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Christopher N, Periaswamy G, Arunachalam VK, Pilli V, Renganathan R, Rajasekaran S, Mehta P, Cherian M. Comparison of Turbo Flash and dual-energy modes of third-generation dual-source CT in pre-transplant renal angiography: a prospective observational study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00876-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The purpose of this study was to compare the Image Quality, Contrast Medium Volume, and Radiation dose in renal angiography performed using Turbo Flash mode and dual-energy (DE) mode in the third-generation dual-source dual-energy CT.
This prospective observational study was performed on renal donors who underwent CTA imaging as a pre-transplant workup. The study population was divided into two groups. Group A underwent DECT renal angiography. Group B underwent Turbo Flash Mode CT renal angiography. For group A, a contrast volume of 1 ml/kg and for group B at 0.5 ml/kg was administered. Image Quality was evaluated objectively by calculating CNR and SNR and subjectively by a 5-point scale. Radiation Dose analysis was done by noting CTDIvol and DLP on the scanner system and calculating effective radiation dose (ED).
Results
The subjective image quality scores for the Turbo Flash group were comparable with the DE group in qualitative image analysis. Additionally, in the Turbo Flash group, there was a reduction in contrast media and effective radiation dose by 47.5% and 32.7%, respectively. Nevertheless, mean attenuation of the abdominal arteries, CNR, SNR, and Noise (S.D) showed statistical significance between the two groups (p value < 0.01).
Conclusions
To our knowledge, no previous study compared Turboflash mode with DE protocol in CT renal angiography in a donor group of patients. Turbo Flash CT is an excellent modality that is faster and has an added advantage of decreased radiation dose and contrast media volume reduction, which can be recommended for screening of voluntary kidney donors but needs further clinical studies, validation, and standardization with tailored protocols.
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Zhang X, Chen J, Yu N, Ren Z, Tian Q, Tian X, Jia Y, He T, Guo C. Reducing contrast medium dose with low photon energy images in renal dual-energy spectral CT angiography and adaptive statistical iterative reconstruction (ASIR). Br J Radiol 2021; 94:20200974. [PMID: 33684310 DOI: 10.1259/bjr.20200974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the value of using low energy (keV) images in renal dual-energy spectral CT angiography (CTA) and adaptive statistical iterative reconstruction (ASIR) to reduce contrast medium dose. METHODS 40 patients with renal CTA on a Discovery CT750HD were randomly divided into two groups: 20 cases (Group A) with 600 mgI kg-1 and 20 cases (Group B) with 300 mgI kg-1. The scan protocol for both groups was: dual-energy mode with mA selection for noise index of 10 HU, pitch 1.375:1, rotating speed 0.6 s/r. Images were reconstructed at 0.625 mm thickness with 40%ASIR, Group A used the conventional 70keV monochromatic images, and Group B used monochromatic images from 40 to 70 keV at 5 keV interval for analysis. The CT values and standard deviation (SD) values of the renal artery and erector spine in the plain and arterial phases were measured with the erector spine SD value representing image noise. The enhancement degree of the renal artery (ΔCT = CT(arterial) -CT(plain)), signal-to-noise ratio (SNR=CTrenal-artery/SDrenal-artery) and contrast-to-noise ratio (CNR=(CTrenal-artery-CTerector spine)/SDerector-spine) were calculated. The single factor analysis of variance was used to analyze the difference of ΔCT, SNR and CNR among image groups with p < 0.05 being statistically significant. The subjective image scores of the groups were assessed blindly by two experienced physicians using a 5-point system and the score consistency was compared by the κ test. RESULTS Contrast medium dose in the 300 mgI kg-1 group was reduced by 50% compared with the 600 mgI kg-1 group, while radiation dose was similar between the two groups. The subjective scores were 4.00 ± 0.65, 4.50 ± 0.60 and 3.70 ± 0.80 for images at 70 keV (600 mgI kg-1 group), 40 keV (300 mgI kg-1 group) and 45 keV (300 mgI kg-1 group), respectively with good consistency between the two reviewers (p > 0.05). The 40 keV images in the 300 mgI kg-1 group had similar ΔCT (469.77 ± 86.95 HU vs 398.54 ± 73.68 HU) and CNR (15.52 ± 3.32 vs 18.78 ± 6.71) values as the 70 keV images in the 600 mgI kg-1) group but higher SNR values (30.19 ± 4.41 vs 16.91 ± 11.12, p < 0,05). CONCLUSION Contrast dose may be reduced by 50% while maintaining image quality by using lower energy images combined with ASIR in renal dual-energy CTA. ADVANCES IN KNOWLEDGE Combined with ASIR and energy spectrum, can reduce the amount of contrast dose in renal CTA.
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Affiliation(s)
- Xirong Zhang
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Jing Chen
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Nan Yu
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Zhanli Ren
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Qian Tian
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Xin Tian
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Yongjun Jia
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Taiping He
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
| | - Changyi Guo
- Department of Medical Techniques, Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China.,Department of Radiology, The Second Affiliated Hospital of Shaanxi University of Chinese medicine, Xianyang, China
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Abstract
Computed tomography angiography (CTA) has become a mainstay for the imaging of vascular diseases, because of high accuracy, availability, and rapid turnaround time. High-quality CTA images can now be routinely obtained with high isotropic spatial resolution and temporal resolution. Advances in CTA have focused on improving the image quality, increasing the acquisition speed, eliminating artifacts, and reducing the doses of radiation and iodinated contrast media. Dual-energy computed tomography provides material composition capabilities that can be used for characterizing lesions, optimizing contrast, decreasing artifact, and reducing radiation dose. Deep learning techniques can be used for classification, segmentation, quantification, and image enhancement.
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Affiliation(s)
- Prabhakar Rajiah
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55904, USA.
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Ren Z, Zhang X, Hu Z, Li D, Liu Z, Wei D, Jia Y, Yu N, Yu Y, Lei Y, Chen X, Guo C, Ren Z, He T. Application of Adaptive Statistical Iterative Reconstruction-V With Combination of 80 kV for Reducing Radiation Dose and Improving Image Quality in Renal Computed Tomography Angiography for Slim Patients. Acad Radiol 2019; 26:e324-e332. [PMID: 30655053 DOI: 10.1016/j.acra.2018.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/23/2018] [Accepted: 12/24/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To explore the application of adaptive statistical iterative reconstruction-V (ASIR-V) with combination of 80 kV for reducing radiation dose and improving image quality in renal computed tomography angiography (CTA) for slim patients compared with traditional filtered back projection (FBP) reconstruction using 120 kV. METHODS Eighty patients for renal CTA were prospectively enrolled and randomly divided into group A and group B. Group A used 120 kV and 600 mgI/kg contrast agent and FBP reconstruction, while group B used 80 kV and 350 mgI/kg contrast agent and both FBP and ASIR-V reconstruction from 10%ASIR-V to 100%ASIR-V with 10%ASIR-V interval. The CT values and SD values of the right renal artery and left renal artery were measured to calculate the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The image quality was subjectively scored by two experienced radiologists blindly using a five-point criterion. The contrast agent, volumetric CT dose index (CTDIvol), and dose length product in both groups were recorded and the effective radiation dose was calculated. RESULTS There were no significant difference in patient characteristics between two groups (p > 0.05). The CTDIvol, dose length product and effective radiation dose in group B were 59.0%, 65.0%, and 65.1% lower than those in group A, respectively (all p < 0.05), and the contrast agent in group B was 42.2% lower than that in group A (p < 0.05). In group B, with the increase of ASIR-V percentage, CT values showed no significant difference, SD values decreased gradually, SNR values and CNR values increased gradually. The CT values showed no statistically significant difference (p > 0.05) between two groups with different reconstructions. The SD values with 40%ASIR-V to 100%ASIR-V reconstruction in group B was significantly lower(p < 0.5), while the SNR values with 50% ASIR-V to 100% ASIR-V reconstruction and CNR values with 70%ASIR-V to 100%ASIR-V were significantly higher than those of group A with FBP reconstruction (p < 0.5). Two radiologists had excellent consistency in subjective scores of image quality for renal CTA (kappa >0.75, p < 0.05). The subjective scores with 60% ASIR-V to 90% ASIR-V in group B were significantly higher than those of FBP in group A (p < 0.5), of which 70%ASIR-V reconstruction obtained the highest subjective score for renal CTA. CONCLUSION ASIR-V with combination of 80 kV can significantly reduce effective radiation dose (about 65.1%) and contrast agent (about 42.2%) and improve image quality in renal CTA for slim patients compared with traditional FBP reconstruction using 120 kV, and the 70% ASIR-V was the best reconstruction algorithm in 80 kV renal CTA. ADVANCES IN KNOWLEDGE Using 80 kV with combination of ASIR-V can significantly reduce radiation dose and contrast agent dose as well as improve image quality in renal CTA for thin patients when compared with FBP using 120 kV.
