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Zou X, Liu L, Tan F, Tang H, Hu D, Li Z, Wang Q, Shen Y. Non-contrast-enhanced MR angiography of left gastric vein in patients with gastroesophageal varices: morphology and blood supply analysis. Eur Radiol 2024; 34:4686-4696. [PMID: 38133674 DOI: 10.1007/s00330-023-10497-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/07/2023] [Accepted: 10/29/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES To investigate the feasibility of non-contrast-enhanced MR angiography (NCE-MRA) in evaluating the morphology and blood supply of left gastric vein (LGV) in patients with gastroesophageal varices. METHODS Between March 2021 and October 2022, patients with gastroesophageal varices and who underwent NCE-MRA were retrospectively reviewed. In order to evaluate the blood supply of LGV, superior mesenteric vein (SMV) and splenic vein (SV) were visualized separately by using inflow-sensitive inversion recovery sequence. Two radiologists independently assessed the image quality, determined the origination and the blood supply of LGV, and measured the diameter of LGV. The origination and diameter of LGV were compared between NCE-MRA and contrast-enhanced CT. Differences in blood supply were compared between LGVs with different originations. RESULTS A total of 53 patients were enrolled in this study and the image quality was categorized as good or excellent in 52 patients. No significant differences were observed in visualizing the origination and the diameter of LGV between NCE-MRA and contrast-enhanced CT (p > .05). The blood supply of LGV was related to its origination (p < .001). Most LGVs with SV origination were supplied by SV. If LGV was originated from the portal vein (PV), about 70% of them were supplied by both SV and SMV. Compared with LGVs with SV origination, LGVs with PV origination showed more chance to receive blood from SMV (p < .001). CONCLUSION Non-contrast-enhanced MR angiography appears to be a reliable technique in evaluating the morphology and blood supply of LGV in patients with gastroesophageal varices. CLINICAL RELEVANCE STATEMENT Non-contrast-enhanced MR angiography provides valuable information for the management of gastroesophageal varices. Especially, it benefits patients with renal insufficiency. KEY POINTS • Non-contrast-enhanced MR angiography using inflow-sensitive inversion recovery technique can be used for evaluating not only morphology as CT but also blood supply of left gastric vein. • The blood supply of left gastric vein is related to its origination and left gastric vein with portal vein origination shows more chance to receive blood from superior mesenteric vein.
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Affiliation(s)
- Xianlun Zou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Lisi Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Fangqin Tan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Hao Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Qiuxia Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Yaqi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Ludes G, Ohana M, Labani A, Meyer N, Moliére S, Roy C. Impact of a reduced iodine load with deep learning reconstruction on abdominal MDCT. Medicine (Baltimore) 2023; 102:e34579. [PMID: 37657067 PMCID: PMC10476859 DOI: 10.1097/md.0000000000034579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/13/2023] [Indexed: 09/03/2023] Open
Abstract
To evaluate the impact of a reduced iodine load using deep learning reconstruction (DLR) on the hepatic parenchyma compared to conventional iterative reconstruction (hybrid IR) and its consequence on the radiation dose and image quality. This retrospective monocentric intraindividual comparison study included 66 patients explored at the portal phase using different multidetector computed tomography parameters: Group A, hybrid IR algorithm (hybrid IR) and a nonionic low-osmolality contrast agent (350 mgI/mL); Group B, DLR algorithm (DLR) and a nonionic iso-osmolality contrast agent (270 mgI/mL). We recorded the attenuation of the liver parenchyma, image quality, and radiation dose parameters. The mean hounsfield units (HU) value of the liver parenchyma was significantly lower in group B, at 105.9 ± 10.9 HU versus 118.5 ± 14.6 HU in group A. However, the 90%IC of mean liver attenuation in the group B (DLR) was between 100.8 HU and 109.3 HU. The signal-to-noise ratio of the liver parenchyma was significantly higher on DLR images, increasing by 56%. However, for both the contrast-to-noise ratio (CNR) and CNR liver/PV no statistical difference was found, even if the CNR liver/PV ratio was slightly higher for group A. The mean dose-length product and computed tomography dose index volume values were significantly lower with DLR, corresponding to a radiation dose reduction of 36% for the DLR. Using a DLR algorithm for abdominal multidetector computed tomography with a low iodine load can provide sufficient enhancement of the liver parenchyma up to 100 HU in addition to the advantages of a higher image quality, a better signal-to-noise ratio and a lower radiation dose.
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Affiliation(s)
- Gaspard Ludes
- Department of Radiology B, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France
| | - Mickael Ohana
- Department of Radiology B, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France
| | - Aissam Labani
- Department of Radiology B, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France
| | - Nicolas Meyer
- Department of Statistics, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France
| | - Sébastien Moliére
- Department of Radiology B, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France
| | - Catherine Roy
- Department of Radiology B, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France
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Kuba T, Tokushige A, Murayama S, Ueda S. Proposal of a novel protocol using estimated cardiac index fractional dose to improve aortic contrast enhancement for early-phase dynamic CT. Medicine (Baltimore) 2022; 101:e29410. [PMID: 35758375 PMCID: PMC9276326 DOI: 10.1097/md.0000000000029410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
Maximum aortic computed tomography value (CTV) is difficult to control because of variations in cardiac function and patient physique. Therefore, to improve early-phase aortic enhancement on dynamic computed tomography (CT), we developed an estimated cardiac index fractional dose (eciFD). The eciFD protocol is a novel and original protocol for administering fractional dose (FD), representing the amount of iodine per unit body weight per injection duration, based on cardiac index (cardiac output divided by body surface area) as estimated by age in early-phase dynamic CT. At the time of administration, by selecting FD based on the patient's age and selecting a parameter that can achieve this FD, an aortic CTV ≥300 HU (ACTV≥300) can be obtained. This study aimed to investigate aortic enhancement on CT angiography using the eciFD protocol.This retrospective study investigated 291 consecutive patients who underwent dynamic CT from neck to abdomen after recommendation of the eciFD protocol at our institution. We compared early-phase aortic CTV distributions by scan delay between an eciFD group (eciFD applied, n = 135) and a non-eciFD group (eciFD not applied, n = 80). The effect of eciFD on early-phase ACTV≥300 was evaluated using logistic regression analysis adjusted for several potentially meaningful clinical confounders related to aortic CTV, namely male sex, heart rate ≤80 beats/min, estimated glomerular filtration rate ≤40 mL/min, use of eciFD, bolus tracking (BT), history of myocardial infarction, and order from the emergency center.The eciFD protocol was a significant factor for early-phase ACTV≥300 after adjusting for several confounders (odds ratio 3.03; 95% confidence intervals 1.59-5.77; P = .001). No interaction was seen between BT and eciFD protocol (p for interaction = 0.76). In terms of CTV distribution, with both a fixed scan delay time and BT, the eciFD group showed a high aortic CTV. The combination of eciFD protocol with BT provided a particularly high percentage of patients with ACTV≥300 (86.4%).The eciFD protocol was useful for improving aortic contrast enhancement. These findings need to be validated in a randomized controlled study.
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Affiliation(s)
- Tadashi Kuba
- Department of Clinical Research and Quality Management, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
| | - Akihiro Tokushige
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
| | - Sadayuki Murayama
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
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Yoshida M, Nakaura T, Oda S, Kidoh M, Nagayama Y, Uetani H, Azuma M, Sakabe D, Hirai T, Funama Y. Effects of tube voltage and iodine contrast medium on radiation dose of whole-body CT. Acta Radiol 2022; 63:458-466. [PMID: 33709794 DOI: 10.1177/02841851211001539] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The low-tube-voltage scan generally needs a higher tube current than the conventional 120 kVp to maintain the image noise. In addition, the low-tube-voltage scan increases the photoelectric effect, which increases the radiation absorption in organs. PURPOSE To compare the organ radiation dose caused by iodine contrast medium between low tube voltage with low contrast medium and that of conventional 120-kVp protocol with standard contrast medium. MATERIAL AND METHODS After the propensity-matching analysis, 66 patients were enrolled including 33 patients with 120 kVp and 600 mgI/kg and 33 patients with 80 kVp and 300 mgI/kg (50% iodine reduction). The pre- and post-contrast phases were assessed in all patients. The Monte Carlo simulation tool was used to simulate the radiation dose. The computed tomography (CT) numbers for 10 organs and the organ doses were measured. The organ doses were normalized by the volume CT dose index, and the 120-kVp protocol was compared with the 80-kVp protocol. RESULTS On contrast-enhanced CT, there were no significant differences in the mean CT numbers of the organs between 80-kVp and 120-kVp protocols except for the pancreas, kidneys, and small intestine. The normalized organ doses at 80 kVp were significantly lower than those of 120 kVp in all organs (e.g. liver, 1.6 vs. 1.9; pancreas, 1.5 vs. 1.8; spleen, 1.7 vs. 2.0) on contrast-enhanced CT. CONCLUSION The low tube voltage with low-contrast-medium protocol significantly reduces organ doses at the same volume CT dose index setting compared with conventional 120-kVp protocol with standard contrast medium on contrast-enhanced CT.
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Affiliation(s)
| | | | - Seitaro Oda
- Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masafumi Kidoh
- Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Hiroyuki Uetani
- Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - M Azuma
- Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Daisuke Sakabe
- Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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The Image Quality and Diagnostic Performance of CT with Low-Concentration Iodine Contrast (240 mg Iodine/mL) for the Abdominal Organs. Diagnostics (Basel) 2022; 12:diagnostics12030752. [PMID: 35328304 PMCID: PMC8947528 DOI: 10.3390/diagnostics12030752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose: To evaluate the difference between CT examinations using 240 mgI/mL contrast material (CM) and 320 mgI/mL CM in the contrast enhancement of the abdominal organs and the diagnostic performance for focal hepatic lesions. Materials and methods: This retrospective study included 422 CT examinations, using 240 mgI/mL iohexol (Group A, 206 examinations) and 320 mgI/mL ioversol (Group B, 216 examinations), performed between April 2019 and May 2020. Two CT scanners (single-source CT (machine A) and dual-source CT (machine B)) were used to obtain CT images. Two radiologists independently drew regions of interest (ROIs) in the liver, pancreas, spleen, kidney, aorta, portal vein, and paraspinal muscle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for each organ. They evaluated the degree of subjective enhancement of the organs and detected/differentiated focal hepatic lesions. Results: The SNR, CNR, and subjective enhancement of most organs were significantly higher in Group B than in Group A (p < 0.05). The sensitivity and specificity for cysts and malignancy were higher than 85.0% in both groups. The sensitivity for hemangioma was lower in Group B (<75%) than in Group A. In Group A, the SNR and CNR were significantly higher in most organs with machine B than with machine A. Conclusion: Although the SNR and CNR of the abdominal organs were lower with 240 mgI/mL CM than with 320 mgI/mL CM, 240 mgI/mL CM was feasible for evaluating the liver. A CT scanner with more advanced specifications may be beneficial for examinations with 240 mgI/mL CM by using lower tube voltage.
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Ichikawa S, Motosugi U, Shimizu T, Kromrey ML, Aikawa Y, Tamada D, Onishi H. Diagnostic performance and image quality of low-tube voltage and low-contrast medium dose protocol with hybrid iterative reconstruction for hepatic dynamic CT. Br J Radiol 2021; 94:20210601. [PMID: 34586900 DOI: 10.1259/bjr.20210601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the diagnostic performance and image quality of the low-tube voltage and low-contrast medium dose protocol for hepatic dynamic CT. METHODS This retrospective study was conducted between January and May 2018. All patients underwent hepatic dynamic CT using one of the two protocols: tube voltage, 80 kVp and contrast dose, 370 mgI/kg with hybrid iterative reconstruction or tube voltage, 120 kVp and contrast dose, 600 mgI/kg with filtered back projection. Two radiologists independently scored lesion conspicuity and image quality. Another radiologist measured the CT numbers of abdominal organs, muscles, and hepatocellular carcinoma (HCC) in each phase. Lesion detectability, HCC diagnostic ability, and image quality of the arterial phase were compared between the two protocols using the non-inferiority test. CT numbers and HCC-to-liver contrast were compared between the protocols using the Mann-Whitney U test. RESULTS 424 patients (70.5 ± 10.1 years) were evaluated. The 80-kVp protocol showed non-inferiority in lesion detectability and diagnostic ability for HCC (sensitivity, 85.7-89.3%; specificity, 96.3-98.6%) compared with the 120-kVp protocol (sensitivity, 91.0-93.3%; specificity, 93.6-97.3%) (p < 0.001-0.038). The ratio of fair image quality in the 80-kVp protocol also showed non-inferiority compared with that in the 120-kVp protocol in assessments by both readers (p < 0.001). HCC-to-liver contrast showed no significant differences for all phases (p = 0.309-0.705) between the two protocols. CONCLUSION The 80-kVp protocol with hybrid iterative reconstruction for hepatic dynamic CT can decrease iodine doses while maintaining diagnostic performance and image quality compared with the 120-kVp protocol. ADVANCES IN KNOWLEDGE The 80- and 120-kVp protocols showed equivalent hepatic lesion detectability, diagnostic ability for HCC, image quality, and HCC-to-liver contrast.The 80-kVp protocol showed a 38.3% reduction in iodine dose compared with the 120-kVp protocol.
