, 60, 70, 80, 90, 100, and 110 keV, respectively. The groups were compared in terms of pulmonary artery CT value, image quality, and radiation dose. RESULTS The pulmonary artery CT values were significantly higher in Group C40keV than in Groups B and C, but lower than in Group A. There was no significant difference in the image noise of Groups C40keV, B, and C. Moreover, Group A had the largest beam hardening artifacts of the superior vena cava (SVC), followed by Groups B and C. Group C40keV showed better vascular branching than the other three groups, among which Group B was superior to Group A. The subjective score of the image quality of Groups A, B, and C showed no significant difference, but the score was significantly higher in Group C40keV than in Groups A and B. The radiation dose was significantly lower in Group B than in Groups A and C. CONCLUSION Gd-CTPA is recommended to patients who are unsuitable for receiving an iodine-based CTPA. Furthermore, a turbo flash scan could surpass a dual-energy scan without consideration for virtual monoenergetic imaging.
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van Hamersvelt RW, Willemink MJ, de Jong PA, Milles J, Vlassenbroek A, Schilham AMR, Leiner T. Feasibility and accuracy of dual-layer spectral detector computed tomography for quantification of gadolinium: a phantom study. Eur Radiol 2017; 27:3677-3686. [PMID: 28124106 PMCID: PMC5544796 DOI: 10.1007/s00330-017-4737-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/12/2016] [Accepted: 01/03/2017] [Indexed: 01/24/2023]
Abstract
Objectives The aim of this study was to evaluate the feasibility and accuracy of dual-layer spectral detector CT (SDCT) for the quantification of clinically encountered gadolinium concentrations. Methods The cardiac chamber of an anthropomorphic thoracic phantom was equipped with 14 tubular inserts containing different gadolinium concentrations, ranging from 0 to 26.3 mg/mL (0.0, 0.1, 0.2, 0.4, 0.5, 1.0, 2.0, 3.0, 4.0, 5.1, 10.6, 15.7, 20.7 and 26.3 mg/mL). Images were acquired using a novel 64-detector row SDCT system at 120 and 140 kVp. Acquisitions were repeated five times to assess reproducibility. Regions of interest (ROIs) were drawn on three slices per insert. A spectral plot was extracted for every ROI and mean attenuation profiles were fitted to known attenuation profiles of water and pure gadolinium using in-house-developed software to calculate gadolinium concentrations. Results At both 120 and 140 kVp, excellent correlations between scan repetitions and true and measured gadolinium concentrations were found (R > 0.99, P < 0.001; ICCs > 0.99, CI 0.99–1.00). Relative mean measurement errors stayed below 10% down to 2.0 mg/mL true gadolinium concentration at 120 kVp and below 5% down to 1.0 mg/mL true gadolinium concentration at 140 kVp. Conclusion SDCT allows for accurate quantification of gadolinium at both 120 and 140 kVp. Lowest measurement errors were found for 140 kVp acquisitions. Key Points • Gadolinium quantification may be useful in patients with contraindication to iodine. • Dual-layer spectral detector CT allows for overall accurate quantification of gadolinium. • Interscan variability of gadolinium quantification using SDCT material decomposition is excellent.
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Affiliation(s)
- Robbert W van Hamersvelt
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Martin J Willemink
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Julien Milles
- CT Clinical Science, Philips HealthCare, Best, The Netherlands
| | | | - Arnold M R Schilham
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
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Lambert JW, Edic PM, FitzGerald PF, Torres AS, Yeh BM. Complementary contrast media for metal artifact reduction in dual-energy computed tomography. J Med Imaging (Bellingham) 2015; 2:033503. [PMID: 26839905 DOI: 10.1117/1.jmi.2.3.033503] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 08/13/2015] [Indexed: 11/14/2022] Open
Abstract
Metal artifacts have been a problem associated with computed tomography (CT) since its introduction. Recent techniques to mitigate this problem have included utilization of high-energy (keV) virtual monochromatic spectral (VMS) images, produced via dual-energy CT (DECT). A problem with these high-keV images is that contrast enhancement provided by all commercially available contrast media is severely reduced. Contrast agents based on higher atomic number elements can maintain contrast at the higher energy levels where artifacts are reduced. This study evaluated three such candidate elements: bismuth, tantalum, and tungsten, as well as two conventional contrast elements: iodine and barium. A water-based phantom with vials containing these five elements in solution, as well as different artifact-producing metal structures, was scanned with a DECT scanner capable of rapid operating voltage switching. In the VMS datasets, substantial reductions in the contrast were observed for iodine and barium, which suffered from contrast reductions of 97% and 91%, respectively, at 140 versus 40 keV. In comparison under the same conditions, the candidate agents demonstrated contrast enhancement reductions of only 20%, 29%, and 32% for tungsten, tantalum, and bismuth, respectively. At 140 versus 40 keV, metal artifact severity was reduced by 57% to 85% depending on the phantom configuration.