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Affiliation(s)
- Zhanli Ren
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000; Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China; The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xirong Zhang
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000
| | - Zhijun Hu
- Department of Medical Imaging, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Dou Li
- Department of Medical Imaging, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Zhentang Liu
- Department of Medical Imaging, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Donghong Wei
- Department of Medical Imaging, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Yongjun Jia
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000
| | - Nan Yu
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000
| | - Yong Yu
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000
| | - Yuxin Lei
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000
| | - Xiaoxia Chen
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000
| | - Changyi Guo
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Zhanliang Ren
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000.
| | - Taiping He
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang western road- 2#, Xianyang, Shaanxi, China 712000.
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Saade C, Hamieh N, Deeb IAS, Haddad M, Abi-Ghanem AS, Ghieh D, El-Merhi F. An augmented patient-specific approach to administration of contrast agent for CT renal angiography. Int Braz J Urol 2019; 45:1022-1032. [PMID: 31268642 PMCID: PMC6844352 DOI: 10.1590/s1677-5538.ibju.2018.0366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/14/2018] [Indexed: 12/05/2022] Open
Abstract
Purpose This hybrid retrospective and prospective study performed on 200 consecutive patients undergoing renal CTA, investigates the opacification of renal vasculature, radiation dose, and reader confidence. Materials and Methods 100 patients were assigned retrospectively to protocol A and the other 100 were allocated prospectively to protocol B. Both protocols implemented a contrast material and saline flow rate of 4.5 mL/sec. Protocol A utilized a 100 mL of low-osmolar nonionic IV contrast material (Ioversol 350 mg I/mL) while protocol B employed a patient-tailored contrast media formula using iso-osmolar non-ionic (Iodixanol 320 mg I/mL). Results Arterial opacification in the abdominal aorta and in the bilateral main proximal renal arteries demonstrated no statistical significance (p>0.05). Only the main distal renal artery of the left kidney in protocol B was statistically significant (p<0.046). In the venous circulation, the IVC demonstrated a significant reduction in opacification in protocol B (59.39 HU ± 19.39) compared to A (87.74 HU ± 34.06) (p<0.001). Mean CNR for protocol A (22.68 HU ± 13.72) was significantly higher than that of protocol B (14.75 HU ± 5.76 p< 0.0001). Effective dose was significantly reduced in protocol B (2.46 ± 0.74 mSv) compared to A (3.07 ± 0.68 mSv) (p<0.001). Mean contrast media volume was reduced in protocol B (44.56 ± 14.32 mL) with lower iodine concentration. ROC analysis demonstrated significantly higher area under the ROC curve for protocol B (p< 0.0001), with inter-reader agreement increasing from moderate to excellent in renal arterial visualization. Conclusion Employing a patient-tailored contrast media injection protocol shows a significant refinement in the visualization of renal vasculature and reader confidence during renal CTA.