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Affiliation(s)
- Shintaro Ichikawa
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Utaroh Motosugi
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.,Department of Diagnostic Radiology, Kofu Kyoritsu Hospital, 1-9-1 Takara, Kofu, Yamanashi, Japan
| | - Tatsuya Shimizu
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Marie Luise Kromrey
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.,Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Domstraße 11, Greifswald, Germany
| | - Yoshihito Aikawa
- Division of Radiology, University of Yamanashi Hospital, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Daiki Tamada
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
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Kanatani R, Shirasaka T, Kojima T, Kato T, Kawakubo M. Influence of beam hardening in dual-energy CT imaging: phantom study for iodine mapping, virtual monoenergetic imaging, and virtual non-contrast imaging. Eur Radiol Exp 2021; 5:18. [PMID: 33903993 PMCID: PMC8076398 DOI: 10.1186/s41747-021-00217-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/31/2021] [Indexed: 11/14/2022] Open
Abstract
In this study, we investigated the influence of beam hardening on the dual-energy computed tomography (DECT) values of iodine maps, virtual monoenergetic (VME) images, and virtual non-contrast (VNC) images. 320-row DECT imaging was performed by changing the x-ray tube energy for the first and second rotations. DECT values of 5 mg/mL iodine of the multi-energy CT phantom were compared with and without a 2-mm-thick attenuation rubber layer (~700 HU) wound around the phantom. It was found that the CT density values UH, with/without the rubber layer had statistical differences in the iodine map (184 ± 0.7 versus 186 ± 1.8), VME images (125 ± 0.3 versus 110 ± 0.4), and VNC images (−58 ± 0.7 versus −76 ± 1.7) (p < 0.010 for all). This suggests that iodine mapping may be underestimated by DECT and overestimated by VME imaging because of x-ray beam hardening. The use of VNC images instead of plain CT images requires further investigation because of underestimation.
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Affiliation(s)
- Risa Kanatani
- Department of Health Sciences, School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Radiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Takashi Shirasaka
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Tsukasa Kojima
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan.,Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toyoyuki Kato
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Masateru Kawakubo
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y. Guideline on the use of iodinated contrast media in patients with kidney disease 2018. Clin Exp Nephrol 2020; 24:1-44. [PMID: 31709463 PMCID: PMC6949208 DOI: 10.1007/s10157-019-01750-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Hiromitsu Hayashi
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazutaka Aonuma
- Cardiology Department, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kent Doi
- Department of Acute Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihide Fujigaki
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hideo Yasuda
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Taichi Sato
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoyuki Fujikura
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Ryohei Kuwatsuru
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroshi Toei
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryusuke Murakami
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | | | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tadateru Takayama
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Watanabe
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yukinobu Yagyu
- Department of Radiology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Nobuhiko Joki
- Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yasuhiro Komatsu
- Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine, Gunma, Japan
| | | | - Yugo Ito
- Department of Nephrology, St. Luke's International Hospital, Tokyo, Japan
| | - Ryo Miyazawa
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Tomonari Ogawa
- Department of Nephrology and Hypertension, Saitama Medical Center, Saitama, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Eri Koshi
- Department of Nephrology, Komaki City Hospital, Aichi, Japan
| | - Tomoki Kosugi
- Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives/Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
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Hosogoshi S, Tada K, Iijima J, Kajitani T, Yoshida R, Kitagaki H. Double Dose Reduction in the Equilibrium Phase of Chest-Pelvic CT With Low Tube Voltage and Forward-Projected Model-Based Iterative Reconstruction Solution. Cureus 2020; 12:e10545. [PMID: 33101793 PMCID: PMC7575314 DOI: 10.7759/cureus.10545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives This study aimed to examine whether a new imaging method (80-kV forward-projected model-based iterative reconstruction solution [FIRST] protocol) that uses a combination of low tube voltage and FIRST can reduce radiation dose and contrast medium volume by comparing the quality of the resulting image with that of the image obtained by 120-kV adaptive iterative dose reduction 3D protocol in the equilibrium phase of chest-pelvic computed tomography (CT). Subjects and methods Twenty-seven patients underwent CT by both protocols on different days. Two radiologists subjectively assessed image quality by scoring axial images for sharpness, contrast enhancement, noise, artifacts, and overall quality. The mean CT values, standard deviations, contrast-to-noise ratios, and signal-to-noise ratios in the liver, aorta, and erector spinae muscles were used for objective assessment. Radiation dose parameters included the CT dose index volume, dose-length product, effective dose, and size-specific dose estimate. Results were compared for different body mass index categories. Results The 80-kV FIRST protocol helped achieve mean reductions of 36.3%, 35.7%, and 36.6% in CT dose index volume, effective dose, and size-specific dose estimate, respectively (p < 0.01). Therefore, this protocol was regarded as comparable to the conventional protocol in image quality, except for visual sharpness. Conclusions The 80-kV FIRST protocol is capable of reducing radiation dose and contrast medium volume compared to the adaptive iterative dose reduction 3D protocol in the equilibrium phase of chest-pelvic CT.
