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Jin L, Wang K, Wang X, Li C, Sun Y, Gao P, Xiao Y, Li M. Bodyweight-adjusted Contrast Media With Shortened Injection Duration for Step-and-Shoot Coronary Computed Tomography Angiography to Acquire Improved Image Quality. J Thorac Imaging 2024; 39:146-156. [PMID: 36744945 PMCID: PMC11027974 DOI: 10.1097/rti.0000000000000696] [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: 02/07/2023]
Abstract
PURPOSE Shortened injection durations are not recommended in step-and-shoot coronary computed tomography angiography (CCTA). We aimed to evaluate the image quality of CCTA performed using bodyweight-adjusted iodinated contrast media (ICM) with different injection durations to generate an optimized ICM administration protocol to acquire convincible image quality in step-and-shoot CCTA. MATERIALS AND METHODS A total of 200 consecutive patients with suspected coronary artery disease (CAD) were enrolled in group A (N=50, 350 mgI/mL, bodyweight×0.8 mL/kg with a 13-s injection duration), group B (N=50, 350 mgI/mL, bodyweight×0.9 mL/kg with a 13-s injection duration), group C (N=50, 350 mgI/mL, bodyweight×0.8 mL/kg with a 12-s injection duration), and group D (N=50, 320 mgI/mL, bodyweight×0.8 mL/kg with a 13-s injection duration). Patient characteristics, ICM administration protocols, quantitative computed tomography (CT) value measurements, and qualitative image scores were analyzed and compared among the groups. RESULTS Groups A and D achieved the lowest ICM volume, saline volume, injection flow rate, and total iodine and iodine injection rates among the groups. All the CT values of the coronary arteries in all groups were >300 HU. All the observers' average scores exceeded three points. In group A, the CT values showed significant positive correlation with the iodine injection rate ( r =0.226, P <0.001), whereas the signal-to-noise ratio ( r =-0.004, P =0.927) and contrast-to-noise ratio ( r =-0.006, P =0.893) values were not. CONCLUSIONS Bodyweight×0.8 mL/kg with a 13-second injection duration is a comprehensive option for step-and-shoot CCTA with improved image quality, and a 350 mgI/mL iodine concentration is preferred.
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Affiliation(s)
- Liang Jin
- Radiology Department, Huadong Hospital, Affiliated with Fudan University
| | - Kun Wang
- Radiology Department, Huadong Hospital, Affiliated with Fudan University
| | | | - Cheng Li
- Radiology Department, Huadong Hospital, Affiliated with Fudan University
| | - Yingli Sun
- Radiology Department, Huadong Hospital, Affiliated with Fudan University
| | - Pan Gao
- Radiology Department, Huadong Hospital, Affiliated with Fudan University
| | - Yi Xiao
- Department of Radiology, Changzheng Hospital, Second Military Medical University
| | - Ming Li
- Radiology Department, Huadong Hospital, Affiliated with Fudan University
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
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Aubert S, Tanguay J. Experimental optimization of single-exposure dual-energy angiography with photon-counting x-ray detectors. Med Phys 2023; 50:763-777. [PMID: 36326010 DOI: 10.1002/mp.16079] [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: 10/16/2022] [Revised: 09/24/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Photon-counting x-ray detectors may enable single-exposure dual-energy (DE) x-ray angiography. PURPOSE The purpose of this paper is to experimentally optimize the energy thresholds and tube voltage for single-exposure DE x-ray angiography. METHODS We optimized single-exposure DE x-ray angiography using the iodine signal-difference-to-noise ratio (SDNR) per root patient air kerma (κ) as a figure of merit. We measured the iodine SDNR by imaging an iodine stepwedge immersed in a water tank with a depth of 30 cm in the direction of x-ray propagation. The stepwedge was imaged using tube voltages ranging from 90 to 150 kV and a cadmium telluride (CdTe) x-ray detector with two energy bins and analog charge summing for charge sharing suppression. The energy threshold that separates the two energy bins was varied from approximately 35 keV to approximately 75% of the maximum energy of the x-ray beam. Curve fitting was used to determine the threshold that maximized SDNR / κ $\mathrm{SDNR}/\sqrt {\kappa }$ . The effect of scatter was determined from measurements of the scatter-to-primary ratios (SPRs) of the low-energy and high-energy images and a semi-empirical model of the relationship between SDNR and SPR. Using the optimal parameters, we imaged a phantom with vessel-simulating structures and background clutter. RESULTS The optimal energy thresholds increased monotonically from ∼50 to ∼85 keV over the range of tube voltages considered. For tube voltages greater than 90 kV, the optimal energy thresholds consistently allocated approximately two thirds of all detected primary photons to the low energy bin; this ratio was preserved without scatter. Consistent with prior modeling studies, SDNR / κ $\mathrm{SDNR}/\sqrt {\kappa }$ increased monotonically with tube voltage from 90 to 150 kV; SDNR / κ $\mathrm{SDNR}/\sqrt {\kappa }$ at 150 kV was approximately 38% higher than that at 90 kV for an iodine area density of ∼50 mg/cm2 . Scatter reduced SDNR by approximately 25% for SPRs of ∼1 and 0.4 in low-energy and high-energy images, respectively. CONCLUSIONS Achieving optimal image quality in single-exposure DE angiography with photon-counting x-ray detectors will require high tube voltages (i.e., >130 kV) and, for thick patients, energy thresholds that allocate approximately two thirds of all primary photons to the low-energy image. Future work will compare the image quality of singe-exposure photon-counting and kV-switching approaches to DE x-ray angiography.