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Saade C, Chokr J, Naffaa L, Faraj W, Shamseddine A, Mukherji D, Sayegh SE, Assi R, Haydar A. Reduced Contrast Volume and Radiation Dose During Computed Tomography of the Pancreas: Timing-Specific Contrast Media Protocol. Acad Radiol 2019; 26:480-488. [PMID: 30122624 DOI: 10.1016/j.acra.2018.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE AND OBJECTIVE To investigate the opacification of the pancreatic vasculature and parenchyma during computed tomography utilizing a patient-specific contrast formula. MATERIALS AND METHODS This hybrid prospective and retrospective study was approved by the institution review board. In 220 consecutive patients, pancreatic CT was performed with one of two protocols: protocol A, 100mL of contrast material injected via timed bolus triggering technique; or protocol B, employing a patient-specific contrast media protocol specifically timed at the gastroduodenal artery; both protocols employed 4.5 mL/s contrast media and 100mL saline chaser. Attenuation of pancreatic parenchymal, arterial, and venous vasculature supplying the pancreas was measured. Effective dose was calculated. Data were compared to the independent two-sample t test. Receiver operating characteristic, visual grading characteristic, and Cohens' kappa analyses were performed. RESULTS Mean pancreatic density measurements in each of the pancreatic segments during the arterial and venous phase were significantly higher in Protocol B (mean ± standard deviation, art: 96.59 HU ± 27.37; venous: 91.28 HU ± 20.88) compared to A (art: 77.86 HU ± 21.14; venous: 73.99 HU ± 14.75) (p < 0.0001). Mean arterial opacification was significantly higher in protocol B compared to A with the abdominal aorta (p < 0.007), superior mesenteric (p < 0.0002), gastroduodenal (proximal segment only p < 0.014), and splenic arteries (p < 0.036). In the venous circulation, the inferior vena cava, superior mesenteric, portal and splenic veins (all segments) demonstrated significant reduction in vascular opacification protocol B compared to A (p < 0.001). The contrast media volume in protocol B (57.60 ± 12.25 mL) was significantly lower than in protocol A (100 ± 1 mL) (p < 0.001). Effective dose was significantly reduced in protocol B (2.75 ± 0.63 mSv) compared to A (4.015 ± 0.89 mSv) (p < 0.001). Receiver operating characteristic and visual grading characteristic analysis demonstrated significantly higher area under the curve for protocol B (p < 0.0001) (p < 0.034) respectively, with inter-reader agreement increasing from good to excellent in pancreatic lesion detection. CONCLUSION Timing-specific contrast media protocol enhances image quality at reduced contrast volume and radiation dose during computed tomography of the pancreas.
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Zein-El-Dine S, Bou Akl I, Mohamad M, Chmaisse A, Chahwan S, Asmar K, El-Merhi F, Saade C. Split-bolus contrast injection protocol enhances the visualization of the thoracic vasculature and reduced radiation dose during chest CT. Br J Radiol 2018; 91:20180509. [PMID: 30160182 DOI: 10.1259/bjr.20180509] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate the visualization of mediastinal lymph nodes during thoracic CT employing a multiphasic contrast media (CM) protocol. METHODS Institutional review board approved retrospective study consisting of 300 patients with known chest malignancy. Patients were allocated to one of two CM protocols: Protocol A, consisted of dual bolus (Phase 1:100 ml CM followed by 100 ml saline chaser) i.v. injected at 2.5 ml s-1; Protocol B employed 100 ml of CM using a multiphasic injection protocol (Phase 1 and 2:60 ml contrast and saline, followed by Phase 3 and 4:40 ml contrast and saline injected at 2.5 ml s-1) with a fixed scan delay of 70 s for each acquisition. Attenuation profiles of the thoracic arteries and veins were calculated as well as the arterio-venous contrast ratios (AVCR). Receiver operating characteristic (ROC), visual grading characteristic (VGC), and Cohen's kappa analysis were assessed. RESULTS Arterial opacification was up to 24% (p < 0.032) higher in protocol B than A, whereas, in the veins it was significantly lower in protocol B than A, with a maximum reduction of up to 84% (p < 0.0001). There was no statistical significance between the central and peripheral pulmonary arteries [>263 Hounsfield units (HU)] in each protocol. Protocol B, demonstrated significant improvement in AVCR at various anatomical sites (p < 0.002). Radiation dose was significantly reduced in protocol B compared to A (p < 0.004). Both ROC and VGC demonstrated significantly higher Az score for protocol B compared to A (p < 0.0001) with an increased inter reader agreement from poor to excellent. CONCLUSION Employing a multiphasic CM protocol significantly improves opacification of the thoracic vasculature and visualization of mediastinal lymph nodes during thoracic CT. ADVANCES IN KNOWLEDGE Uniform opacification between thoracic arteries and veins increases the delineation between vasculature and lymph nodes, reduces radiation dose when employing a multiphase contrast media injection protocol.