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10
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Holmquist F, Söderberg M, Nyman U, Fält T, Siemund R, Geijer M. 80-kV p hepatic CT to reduce contrast medium dose in azotemic patients: a feasibility study. Acta Radiol 2020; 61:441-449. [PMID: 31378079 DOI: 10.1177/0284185119866807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Low peak kilovoltage (kVp) computed tomography (CT) may be used to reduce contrast medium doses in patients at risk of contrast medium-induced acute kidney injury if image noise can be controlled by increasing X-ray tube loading (mAs). Purpose To evaluate objective and subjective image quality in 80-kVp CT with reduced contrast medium dose and compensated mAs for unchanged image noise in patients with estimated glomerular filtration rate <45 mL/min compared with the standard 120-kVp protocol. Material and Methods 80-kVp CT with 300 mg I/kg in 40 patients (body mass index 18–32 kg/m2, glomerular filtration rate <45 mL/min) and 120-kVp CT with 500 mg I/kg in 40 patients (body mass index = 17–30 kg/m2, glomerular filtration rate ≥45 mL/min) was compared on mean hepatic attenuation, image noise, contrast medium enhancement, signal-to-noise ratio, contrast-to-noise ratio, effective radiation dose, and subjective image quality. Results There were no significant differences regarding median hepatic post-contrast attenuation, image noise, contrast medium enhancement, signal-to-noise ratio, contrast-to-noise ratio, or effective dose between the 80-kVp and 120-kVp cohorts: 114/110 HU; 14/14 HU; 57/53 HU; 8.0/7.4; 3.8/3.5; and 5.3/5.9 mSv, respectively. However, subjective image visual grading showed statistically significantly inferior scores for 80 kVp for six of eight items. After exclusion of seven inferior examinations not caused by the chosen kVp technique, only three items showed inferior scores for 80 kVp. Only 5% of gradings regarding overall image quality were <3 of 5 points. Conclusion Despite lower subjective image quality, objective data indicate that 80-kVp CT with reduced contrast medium doses and compensated mAs may have the potential to provide satisfactory diagnostic quality in patients with body mass index <30 kg/m2, which could benefit patients at risk of contrast medium-induced acute kidney injury.
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Affiliation(s)
- Fredrik Holmquist
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Marcus Söderberg
- Department of Translational Medicine, Medical Radiation Physics, Skåne University Hospital, Lund University, Malmö, Sweden.,Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Tobias Fält
- Department of Translational Medicine, Division of Medical Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Roger Siemund
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Mats Geijer
- Institute of Clinical Sciences, Department of Radiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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11
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Holmquist F, Söderberg M, Nyman U, Fält T, Siemund R, Geijer M. Can iterative reconstruction algorithms replace tube loading compensation in low kVp hepatic CT? Subjective versus objective image quality. Acta Radiol Open 2020; 9:2058460120910575. [PMID: 32206344 PMCID: PMC7076580 DOI: 10.1177/2058460120910575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Abstract
Background Hepatic computed tomography (CT) with decreased peak kilovoltage (kVp) may be used to reduce contrast medium doses in patients at risk of contrast-induced acute kidney injury (CI-AKI); however, it increases image noise. To preserve image quality, noise has been controlled by X-ray tube loading (mAs) compensation (TLC), i.e. increased mAs. Another option to control image noise would be to use iterative reconstructions (IR) algorithms without TLC (No-TLC). It is unclear whether this may preserve image quality or only reduce image noise. Purpose To evaluate image quality of 80 kVp hepatic CT with TLC and filtered back projection (FBP) compared with 80 kVp with No-TLC and IR algorithms (SAFIRE 3 and 5) in patients with eGFR <45 mL/min. Material and Methods Forty patients (BMI 18–32 kg/m2) were examined with both protocols following injection of 300 mg I/kg. Hepatic attenuation, image noise, enhancement, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality were evaluated for each patient. Results Comparing TLC/FBP with No-TLC/IR-S5, there were no significant differences regarding hepatic attenuation, image noise, enhancement, SNR and CNR: 114 vs. 115 HU, 14 vs. 14 HU, 55 vs. 57 HU, 8.0 vs. 8.4, and 3.8 vs. 4.0 in median, respectively. No-TLC/IR-S3 resulted in higher image noise and lower SNR and CNR than TLC/FBP. Subjective image quality scoring with visual grading showed statistically significantly inferior scores for IR-S5 images. Conclusion CT of 80 kVp to reduce contrast medium dose in patients at risk of CI-AKI combined with IR algorithms with unchanged tube loading to control image noise does not provide sufficient diagnostic quality.
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Affiliation(s)
- Fredrik Holmquist
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Marcus Söderberg
- Medical Radiation Physics, Department of Translational Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.,Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Tobias Fält
- Department of Translational Medicine, Division of Medical Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Roger Siemund
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Mats Geijer
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden.,Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Radiology, Gothenburg, Sweden
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12
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Funama Y. [1. Basic Characteristics of Tube Voltages in X- ray CT Scanner]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:1321-1326. [PMID: 33342954 DOI: 10.6009/jjrt.2020_jsrt_76.12.1321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University
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13
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Venous-phase chest CT with reduced contrast medium dose: Utilization of spectral low keV monoenergetic images improves image quality. Eur J Radiol 2019; 122:108756. [PMID: 31786505 DOI: 10.1016/j.ejrad.2019.108756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/06/2019] [Accepted: 11/18/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Intravenous contrast administration is crucial in many CT examinations but also poses a potential risk to the patient. Monoenergetic images (MonoE) of dual-energy CT systems can virtually increase iodine attenuation and might improve image quality (IQ) if contrast dose is reduced. In this study, we investigated the influence of MonoE on lymph node (LN) delineation and IQ in chest CT examinations with significantly reduced contrast dose (50 %) of a novel dual-layer CT (DLCT). METHOD 30 patients with clinically indicated reduced contrast dose underwent venous-phase chest DLCT scans. Conventional polyenergetic (PolyE) and MonoE images at 40 keV were calculated. The contrast difference of hilar lymph nodes (LN-CD) to the adjacent right pulmonary artery, their signal-to-noise (SNR) and contrast-to-noise-ratio (CNR) were determined. Subjective IQ was evaluated by 2 readers with respect to LN delineation and overall contrast enhancement (CE) using a 5-point-Likert-scale. RESULTS LN-CD, SNR and CNR were significantly higher in MonoE than in PolyE images (LN-CD 92.3 ± 37.9 vs. 33.1 ± 14.5 HU, SNR 8.4 ± 3.4 vs. 4.0 ± 1.2, CNR 9.2 ± 6.3 vs. 2.6 ± 1.5; all p < 0.01). The LN delineation (3.7 ± 0.9 vs.1.8 ± 0.7; p < 0.01) and the CE (3.9 ± 0.7 vs. 2.3 ± 0.7; p < 0.01) were rated significantly better for MonoE than for PolyE images. There was no MonoE examination classified as non-diagnostic. CONCLUSIONS Subjective and objective IQ parameters can be significantly improved for venous-phase chest CT examinations with reduced contrast doses by utilization of low-keV MonoE reconstructions. All MonoE images provided sufficient overall CE and therefore reduced contrast doses might be considered in a wider range of DLCT examinations and patients.