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Affiliation(s)
- Sarah Aubert
- Department of Physics, Toronto Metropolitan University, Toronto, Canada
| | - Jesse Tanguay
- Department of Physics, Toronto Metropolitan University, Toronto, Canada
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An H, Xie R, Ge Y, Wang T. Progress of CT aortic angiography combined with coronary artery in the evaluation of acute aortic syndrome. Front Cardiovasc Med 2022; 9:1036982. [PMID: 36479572 PMCID: PMC9719981 DOI: 10.3389/fcvm.2022.1036982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/12/2022] [Indexed: 09/19/2023] Open
Abstract
Acute aortic syndrome (AAS) is a group of cardiovascular diseases that seriously threaten human life and health. AAS patients are often complicated with coronary artery disease and other related diseases, which require rapid and clear clinical diagnosis to avoid serious adverse events. In recent years, with the progress of science and technology, a variety of computer tomography (CT) angiography techniques have been applied in the clinic, and the diagnosis rate of AAS with coronary heart disease (CAD) has greatly increased. At the same time, the development of surgical technology and endovascular repair technology has significantly reduced the mortality and complication rate of AAS surgery. In the clinical diagnosis of AAS and related diseases, CT aortic angiography (CTA) combined with coronary CTA is increasingly applied to identify related diseases. Here, the current research progress on the technique of aortic CTA combined with coronary CTA is reviewed.
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Affiliation(s)
- Hengbin An
- School of Basic Medicine, Xinxiang Medical University, Xinxiang, China
- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
- Henan Provincial Key Laboratory of Cardiology Medical Imaging, Zhengzhou, China
| | - Ruigang Xie
- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
- Henan Provincial Key Laboratory of Cardiology Medical Imaging, Zhengzhou, China
| | - Yinghui Ge
- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
- Henan Provincial Key Laboratory of Cardiology Medical Imaging, Zhengzhou, China
| | - Tianyun Wang
- School of Basic Medicine, Xinxiang Medical University, Xinxiang, China
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Morisaka H, Matsuura K, Yamaguchi H, Ichikawa T, Onishi H. Effect of decreased contrast injection flow rate on aortic enhancement in 80-KV peak CT with contrast dose reduction. Acta Radiol 2021; 64:353-359. [PMID: 34923851 DOI: 10.1177/02841851211067144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Effect of decreased injection flow rate of contrast agent at the same iodine dose and delivery rate on aortic enhancement has not been clearly elucidated. PURPOSE To evaluate the effect of decreased injection flow rate of contrast agent on aortic peak enhancement in a dynamic flow phantom and on aortic enhancement in clinical dynamic 80-kVp computed tomography (CT) with contrast dose reduction. MATERIAL AND METHODS In the dynamic flow phantom experiment, the effect of a decreased injection flow rate at the same total iodine dose and delivery rate on simulated aortic peak enhancement was evaluated. In the clinical retrospective study, we searched 312 patients with renal dysfunction who underwent an 80-kVp abdominal dynamic CT with 40% reduction of contrast agent from a standard 120-kVp protocol and measured the aortic enhancement at the level of the hepatic hilum. