1
|
Zhou X, Cui M, Liu Y, Wu Y, Hu D, Zhai D, Qin M, Shen J, Ju S, Fan G, Cai W. Low Dose Iodinated Contrast Material and Radiation for Virtual Monochromatic Imaging in Craniocervical Dual-Layer Spectral Detector Computed Tomography Angiography: A Prospective and Randomized Study. Acad Radiol 2024; 31:2501-2510. [PMID: 38135625 DOI: 10.1016/j.acra.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility of virtual monochromatic imaging (VMI) of dual-layer spectral detector computed tomography (SDCT) to reduce iodinated contrast material (CM) and radiation dose in craniocervical computed tomography angiography (CTA). MATERIALS AND METHODS A total of 280 consecutively selected patients performed craniocervical CTA with SDCT were prospectively selected and randomly divided into four groups (A, DoseRight index (DRI) 31, iopromide 370mgI/mL, volume 0.8 mL/kg; B, DRI 26, iopromide 370mgI/mL, volume 0.4 mL/kg; C, DRI 26, ioversol 320mgI/mL, volume 0.4 mL/kg; D, DRI 26, iohexol 300mgI/mL, volume 0.4 mL/kg). 50-70 kiloelectron volts (keV) VMIs in group B were reconstructed and compared to group A to select the optimal keV. Then, the optimal keV in groups B, C and D was reconstructed and compared. Objective image quality, including vascular attenuation, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), was evaluated. Subjective image quality was assessed using a 5-point Likert scale. In addition, the effective dose (ED), iodine load and iodine delivery rate (IDR) were compared between groups A and D. RESULTS 55 keV VMI was the optimal VMI in group B. The objective and subjective image quality of 55 keV VMI in group B were equal to or better than those of the CI in group A. The SNR, CNR and subjective image quality in group D were similar to those in group B (P > 0.05). The ED, iodine load and IDR of group D were reduced by 44%, 59% and 19%, respectively, when compared to those of group A. CONCLUSION Low dose iodinated CM and radiation for 55 keV VMI in craniocervical CTA using SDCT could still provide equivalent or better image quality than the conventional scanning protocol.
Collapse
Affiliation(s)
- Xiuzhi Zhou
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Manman Cui
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Yan Liu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Yuanyuan Wu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Dongliang Hu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Duchang Zhai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Mingyu Qin
- Suzhou Medical College of Soochow University, Suzhou, 215026, Jiangsu, China (M.Q.)
| | - Junkang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, Jiangsu, China (S.J.)
| | - Guohua Fan
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Wu Cai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.).
| |
Collapse
|
2
|
Yuan D, Li L, Zhang Y, Qi K, Zhang M, Zhang W, Lyu P, Zhang Y, Gao J, Liu J. Image quality improvement in head and neck CT angiography: Individualized post-trigger delay versus fixed delay. Eur J Radiol 2023; 168:111142. [PMID: 37832195 DOI: 10.1016/j.ejrad.2023.111142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE To compare the contrast media opacification of head and neck CT angiography (CTA) between conventional fixed trigger delay and individualized post-trigger delay (PTD). METHODS In this prospective study (April-October 2022), 196 consecutive participants were randomly divided into two groups to perform head and neck CTA in bolus tracking with either an individualized PTD (Group A) or a fixed 4-second PTD (Group B). All CT and contrast media protocol parameters were consistent between the two groups. One reader evaluated objective image quality, while two readers rated subjective image quality. Objective image quality was compared between groups via two-sample t-test, while the subjective ratings were compared with chi-square analysis. RESULTS Participants' clinical information including sex, age, weight, body weight index (BMI), and heart rate were not statistically different between two groups (all p > 0.05). Individualized PTD ranging from 3.5 to 7.9 s (average 5.6 s), which is shorter than fixed delays (p < 0.05). Both readers rated better subjective image quality for the Group A (p < 0.05). The mean vessel enhancement was significantly higher in Group A in all vessels (all p < 0.05). CONCLUSIONS Compared to the fixed post-trigger delay in bolus tracking technique, individualized post-trigger delay could achieve reliable scan timing, optimize vessel opacification and obtain better image quality for head and neck CT angiography.
Collapse
Affiliation(s)
- Dian Yuan
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Linfeng Li
- Siemens Healthineers GmbH, Forchheim, Germany
| | - Yicun Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Ke Qi
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Mengyuan Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Weiting Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Peijie Lyu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Yonggao Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Jianbo Gao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Jie Liu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China.
| |
Collapse
|
3
|
Rabinowich A, Shendler G, Ben-Sira L, Shiran SI. Pediatric low-dose head CT: Image quality improvement using iterative model reconstruction. Neuroradiol J 2023; 36:555-562. [PMID: 36897057 PMCID: PMC10569199 DOI: 10.1177/19714009231163559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
PURPOSE To evaluate the differences in pediatric non-contrast low-dose head computed tomography (CT) between filtered-back projection and iterative model reconstruction using objective and subjective image quality evaluation. METHODS A retrospective study evaluated children undergoing low-dose non-contrast head CT. All CT scans were reconstructed using both filtered-back projection and iterative model reconstruction. Objective image quality analysis was performed using contrast and signal-to-noise ratios for the supra- and infratentorial brain regions of identical regions of interest on the two reconstruction methods. Two experienced pediatric neuroradiologists evaluated subjective image quality, visibility of structures, and artifacts. RESULTS We evaluated 233 low-dose brain CT scans of 148 pediatric patients. There was a ∼2-fold improvement in the contrast-to-noise ratio between gray and white matter in the infra- and supratentorial regions (p < 0.001) using iterative model reconstruction compared to filtered-back projection. The white and gray matter signal-to-noise ratio improved more than 2-fold using iterative model reconstruction (p < 0.001). Furthermore, radiologists graded anatomical details, gray-white matter differentiation, beam hardening artifacts, and image quality using iterative model reconstructions as superior to filtered-back projection reconstructions. CONCLUSION Iterative model reconstructions had better contrast-to-noise and signal-to-noise ratios with fewer artifacts in pediatric CT brain scans using low-dose radiation protocols. This image quality improvement was demonstrated in the supra- and infratentorial regions. This method thus comprises an important tool for reducing children's exposure while maintaining diagnostic capability.
Collapse
Affiliation(s)
- Aviad Rabinowich
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Genady Shendler
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Ben-Sira
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shelly I Shiran
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
4
|
An J, Dong Y, Niu H. FEASIBILITY STUDY OF LOW TUBE VOLTAGE COMPUTER TOMOGRAPHY ANGIOGRAPHY (CTA) FOR BRONCHIAL ARTERY IMAGING IN PATIENTS WITH HEMOPTYSIS. RADIATION PROTECTION DOSIMETRY 2023; 199:171-177. [PMID: 36521800 DOI: 10.1093/rpd/ncac254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To investigate the application of low tube voltage computer tomography angiography (CTA) in bronchial artery (BA) imaging in hemoptysis patients. METHODS Between January 2017 and December 2021, 119 patients were studied, including 31 in the 80-kV group, 39 in the 100-kV group and 49 in the control group (120 kV). The CT dose index-volume (CTDIvol) (mGy) and effective dose (ED) (mSv) of each group were comparatively analysed. Image quality evaluation included the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective 5-scores. RESULTS Statistically significant differences were noted in CTDIvol, ED, SNR, CNR and image quality scores of the groups (P < 0.05). Comparative analysis showed no statistical difference in CTDIvol, ED and image quality scores between the 80- and 100-kV groups. CONCLUSION Low tube voltage CTA is useful in BA imaging for hemoptysis patients. Tube voltages of 100 kV have better image quality and lower radiation dose.
Collapse
Affiliation(s)
- Jianli An
- Department of Interventional treatment, Qinhuangdao Municipal No. 1 Hospital, No. 258 Wenhua Road, Qinhuangdao, Hebei Province 066001, PR China
| | - Yanchao Dong
- Department of Interventional treatment, Qinhuangdao Municipal No. 1 Hospital, No. 258 Wenhua Road, Qinhuangdao, Hebei Province 066001, PR China
| | - Hongtao Niu
- Department of Interventional treatment, Qinhuangdao Municipal No. 1 Hospital, No. 258 Wenhua Road, Qinhuangdao, Hebei Province 066001, PR China
| |
Collapse
|
5
|
Mo X, Cui Y, Yuan J, Hang Z, Jiang X, Duan G, Liang L, Huang Z, Li S, Sun P, Chen W, Wei L, Guo Y, Deng D. Study on a new "One-stop-shop" scan protocol combining brain CT perfusion and head-and-neck CT angiography by using 256-detector CT for stroke patients. Eur J Radiol 2022; 154:110426. [PMID: 35797790 DOI: 10.1016/j.ejrad.2022.110426] [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: 01/09/2022] [Revised: 03/20/2022] [Accepted: 06/24/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE We sought to evaluate the performance of a new "one-stop-shop" scan protocol combining brain computed tomography perfusion (CTP) and head-and-neck CT angiography (CTA) imaging for acute stroke patients using a 256-detector CT scanner. METHOD From March to August 2020, 60 patients (30 men and 30 women) aged 22-88 years with suspected acute stroke were enrolled and randomly divided into 2 groups to undergo brain CTP and head-and-neck CTA with a 256-detector CT system. Group A used traditional scan protocol with a separate brain CTP and head-and-neck CT examination that included non-contrast-enhanced and contrast-enhanced acquisitions; group B used the new "one-stop-shop" scan protocol with head-and-neck CTA data inserted into brain CTP scans at the peak time (PT) of the arterial phase. The insertion point of the head-and-neck CTA data was determined by a test bolus. The examination time, contrast dose, radiation dose, and image quality were compared between the groups. RESULTS The total contrast dose was reduced by 40% in group B compared to group A (60 mL vs. 100 mL). The imaging time was 52.5 ± 2.6 s in group B and 74.9 ± 3.3 s in group A, showing a reduction of approximately 43% in group B. There was no significant difference in image quality both quantitatively and qualitatively between the groups (all P > 0.05). Group B had a slight reduction in dose length product (1139.0 ± 45.3 vs. 1211.6 ± 31.9 mGy·cm, P < 0.001). CONCLUSIONS The proposed "one-stop-shop" scan protocol combining brain CTP and head-and-neck CTA on a 256-detector CT system can reduce imaging time and contrast dose, without affecting image quality or perfusion results, compared to the traditional protocol of separating the examinations.
Collapse
Affiliation(s)
- Xiaping Mo
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Yu Cui
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Jie Yuan
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Zufei Hang
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Xueyuan Jiang
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Gaoxiong Duan
- Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, China
| | - Lingyan Liang
- Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, China
| | - Zengchao Huang
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Shasha Li
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Peiyi Sun
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Wei Chen
- Department of Neurology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Lanzhen Wei
- Department of Radiology, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, Guangxi, China
| | - Ying Guo
- GE Healthcare, Computed Tomography Research Center, Beijing 100176, China
| | - Demao Deng
- Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, China.
| |
Collapse
|
6
|
Chhetri S, Pendem S, Bharath J, Priyanka. Low kilovoltage and low contrast volume neck CT protocol using iterative reconstruction techniques: A comparison with standard dose protocol. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2021.109935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Zhang T, Zhao S, Liu Y, Liu Z, Ma Z, Zuo Z, Zhao Y. Comparison of two different GSI scanning protocols in head and neck CT angiography: Image quality and radiation dose. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2022; 30:689-696. [PMID: 35527624 DOI: 10.3233/xst-221181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To compare image quality and radiation dose of computed tomography angiography (CTA) of the head and neck in patients using two Gemstone Spectral Imaging (GSI) scanning protocols. METHODS A total of 100 patients who underwent head-neck CTA were divided into two groups (A and B) according to the scanning protocols, with 50 patients in each group. The patients in group A underwent GSI scanning protocol 1 (GSI profile: head and neck CTA), while those in group B underwent GSI scanning protocol 2 (GSI profile: chest 80 mm). All images were reconstructed using 40% and 70% pre- and post-adaptive level statistical iterative reconstruction V (pre-ASiR-V and post-ASiR-V) algorithms, respectively. The CT dose index (CTDIvol) and dose-length (DLP) product were recorded and the mean value was calculated and converted to the effective dose. CT values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of all images were calculated. Additionally, subjective image evaluation was conducted by two independent radiologists using a five-point scoring method. All data were statistically analyzed. RESULTS There were no significant differences in the CT values, SNR, CNR, and subjective score between groups A and B (p > 0.05); however, the mean effective dose (1.2±0.1 mSv) in group B was 45.5% lower than that in group A (2.2±0.2 mSv) (p < 0.05). CONCLUSIONS GSI scanning protocol 2 could more effectively reduce the radiation dose in head-neck CT angiography while maintaining image quality compared to GSI scanning protocol 1.
Collapse
Affiliation(s)
- Tianle Zhang
- Department of Radiology, the Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
| | - Sai Zhao
- Department of Radiology, the Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
| | - Yiwen Liu
- Hebei University, Baoding, Hebei Province, China
| | - Zhichao Liu
- Department of Radiology, the Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
| | - Zepeng Ma
- Department of Radiology, the Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
| | - Ziwei Zuo
- Department of Radiology, the Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
| | - Yongxia Zhao
- Department of Radiology, the Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
| |
Collapse
|
8
|
Chen PA, Chen CW, Chou CC, Fu JH, Wang PC, Hsu SH, Lai PH. Impact of 80 kVp with iterative reconstruction algorithm and low-dose contrast medium on the image quality of craniocervical CT angiography. Clin Imaging 2020; 68:124-130. [PMID: 32592973 DOI: 10.1016/j.clinimag.2020.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/08/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the image quality of 80-kVp craniocervical CT angiography (CCCTA) protocol combined with adaptive statistical iterative reconstruction-V (ASIR-V) and low-dose contrast medium (CM). METHODS A total of 119 patients were randomly divided into three groups. For group A, 120-kVp protocol was followed with 60 ml CM and filtered back projection; for group B, 80-kVp protocol with 60 ml CM and ASIR-V; and for group C, 80-kVp protocol with 45 ml CM and ASIR-V. Both subjective and objective image quality and radiation doses were evaluated. RESULTS Arterial attenuation, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the head, neck, and shoulder regions were significantly higher in groups B and C compared with group A. Group C yielded significantly better subjective image quality than that observed in groups A and B (both p < .05). As compared with group A, effective radiation dose and the iodine load of group C were reduced by 51.4% and 25%, respectively. CONCLUSIONS The CCCTA protocol with 80 kVp, ASIR-V, and 45 ml of CM injected at 3 ml/s significantly reduced the radiation dose, iodine load, and iodine delivery rate while providing better subjective and objective image quality, including higher arterial enhancement and a higher SNR and CNR compared with the 120-kVp protocol.
Collapse
Affiliation(s)
- Po-An Chen
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan
| | - Chih-Wei Chen
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan
| | - Chiung-Chen Chou
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan
| | - Jui-Hsun Fu
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan
| | - Po-Chin Wang
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan
| | - Shuo-Hsiu Hsu
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan
| | - Ping-Hong Lai
- Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan.
| |
Collapse
|
9
|
Cao R, Jiang Y, Lu J, Wu G, Zhang L, Chen J. Evaluation of Intracranial Vascular Status in Patients with Acute Ischemic Stroke by Time Maximum Intensity Projection CT Angiography: A Preliminary Study. Acad Radiol 2020; 27:696-703. [PMID: 31324580 DOI: 10.1016/j.acra.2019.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 02/05/2023]
Abstract
RATIONALE AND OBJECTIVES To describe the application of time maximum intensity projection CTA (t-MIP CTA) in acute ischemic stroke and compare t-MIP CTA and single-phase CTA (sCTA) in assessing collateral circulation and predicting prognosis. MATERIALS AND METHODS Twenty-nine acute ischemic stroke patients who underwent one-stop CT angiography (CTA)-CT perfusion scan were reviewed retrospectively. sCTA and t-MIP CTA were developed by CT perfusion scanning data. Image quality and collateral circulation were compared between the sCTA and t-MIP CTA groups. CT attenuation values, image noise, signal to noise , contrast to noise, and subjective image quality were obtained and compared between these two groups. The correlations of clinical prognosis and infarct volume with collateral status on t-MIP CTA and sCTA were analyzed, separately. Receiver operating characteristic curve was used to reveal the sensitivity and specificity of t-MIP CTA and sCTA in predicting outcome. RESULTS All images exhibited good quality for diagnosis. In objective evaluation, the noise level of t-MIP CTA was significantly lower than that of sCTA (p < 0.001). Vascular attenuation (signal to noise and contrast to noise) of t-MIP were higher than those of sCTA (all, p < 0.001). The collateral status on t-MIP CTA and sCTA were both negatively correlated with modified Rankin Scale scores (t-MIP CTA, r = -0.709, p < 0.001; sCTA, r = -0.551, p = 0.024) and the final infarction volume (t-MIP CTA, r = -0.716, p = 0.001; sCTA, r = -0.629, p = 0.003). t-MIP CTA was better for predicting prognosis (AUC, 0.956; sensitivity, 0.917; specificity, 0.941; p < 0.001) than sCTA (AUC, 0.824; sensitivity, 0.500; specificity, 0.941; p = 0.003). CONCLUSION In comparison with sCTA, t-MIP images showed higher image quality of intracranial vascularity and MIP could reveal vascular occlusion and evaluate collateral circulation more accurately. It was speculated that t-MIP could predict the prognosis more precisely.
Collapse
Affiliation(s)
- Ruoyao Cao
- Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, China; Department of Radiology, Beijing Hospital, National Center of Gerontology, No.1, DaHua Road, Dong Dan, Beijing 100730, China
| | - Yun Jiang
- Department of Neurology, Beijing Hospital, National Center of Gerontology, China
| | - Jun Lu
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, China
| | - Guogeng Wu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No.1, DaHua Road, Dong Dan, Beijing 100730, China
| | - Lei Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No.1, DaHua Road, Dong Dan, Beijing 100730, China
| | - Juan Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No.1, DaHua Road, Dong Dan, Beijing 100730, China.
| |
Collapse
|
10
|
Sun J, Yang L, Zhou Z, Zhang D, Han W, Zhang Q, Peng Y. Performance evaluation of two iterative reconstruction algorithms, MBIR and ASIR, in low radiation dose and low contrast dose abdominal CT in children. Radiol Med 2020; 125:918-925. [DOI: 10.1007/s11547-020-01191-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 03/30/2020] [Indexed: 12/21/2022]
|
11
|
Tang S, Zhang G, Chen Z, Liu X, Fan X, Liu D, He L. Application of multiple injections of contrast agent in head and neck CT arteriovenous angiography in children: Study protocol clinical trial (SPIRIT Compliant). Medicine (Baltimore) 2020; 99:e19773. [PMID: 32282739 PMCID: PMC7220194 DOI: 10.1097/md.0000000000019773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the application value of multiple injections of contrast agent in head and neck CT arteriovenous angiography in children. METHODS A total of 100 children aged 6 to 7 years who needed head and neck CT arteriovenous angiography were prospectively selected. They were randomly divided into a control group and a research group, with 50 children in each group. The same scanning parameters and reconstruction methods were used. The right median cubital vein was injected intravenously with the contrast agent Omnipaque (350 mg I/ml). For children in the control group, a bolus of undiluted contrast agent (dose was 2 ml/kg, upper limit was 50 ml) was injected 1 time. The arterial phase and vein phase of the head and neck vessels were scanned. For children in the research group, a contrast agent bolus diluted with saline to a concentration of 20% was first injected (dose was 1 ml/kg, upper limit was 25 ml), and then an undiluted contrast agent bolus (dose was 1 ml/kg, upper limit was 25 ml) was injected. Thresholds were used to trigger the scanning of the head and neck arterial phases. The CT image quality of the head and neck arteries and veins, radiation dose and contrast agent dose were compared between the 2 groups. RESULTS Subjective evaluation of CT image quality of arteries: there were 47 cases of 4 points and 3 cases of 3 points in the control group and 34 cases of 4 points and 16 cases of 3 points in the research group. Subjective evaluation of CT image quality of veins: there were 47 cases of 4 points and 3 cases of 3 points in the control group and 5 cases of 4 points, 42 cases of 3 points and 3 cases of 2 points in the research group. The CT value of brain arterial vessel enhancement was higher in the control group than the research group, and the difference was statistically significant (P < .05). The CT value of vein enhancement was higher in the control group than the research group, and the difference was statistically significant (P < .05). The X-ray dose in the research group was 51% lower than that in the control group; the contrast agent dose in the research group was 44% lower than that in the control group. CONCLUSION For the head and neck enhanced CT examination of children, the method of first bolus injection of 20% diluted contrast agent and later bolus injection of undiluted contrast agent can clearly demonstrate the head and neck arteries and veins one time, reducing the X-ray dose and contrast agent dose, which has clinical practical value in the enhanced CT examination of children with head and neck disease.