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14
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Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y. Guideline on the Use of Iodinated Contrast Media in Patients With Kidney Disease 2018. Circ J 2019; 83:2572-2607. [PMID: 31708511 DOI: 10.1253/circj.cj-19-0783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshitaka Isaka
- Japanese Society of Nephrology.,Department of Nephrology, Osaka University Graduate School of Medicine
| | - Hiromitsu Hayashi
- Japan Radiological Society.,Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School
| | - Kazutaka Aonuma
- the Japanese Circulation Society.,Cardiology Department, Institute of Clinical Medicine, University of Tsukuba
| | - Masaru Horio
- Japanese Society of Nephrology.,Kansai Medical Hospital
| | - Yoshio Terada
- Japanese Society of Nephrology.,Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University
| | - Kent Doi
- Japanese Society of Nephrology.,Department of Acute Medicine, The University of Tokyo
| | - Yoshihide Fujigaki
- Japanese Society of Nephrology.,Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine
| | - Hideo Yasuda
- Japanese Society of Nephrology.,First Department of Medicine, Hamamatsu University School of Medicine
| | - Taichi Sato
- Japanese Society of Nephrology.,First Department of Medicine, Hamamatsu University School of Medicine
| | - Tomoyuki Fujikura
- Japanese Society of Nephrology.,First Department of Medicine, Hamamatsu University School of Medicine
| | - Ryohei Kuwatsuru
- Japan Radiological Society.,Department of Radiology, Graduate School of Medicine, Juntendo University
| | - Hiroshi Toei
- Japan Radiological Society.,Department of Radiology, Graduate School of Medicine, Juntendo University
| | - Ryusuke Murakami
- Japan Radiological Society.,Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School
| | - Yoshihiko Saito
- the Japanese Circulation Society.,Department of Cardiovascular Medicine, Nara Medical University
| | - Atsushi Hirayama
- the Japanese Circulation Society.,Department of Cardiology, Osaka Police Hospital
| | - Toyoaki Murohara
- the Japanese Circulation Society.,Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Akira Sato
- the Japanese Circulation Society.,Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Hideki Ishii
- the Japanese Circulation Society.,Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Tadateru Takayama
- the Japanese Circulation Society.,Division of General Medicine, Department of Medicine, Nihon University School of Medicine
| | - Makoto Watanabe
- the Japanese Circulation Society.,Department of Cardiovascular Medicine, Nara Medical University
| | - Kazuo Awai
- Japan Radiological Society.,Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Seitaro Oda
- Japan Radiological Society.,Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Takamichi Murakami
- Japan Radiological Society.,Department of Radiology, Kobe University Graduate School of Medicine
| | - Yukinobu Yagyu
- Japan Radiological Society.,Department of Radiology, Kindai University, Faculty of Medicine
| | - Nobuhiko Joki
- Japanese Society of Nephrology.,Division of Nephrology, Toho University Ohashi Medical Center
| | - Yasuhiro Komatsu
- Japanese Society of Nephrology.,Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine
| | | | - Yugo Ito
- Japanese Society of Nephrology.,Department of Nephrology, St. Luke's International Hospital
| | - Ryo Miyazawa
- Japan Radiological Society.,Department of Radiology, St. Luke's International Hospital
| | - Yoshihiko Kanno
- Japanese Society of Nephrology.,Department of Nephrology, Tokyo Medical University
| | - Tomonari Ogawa
- Japanese Society of Nephrology.,Department of Nephrology & Hypertension, Saitama Medical Center
| | - Hiroki Hayashi
- Japanese Society of Nephrology.,Department of Nephrology, Fujita Health University School of Medicine
| | - Eri Koshi
- Japanese Society of Nephrology.,Department of Nephrology, Komaki City Hospital
| | - Tomoki Kosugi
- Japanese Society of Nephrology.,Nephrology, Nagoya University Graduate School of Medicine
| | - Yoshinari Yasuda
- Japanese Society of Nephrology.,Department of CKD Initiatives/Nephrology, Nagoya University Graduate School of Medicine
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15
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Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y. Guideline on the use of iodinated contrast media in patients with kidney disease 2018. Jpn J Radiol 2019; 38:3-46. [PMID: 31709498 DOI: 10.1007/s11604-019-00850-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Hiromitsu Hayashi
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazutaka Aonuma
- Cardiology Department, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kent Doi
- Department of Acute Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihide Fujigaki
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hideo Yasuda
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Taichi Sato
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoyuki Fujikura
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Ryohei Kuwatsuru
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroshi Toei
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryusuke Murakami
- Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | | | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tadateru Takayama
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Watanabe
- Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yukinobu Yagyu
- Department of Radiology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Nobuhiko Joki
- Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yasuhiro Komatsu
- Department of Healthcare Quality and Safety, Gunma University Graduate School of Medicine, Gunma, Japan
| | | | - Yugo Ito
- Department of Nephrology, St. Luke's International Hospital, Tokyo, Japan
| | - Ryo Miyazawa
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Tomonari Ogawa
- Department of Nephrology and Hypertension, Saitama Medical Center, Saitama, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Eri Koshi
- Department of Nephrology, Komaki City Hospital, Aichi, Japan
| | - Tomoki Kosugi
- Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives/Nephrology, Nagoya University Graduate School of Medicine, Aichi, Japan
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16
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Lin YM, Chiou YY, Wu MH, Huang SS, Shen SH. Postablation assessment of hepatocellular carcinoma using dual-energy CT: Comparison of half versus standard iodine contrast medium. PLoS One 2019; 14:e0219577. [PMID: 31287838 PMCID: PMC6615706 DOI: 10.1371/journal.pone.0219577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/26/2019] [Indexed: 12/15/2022] Open