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Affiliation(s)
- Jack W Lambert
- University of California , Department of Radiology & Biomedical Imaging, 505 Parnassus Avenue, San Francisco, California 94143, United States
| | - Peter M Edic
- GE Global Research , 1 Research Circle, Niskayuna, New York 12309, United States
| | - Paul F FitzGerald
- GE Global Research , 1 Research Circle, Niskayuna, New York 12309, United States
| | - Andrew S Torres
- GE Global Research , 1 Research Circle, Niskayuna, New York 12309, United States
| | - Benjamin M Yeh
- University of California , Department of Radiology & Biomedical Imaging, 505 Parnassus Avenue, San Francisco, California 94143, United States
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FitzGerald PF, Colborn RE, Edic PM, Lambert JW, Torres AS, Bonitatibus PJ, Yeh BM. CT Image Contrast of High-Z Elements: Phantom Imaging Studies and Clinical Implications. Radiology 2015; 278:723-33. [PMID: 26356064 DOI: 10.1148/radiol.2015150577] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To quantify the computed tomographic (CT) image contrast produced by potentially useful contrast material elements in clinically relevant imaging conditions. MATERIALS AND METHODS Equal mass concentrations (grams of active element per milliliter of solution) of seven radiodense elements, including iodine, barium, gadolinium, tantalum, ytterbium, gold, and bismuth, were formulated as compounds in aqueous solutions. The compounds were chosen such that the active element dominated the x-ray attenuation of the solution. The solutions were imaged within a modified 32-cm CT dose index phantom at 80, 100, 120, and 140 kVp at CT. To simulate larger body sizes, 0.2-, 0.5-, and 1.0-mm-thick copper filters were applied. CT image contrast was measured and corrected for measured concentrations and presence of chlorine in some compounds. RESULTS Each element tested provided higher image contrast than iodine at some tube potential levels. Over the range of tube potentials that are clinically practical for average-sized and larger adults-that is, 100 kVp and higher-barium, gadolinium, ytterbium, and tantalum provided consistently increased image contrast compared with iodine, respectively demonstrating 39%, 56%, 34%, and 24% increases at 100 kVp; 39%, 66%, 53%, and 46% increases at 120 kVp; and 40%, 72%, 65%, and 60% increases at 140 kVp, with no added x-ray filter. CONCLUSION The consistently high image contrast produced with 100-140 kVp by tantalum compared with bismuth and iodine at equal mass concentration suggests that tantalum could potentially be favorable for use as a clinical CT contrast agent.
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Affiliation(s)
- Paul F FitzGerald
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
| | - Robert E Colborn
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
| | - Peter M Edic
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
| | - Jack W Lambert
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
| | - Andrew S Torres
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
| | - Peter J Bonitatibus
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
| | - Benjamin M Yeh
- From the Radiation Systems Lab (P.F.F.), Emission Chemistry and Catalysis Lab (R.E.C., P.J.B.), Department of CT, X-ray and Functional Imaging (P.M.E.), and GE Ventures (A.S.T.), GE Global Research, One Research Circle, Niskayuna, NY 12309; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (J.W.L., B.M.Y.)
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Endovascular Intervention for Central Venous Cannulation in Patients with Vascular Occlusion after Previous Catheterization. J Vasc Access 2010; 11:323-8. [DOI: 10.5301/jva.2010.5813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2010] [Indexed: 11/20/2022] Open
Abstract
Objectives This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. Methods Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively. Results Sixteen patients aged 48 years (range 0.5–76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, p<0.001) before endovascular intervention. Preoperative imaging by magnetic resonance tomography (MRT) in 8 patients, computed tomography (CT) venography in 3, conventional angiography in 6, and/or ultrasonography in 8, verified 15 brachiocephalic, 13 internal jugular, 3 superior caval, and/or 3 subclavian venous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route. Conclusions Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention.
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Acosta S, Björnsson S, Ekberg O, Resch T. CT angiography followed by endovascular intervention for acute superior mesenteric artery occlusion does not increase risk of contrast-induced renal failure. Eur J Vasc Endovasc Surg 2010; 39:726-30. [PMID: 20189850 DOI: 10.1016/j.ejvs.2010.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Accepted: 01/24/2010] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Acute superior mesenteric artery (SMA) occlusion can be diagnosed in an early phase by computed tomography (CT) angiography, which is also a prerequisite for endovascular intervention. However, the issue of development of postoperative permanent renal failure due to contrast-induced nephropathy has not been evaluated. DESIGN Retrospective MATERIALS A total of 55 patients with acute SMA occlusion were retrieved from the in-hospital register during a 4-year period between 2005 and 2009. METHODS Glomerular filtration rate was calculated as a simplified variant of Modification of Diet in Renal Disease Study Group (MDRD). RESULTS Preoperative renal insufficiency was found in 52%; advanced state in one patient. Creatinine was lower (p = 0.018) at discharge (median: 71 micromol L(-1)), compared to admission (median: 76 micromol L(-1)), in the 32 survivors exposed to repeated iodinated contrast media (median: 54.7 g iodine). No patient died due to renal failure or needed dialysis after endovascular intervention. Endovascular intervention was associated with a higher survival rate (p = 0.001). CONCLUSION Serious acute contrast-induced nephropathy was not found in patients diagnosed by CT angiography and treated by endovascular procedures for acute SMA occlusion. Elevated serum creatinine levels should not deter the clinician from ordering a CT angiography in patients with suspicion of acute SMA occlusion.
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Affiliation(s)
- S Acosta
- Vascular Center, Malmö University Hospital, 205 02 Malmö, Sweden.
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