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Affiliation(s)
- Salah Zein-El-Dine
- 1 Respiratory Medicine Department, American University of Beirut Medical Center , Beirut , Lebanon
| | - Imad Bou Akl
- 1 Respiratory Medicine Department, American University of Beirut Medical Center , Beirut , Lebanon
| | - Maha Mohamad
- 2 Diagnostic Radiology Department, University of Beirut Medical Center , Beirut , Lebanon
| | - Ahmad Chmaisse
- 2 Diagnostic Radiology Department, University of Beirut Medical Center , Beirut , Lebanon
| | - Stephanie Chahwan
- 2 Diagnostic Radiology Department, University of Beirut Medical Center , Beirut , Lebanon
| | - Karl Asmar
- 2 Diagnostic Radiology Department, University of Beirut Medical Center , Beirut , Lebanon
| | - Fadi El-Merhi
- 2 Diagnostic Radiology Department, University of Beirut Medical Center , Beirut , Lebanon
| | - Charbel Saade
- 3 Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut , Beirut , Lebanon
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Qin L, Ma Z, Yan F, Yang W. Iterative model reconstruction (IMR) algorithm for reduced radiation dose renal artery CT angiography with different tube voltage protocols. Radiol Med 2017; 123:83-90. [DOI: 10.1007/s11547-017-0821-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
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Saade C, Deeb IA, Mohamad M, Al-Mohiy H, El-Merhi F. Contrast medium administration and image acquisition parameters in renal CT angiography: what radiologists need to know. Diagn Interv Radiol 2016; 22:116-24. [PMID: 26728701 PMCID: PMC4790062 DOI: 10.5152/dir.2015.15219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/06/2015] [Accepted: 07/20/2015] [Indexed: 12/12/2022]
Abstract
Over the last decade, exponential advances in computed tomography (CT) technology have resulted in improved spatial and temporal resolution. Faster image acquisition enabled renal CT angiography to become a viable and effective noninvasive alternative in diagnosing renal vascular pathologies. However, with these advances, new challenges in contrast media administration have emerged. Poor synchronization between scanner and contrast media administration have reduced the consistency in image quality with poor spatial and contrast resolution. Comprehensive understanding of contrast media dynamics is essential in the design and implementation of contrast administration and image acquisition protocols. This review includes an overview of the parameters affecting renal artery opacification and current protocol strategies to achieve optimal image quality during renal CT angiography with iodinated contrast media, with current safety issues highlighted.
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Affiliation(s)
- Charbel Saade
- From the Department of Radiology (C.S., I.A.D., M.M., F.E.M. ), American University of Beirut, Beirut, Lebanon; the Department of Radiology (H.A.M.), King Khalid University, Abha, Saudi Arabia
| | - Ibrahim Alsheikh Deeb
- From the Department of Radiology (C.S., I.A.D., M.M., F.E.M. ), American University of Beirut, Beirut, Lebanon; the Department of Radiology (H.A.M.), King Khalid University, Abha, Saudi Arabia
| | - Maha Mohamad
- From the Department of Radiology (C.S., I.A.D., M.M., F.E.M. ), American University of Beirut, Beirut, Lebanon; the Department of Radiology (H.A.M.), King Khalid University, Abha, Saudi Arabia
| | - Hussain Al-Mohiy
- From the Department of Radiology (C.S., I.A.D., M.M., F.E.M. ), American University of Beirut, Beirut, Lebanon; the Department of Radiology (H.A.M.), King Khalid University, Abha, Saudi Arabia
| | - Fadi El-Merhi
- From the Department of Radiology (C.S., I.A.D., M.M., F.E.M. ), American University of Beirut, Beirut, Lebanon; the Department of Radiology (H.A.M.), King Khalid University, Abha, Saudi Arabia
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