Abstract
This retrospective study was aimed to evaluate the reduced iodine load on image quality and diagnostic performance in multiphasic hepatic CT using a novel monoenergetic reconstruction algorithm (nMERA) in assessment of local tumor progression after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Ninety patients who underwent CT 1 month after RFA of HCC. Forty-five patients had multiphasic hepatic dual-energy CT with a half-reduced contrast medium (HRCM) of 277.5 mg I/kg. The nMERA (40-70-keV) images were reconstructed in each phase. Another 45 patients received a standard contrast medium (SCM) of 555 mg I/kg, and the images were reconstructed as a simulated 120-kVp images. Primary outcome was accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) in assessment of local tumor progression. Additional advanced assessments included the image noise, attenuation value, contrast-to-noise ratio (CNR), and subjective image quality between the groups. The accuracy, sensitivity and specificity of nMERA HRCM images were 95.7%, 100% and 93.9% for 40 keV, 95.7%, 85.7% and 100% for 50 keV, 83.0%, 42.8% and 100% for 60 keV, and 83.0%, 42.9% and 100% for 70 keV. The AUROC was 0.99, 0.99, 0.94, and 0.93 for 40-70 keV nMERA HRCM images, respectively. Compared with simulated 120-kVp SCM images, nMERA HRCM images demonstrated comparable noise at 70-keV (P < 0.05), and comparable CNR at 40- and 50-keV (P < 0.05). nMERA DECT enables the contrast medium to be reduced to up to 50% in multiphasic hepatic CT while preserving diagnostic accuracy.
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Affiliation(s)
- Yuan-Mao Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-You Chiou
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mei-Han Wu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Imaging, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Shan Su Huang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-Huei Shen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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17
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Li J, Liang L, Yu H, Shen Y, Hu Y, Hu D, Tang H, Li Z. Whole-tumor histogram analysis of non-Gaussian distribution DWI parameters to differentiation of pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas. Magn Reson Imaging 2019; 55:52-59. [PMID: 30240758 DOI: 10.1016/j.mri.2018.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/11/2018] [Accepted: 09/16/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE To evaluate the utility of volumetric histogram analysis of monoexponential and non-Gaussian distribution DWI models for discriminating pancreatic ductal adenocarcinoma (PDAC) and neuroendocrine tumor (pNET). MATERIALS AND METHODS A total of 340 patients were retrospectively reviewed. Finally, 62 patients with histopathological confirmed PDAC (n = 42) and pNET (n = 20) were enrolled in the study. All the patients accepted magnetic resonance imaging (MRI) at 3 T (including multi-b value DWI, 0-1000 s/mm2). Isotropic apparent diffusion coefficient (ADC), true molecular diffusion (Dt), perfusion-related diffusion (Dp), perfusion fraction (f), distributed diffusion coefficient (DDC) and alpha (α) were obtained from different DWI models. Then, mean value, median value, 10th and 90th percentiles were obtained from histogram analysis of each DWI parameter. RESULTS Histogram metrics derived from ADC, Dp, f and DDC were significantly lower in PDAC than pNET group (P < 0.05). In contrast, histogram metrics derived from α were observed significantly higher in the PDAC than pNET group (P < 0.05). No significant difference was found in Dt (P ≥ 0.05) between PDAC and pNET patients. Among all parameters, f-median had the highest diagnostic performance (AUC 0.91, cutoff value 0.188, sensitivity 97.62%, specificity 80%). CONCLUSIONS f-Median derived from IVIM DWI model may be potentially more valuable parameter than ADC, Dp, DDC and α for discriminating PDAC and pNET. Histogram analysis based on the entire tumor was an emerging and valuable tool.
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Affiliation(s)
- Jiali Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lili Liang
- Department of Radiology, The first affiliated hospital of Nanyang Medical College, China
| | - Hao Yu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaqi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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18
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Improved visualization of hypodense liver lesions in virtual monoenergetic images from spectral detector CT: Proof of concept in a 3D-printed phantom and evaluation in 74 patients. Eur J Radiol 2018; 109:114-123. [PMID: 30527292 DOI: 10.1016/j.ejrad.2018.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/29/2018] [Accepted: 11/02/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The well-known boost of iodine associated-attenuation in low-keV virtual monoenergetic images (VMI_low) is frequently used to improve visualization of lesions and structures taking up contrast media. This study aimed to evaluate this concept in reverse. Hence to investigate if increased attenuation within the liver allows for improved visualization of little or not-enhancing lesions. METHODS A 3D-printed phantom mimicking the shape of a human liver exhibiting a lesion in its center was designed and printed. Both, parenchyma- and lesion-mimic were filled with different solutions exhibiting 80/100/120HU and 0/15/40/60HU, respectively. Further, a total of 74 contrast-enhanced studies performed on a spectral detector CT scanner (SDCT) were included in this retrospective study. Patients had MRI or follow-up proven cysts and/or hypodense metastases. VMI of 40-200 keV as well as conventional images (CI) were reconstructed. ROI were placed in lesion and parenchyma(-mimics) on CI and transferred to VMI. Signal- and contrast-to-noise ratio were calculated (S-/CNR). Further, two radiologists independently evaluated image quality. Data was statistically assessed using ANOVA or Wilcoxon-test. RESULTS In phantoms, S/CNR was significantly higher in VMI_low. The cyst-mimic in highly attenuating parenchyma-mimic on CI yielded a CNR of 6.4 ± 0.8; using VMI_40 keV, mildly hypodense lesion-mimic in poorly attenuating parenchyma-mimic exhibited a similar CNR (5.8 ± 0.9; p ≤ 0.05). The same tendency was observed in patients (cyst in CI/metastasis in VMI_40 keV: 4.4 ± 1.2/3.9 ± 1.8; p ≤ 0.05). Qualitative analysis indicated a benefit of VMI_40 keV (p ≤ 0.05). CONCLUSIONS VMI_low from SDCT allow for an improved visualization of hypodense focal liver lesions exploiting the concept of contrast blooming in reverse.