Collapse
Affiliation(s)
| | - Guanping Zhang
- National Clinical Research Center for Child Health and Disorders
| | - Zhuo Chen
- Department of Radiology
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xianfan Liu
- Ministry of Education Key Laboratory of Child Development and Disorders
| | - Xiao Fan
- China International Science and Technology Cooperation base of Child development and Critical Disorders
| | | | | |
Collapse
|
12
|
Poon R, Badawy MK. Radiation dose and risk to the lens of the eye during CT examinations of the brain. J Med Imaging Radiat Oncol 2019; 63:786-794. [DOI: 10.1111/1754-9485.12950] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/11/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Rebekah Poon
- Department of Medical Imaging and Radiation Sciences School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences Monash University Clayton Victoria Australia
| | - Mohamed K Badawy
- Department of Medical Imaging and Radiation Sciences School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences Monash University Clayton Victoria Australia
- Monash Imaging Monash Health Clayton Victoria Australia
| |
Collapse
|
13
|
Tube Current Reduction in CT Angiography: How Low Can We Go in Imaging of Patients With Suspected Acute Stroke? AJR Am J Roentgenol 2019; 213:410-416. [DOI: 10.2214/ajr.18.20954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
14
|
Southard RN, Bardo DME, Temkit MH, Thorkelson MA, Augustyn RA, Martinot CA. Comparison of Iterative Model Reconstruction versus Filtered Back-Projection in Pediatric Emergency Head CT: Dose, Image Quality, and Image-Reconstruction Times. AJNR Am J Neuroradiol 2019; 40:866-871. [PMID: 30975652 DOI: 10.3174/ajnr.a6034] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Noncontrast CT of the head is the initial imaging test for traumatic brain injury, stroke, or suspected nonaccidental trauma. Low-dose head CT protocols using filtered back-projection are susceptible to increased noise and decreased image quality. Iterative reconstruction noise suppression allows the use of lower-dose techniques with maintained image quality. We review our experience with children undergoing emergency head CT examinations reconstructed using knowledge-based iterative model reconstruction versus standard filtered back-projection, comparing reconstruction times, radiation dose, and objective and subjective image quality. MATERIALS AND METHODS This was a retrospective study comparing 173 children scanned using standard age-based noncontrast head CT protocols reconstructed with filtered back-projection with 190 children scanned using low-dose protocols reconstructed with iterative model reconstruction. ROIs placed on the frontal white matter and thalamus yielded signal-to-noise and contrast-to-noise ratios. Volume CT dose index and study reconstruction times were recorded. Random subgroups of patients were selected for subjective image-quality review. RESULTS The volume CT dose index was significantly reduced in studies reconstructed with iterative model reconstruction compared with filtered back-projection, (mean, 24.4 ± 3.1 mGy versus 31.1 ± 6.0 mGy, P < .001), while the SNR and contrast-to-noise ratios improved 2-fold (P < .001). Radiologists graded iterative model reconstruction images as superior to filtered back-projection images for gray-white matter differentiation and anatomic detail (P < .001). The average reconstruction time of the filtered back-projection studies was 101 seconds, and with iterative model reconstruction, it was 147 seconds (P < .001), without a practical effect on work flow. CONCLUSIONS In children referred for emergency noncontrast head CT, optimized low-dose protocols with iterative model reconstruction allowed us to significantly reduce the relative dose, on average, 22% compared with filtered back-projection, with significantly improved objective and subjective image quality.
Collapse
Affiliation(s)
- R N Southard
- From the Departments of Medical Imaging (R.N.S., D.M.E.B., M.A.T., R.A.A., C.A.M.)
| | - D M E Bardo
- From the Departments of Medical Imaging (R.N.S., D.M.E.B., M.A.T., R.A.A., C.A.M.)
| | - M H Temkit
- Clinical Research (M.H.T.), Phoenix Children's Hospital, Phoenix Arizona
| | - M A Thorkelson
- From the Departments of Medical Imaging (R.N.S., D.M.E.B., M.A.T., R.A.A., C.A.M.)
| | - R A Augustyn
- From the Departments of Medical Imaging (R.N.S., D.M.E.B., M.A.T., R.A.A., C.A.M.)
| | - C A Martinot
- From the Departments of Medical Imaging (R.N.S., D.M.E.B., M.A.T., R.A.A., C.A.M.)