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19
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Clinical application of radiation dose reduction for head and neck CT. Eur J Radiol 2018; 107:209-215. [DOI: 10.1016/j.ejrad.2018.08.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/14/2018] [Accepted: 08/23/2018] [Indexed: 12/12/2022]
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20
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Nagayama Y, Tanoue S, Tsuji A, Urata J, Furusawa M, Oda S, Nakaura T, Utsunomiya D, Yoshida E, Yoshida M, Kidoh M, Tateishi M, Yamashita Y. Application of 80-kVp scan and raw data-based iterative reconstruction for reduced iodine load abdominal-pelvic CT in patients at risk of contrast-induced nephropathy referred for oncological assessment: effects on radiation dose, image quality and renal function. Br J Radiol 2018; 91:20170632. [PMID: 29470108 DOI: 10.1259/bjr.20170632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the image quality, radiation dose, and renal safety of contrast medium (CM)-reduced abdominal-pelvic CT combining 80-kVp and sinogram-affirmed iterative reconstruction (SAFIRE) in patients with renal dysfunction for oncological assessment. METHODS We included 45 patients with renal dysfunction (estimated glomerular filtration rate <45 ml per min per 1.73 m2) who underwent reduced-CM abdominal-pelvic CT (360 mgI kg-1, 80-kVp, SAFIRE) for oncological assessment. Another 45 patients without renal dysfunction (estimated glomerular filtration rate >60 ml per lmin per 1.73 m2) who underwent standard oncological abdominal-pelvic CT (600 mgI kg-1, 120-kVp, filtered-back projection) were included as controls. CT attenuation, image noise, and contrast-to-noise ratio (CNR) were compared. Two observers performed subjective image analysis on a 4-point scale. Size-specific dose estimate and renal function 1-3 months after CT were measured. RESULTS The size-specific dose estimate and iodine load of 80-kVp protocol were 32 and 41%,, respectively, lower than of 120-kVp protocol (p < 0.01). CT attenuation and contrast-to-noise ratio of parenchymal organs and vessels in 80-kVp images were significantly better than those of 120-kVp images (p < 0.05). There were no significant differences in quantitative or qualitative image noise or subjective overall quality (p > 0.05). No significant kidney injury associated with CM administration was observed. CONCLUSION 80-kVp abdominal-pelvic CT with SAFIRE yields diagnostic image quality in oncology patients with renal dysfunction under substantially reduced iodine and radiation dose without renal safety concerns. Advances in knowledge: Using 80-kVp and SAFIRE allows for 40% iodine load and 32% radiation dose reduction for abdominal-pelvic CT without compromising image quality and renal function in oncology patients at risk of contrast-induced nephropathy.
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Affiliation(s)
- Yasunori Nagayama
- 1 Department of Radiology, Kumamoto City Hospital , Kumamoto , Japan.,2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Shota Tanoue
- 1 Department of Radiology, Kumamoto City Hospital , Kumamoto , Japan.,2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Akinori Tsuji
- 1 Department of Radiology, Kumamoto City Hospital , Kumamoto , Japan
| | - Joji Urata
- 1 Department of Radiology, Kumamoto City Hospital , Kumamoto , Japan
| | | | - Seitaro Oda
- 2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Takeshi Nakaura
- 2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Daisuke Utsunomiya
- 2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Eri Yoshida
- 1 Department of Radiology, Kumamoto City Hospital , Kumamoto , Japan.,2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Morikatsu Yoshida
- 2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Masafumi Kidoh
- 2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Machiko Tateishi
- 1 Department of Radiology, Kumamoto City Hospital , Kumamoto , Japan.,2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
| | - Yasuyuki Yamashita
- 2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan
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21
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Taguchi N, Oda S, Nakaura T, Utsunomiya D, Funama Y, Imuta M, Yuki H, Nagayama Y, Kidoh M, Hirata K, Iyama Y, Namimoto T, Kai N, Hatemura M, Yamashita Y. Contrast enhancement in abdominal computed tomography: influence of photon energy of different scanners. Br J Radiol 2017; 91:20170285. [PMID: 29076752 DOI: 10.1259/bjr.20170285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Different CT scanners have different X-ray spectra and photon energies indicating that contrast enhancement vary among scanners. However, this issue has not been fully validated; therefore, we performed phantom and clinical studies to assess this difference. METHODS Two scanners were used: scanner-A and scanner-B. In the phantom study, we compared the contrast enhancement between the scanners at tube voltage peaks of 80, 100 and 120 kVp. Then, we calculated the effective energies of the two CT scanners. In the clinical study, 40 patients underwent abdominal scanning with scanner-A and another 40 patients with scanner-B, with each group using the same scanning protocol. The contrast enhancement of abdominal organs was assessed quantitatively (based on the absolute difference between the attenuation of unenhanced scans and contrast-enhanced scans) and qualitatively. A two-tailed independent Student's t-test and or the Mann-Whitney U test were used to compare the discrepancies. RESULTS In the phantom study, contrast enhancement for scanner-B was 36.9, 32.6 and 30.8% higher than that for scanner-A at 80, 100 and 120 kVp, respectively. The effective energies were higher for scanner-A than for scanner-B. In the quantitative analysis for the clinical study, scanner-B yielded significantly better contrast enhancement of the hepatic parenchyma, pancreas, kidney, portal vein and inferior vena cava compared with that of scanner-A. The mean visual scores for contrast enhancement were also significantly higher on images obtained by scanner-B than those by scanner-A. CONCLUSION There were significant differences in contrast enhancement of the abdominal organs between the compared CT scanners from two different vendors even at the same scanning and contrast parameters. Advances in knowledge: Awareness of the impact of different X-ray energies on the resultant attenuation of contrast material is important when interpreting clinical CT images.
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Affiliation(s)
- Narumi Taguchi
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Seitaro Oda
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Takeshi Nakaura
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Daisuke Utsunomiya
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Yoshinori Funama
- 2 Department of Medical Physics, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Masanori Imuta
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Hideaki Yuki
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Yasunori Nagayama
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Masafumi Kidoh
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Kenichiro Hirata
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Yuji Iyama
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Tomohiro Namimoto
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
| | - Noriyuki Kai
- 3 Department of Central Radiology, Kumamoto University Hospital , Kumamoto , Japan
| | - Masahiro Hatemura
- 3 Department of Central Radiology, Kumamoto University Hospital , Kumamoto , Japan
| | - Yasuyuki Yamashita
- 1 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , Kumamoto , Japan
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22
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Nagayama Y, Nakaura T, Oda S, Utsunomiya D, Funama Y, Iyama Y, Taguchi N, Namimoto T, Yuki H, Kidoh M, Hirata K, Nakagawa M, Yamashita Y. Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol. Eur Radiol 2017; 28:1719-1730. [PMID: 29063254 DOI: 10.1007/s00330-017-5114-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To evaluate the image quality and lesion conspicuity of virtual-monochromatic-imaging (VMI) with dual-layer DECT (DL-DECT) for reduced-iodine-load multiphasic-hepatic CT. METHODS Forty-five adults with renal dysfunction who had undergone hepatic DL-DECT with 300-mgI/kg were included. VMI (40-70-keV, DL-DECT-VMI) was generated at each enhancement phase. As controls, 45 matched patients undergoing standard 120-kVp protocol (120-kVp, 600-mgI/kg, and iterative reconstruction) were included. We compared the size-specific dose estimate (SSDE), image noise, CT attenuation, and contrast-to-noise ratio (CNR) between protocols. Two radiologists scored the image quality and lesion conspicuity. RESULTS SSDE was significantly lower in DL-DECT group (p < 0.01). Image noise of DL-DECT-VMI was almost constant at each keV (differences of ≤15%) and equivalent to or lower than of 120-kVp. As the energy decreased, CT attenuation and CNR gradually increased; the values of 55-60 keV images were almost equivalent to those of standard 120-kVp. The highest scores for overall quality and lesion conspicuity were assigned at 40-keV followed by 45 to 55-keV, all of which were similar to or better than of 120-kVp. CONCLUSIONS For multiphasic-hepatic CT with 50% iodine-load, DL-DECT-VMI at 40- to 55-keV provides equivalent or better image quality and lesion conspicuity without increasing radiation dose compared with standard 120-kVp protocol. KEY POINTS • 40-55-keV yields optimal image quality for half-iodine-load multiphasic-hepatic CT with DL-DECT. • DL-DECT protocol decreases radiation exposure compared with 120-kVp scans with iterative reconstruction. • 40-keV images maximise conspicuity of hepatocellular carcinoma especially at hepatic-arterial phase.
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Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan
| | - Yuji Iyama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Narumi Taguchi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Tomohiro Namimoto
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hideaki Yuki
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kenichiro Hirata
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masataka Nakagawa
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
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23
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Nagayama Y, Nakaura T, Oda S, Tsuji A, Urata J, Furusawa M, Tanoue S, Utsunomiya D, Yamashita Y. Value of 100 kVp scan with sinogram-affirmed iterative reconstruction algorithm on a single-source CT system during whole-body CT for radiation and contrast medium dose reduction: an intra-individual feasibility study. Clin Radiol 2017; 73:217.e7-217.e16. [PMID: 29029768 DOI: 10.1016/j.crad.2017.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 07/04/2017] [Accepted: 09/12/2017] [Indexed: 01/28/2023]
Abstract
AIM To perform an intra-individual investigation of the usefulness of a contrast medium (CM) and radiation dose-reduction protocol using single-source computed tomography (CT) combined with 100 kVp and sinogram-affirmed iterative reconstruction (SAFIRE) for whole-body CT (WBCT; chest-abdomen-pelvis CT) in oncology patients. MATERIALS AND METHODS Forty-three oncology patients who had undergone WBCT under both 120 and 100 kVp protocols at different time points (mean interscan intervals: 98 days) were included retrospectively. The CM doses for the 120 and 100 kVp protocols were 600 and 480 mg iodine/kg, respectively; 120 kVp images were reconstructed with filtered back-projection (FBP), whereas 100 kVp images were reconstructed with FBP (100 kVp-F) and the SAFIRE (100 kVp-S). The size-specific dose estimate (SSDE), iodine load and image quality of each protocol were compared. RESULTS The SSDE and iodine load of 100 kVp protocol were 34% and 21%, respectively, lower than of 120 kVp protocol (SSDE: 10.6±1.1 versus 16.1±1.8 mGy; iodine load: 24.8±4versus 31.5±5.5 g iodine, p<0.01). Contrast enhancement, objective image noise, contrast-to-noise-ratio, and visual score of 100 kVp-S were similar to or better than of 120 kVp protocol. CONCLUSION Compared with the 120 kVp protocol, the combined use of 100 kVp and SAFIRE in WBCT for oncology assessment with an SSCT facilitated substantial reduction in the CM and radiation dose while maintaining image quality.
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Affiliation(s)
- Y Nagayama
- Department of Radiology, Kumamoto City Hospital 1-1-60, Koto, Higashi-ku, Kumamoto City, 862-0909, Japan; Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - T Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - S Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - A Tsuji
- Department of Radiology, Kumamoto City Hospital 1-1-60, Koto, Higashi-ku, Kumamoto City, 862-0909, Japan
| | - J Urata
- Department of Radiology, Kumamoto City Hospital 1-1-60, Koto, Higashi-ku, Kumamoto City, 862-0909, Japan
| | - M Furusawa
- Department of Radiology, Kumamoto City Hospital 1-1-60, Koto, Higashi-ku, Kumamoto City, 862-0909, Japan
| | - S Tanoue
- Department of Radiology, Kumamoto City Hospital 1-1-60, Koto, Higashi-ku, Kumamoto City, 862-0909, Japan; Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - D Utsunomiya
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Y Yamashita
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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Sofue K, Yoshikawa T, Ohno Y, Negi N, Inokawa H, Sugihara N, Sugimura K. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm. Eur Radiol 2016; 27:2978-2988. [DOI: 10.1007/s00330-016-4660-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 12/13/2022]
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