| |
Collapse
|
15
|
Improving image quality with model-based iterative reconstruction algorithm for chest CT in children with reduced contrast concentration. Radiol Med 2019; 124:595-601. [PMID: 30739289 DOI: 10.1007/s11547-019-00995-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/24/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate model-based iterative reconstruction (MBIR) in improving the image quality of chest CT in children with reduced concentration contrast medium (CM). METHODS Fifty-six children (median age of 4 years) who received low-dose enhanced chest CT were enrolled as the study group and compared with the control group of 56 children. Both groups used the automatic tube current modulation to achieve age-based noise index values of 11-15 HU. The study group used 100 kVp and reduced CM concentration of 270 mgI/ml, and the images in this group were reconstructed with 50% adaptive statistical iterative reconstruction (ASIR) and MBIR. The control group used 120 kV and standard CM of 320 mgI/ml, and the images in this group were reconstructed with ASIR only. Subjective image quality and objective image quality of the three image sets were evaluated. The subjective quality included overall image noise, enhancement degree, lesion (including mediastinum mass, pulmonary space-occupying lesions, and parenchymal infiltrative lesions) conspicuity, and beam-hardening artifacts. The objective quality included the measurement of noise in the left ventricle and back muscle to calculate signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of ventricle. RESULTS There was no difference in radiation dose between the study (CTDIvol of 1.79 ± 1.45 mGy) and control (1.68 ± 0.92 mGy) groups (p = 0.65). However, the study group used 19.7% lower CM dose than the control group (5.84 ± 2.69 vs. 7.27 ± 3.80 gI), and the enhancement in all images met the diagnostic requirements. MBIR reduced image noise by 58.6% and increased SNR and CNR by 143.6% and 165.7%, respectively, compared to ASIR images in the control group. The two ASIR image sets had similar image quality. CONCLUSION MBIR improved the image quality of low-radiation-dose chest CT in children at 19.3% reduced CM dose.
Collapse
|
16
|
Maamoun I, Khalil MM. Assessment of iterative image reconstruction on kidney and liver donors: Potential role of adaptive iterative dose reduction 3D (AIDR 3D) technology. Eur J Radiol 2018; 109:124-129. [PMID: 30527293 DOI: 10.1016/j.ejrad.2018.10.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 09/30/2018] [Accepted: 10/19/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the radiation exposure levels in two different types of subjects including liver and kidney donors in diagnostic assessment of transplant operation and also the significance of dose reduction on total effective dose. MATERIALS AND METHODS A number of Sixty subjects (40 males and 20 females, average age of 35 ± 10 years) were randomly prospectively recruited and equally divided into two distinct groups namely kidney donors (KD, 24 M and 6 F) and liver donors (LD, 21 M and 9 female). Kidney donors were divided into full dose (KFD, n = 20) group and low dose (KLD, n = 10) group. They had undergone dynamic renal scan using Tc99 m-DTPA, CT renal angiography and x-ray plain radiograph. Liver donors were divided into full dose (LFD, n = 20) and low dose (LLD, n = 10) groups and performed CT liver volumetry. The CT dose index (CTDIvol), dose length product (DLP), total milli-ampere product time mAs, effective dose and image noise index were measured in all subjects of kidney and liver donors comparing full dose and low dose protocols. RESULTS In comparison of all subjects of kidney donor groups (KFD vs KLD), the parameters (mAs = 16386.8 ± 3140.7 vs 2830.286 ± 831.676), (CTDIvol = 183.19 ± 32.58 mGy vs. 45.5 ± 13.3 mGy), DLP = 2884 ± 859.0 mGy.cm vs. 1437.5 ± 399 mGy.cm) and (effective dose = 49.0 ± 9.0 mSv vs. 18.9 mSv±5.7 mSv) were significant, p < 0.0005. Statistical evaluation of liver donors groups (LFD vs LLD) showed that (mAs = 14348.8 ± 4571.8 vs 3123.357 ± 794.5), (CTDIvol = 333.6 ± 59.5 mGy vs. 51.4 ± 13 mGy), (DLP = 3268.3 ± 604.3 mGy.cm vs 1260.5 ± 404.6 mGy.cm) and (effective dose = 43.3 mSv±12.9 mSv vs. 21.6 ± 5.9 mSv) are statistically significant, p < 0.0005. Nevertheless, the comparative evaluation of the image quality noise index of KFD vs KLD groups and LFD vs LLD showed a no statistical significance p > 0.05. CONCLUSION Renal and liver donors bear a relatively significant radiation dose due to diagnostic evaluation and patient management. The CT iterative reconstruction using AIDR3D proved very valuable tool in dose reduction such that it can reduce 37% in kidney donors and 48% in liver donors while able to maintain an acceptable image quality. Monitoring of those subjects on the clinical and radiobiological levels are recommended.
Collapse
Affiliation(s)
- I Maamoun
- Department of Intensive Care, Nuclear Cardiology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Magdy M Khalil
- Department of Physics, Faculty of Science, Helwan University, Cairo, Egypt.
| |
Collapse
|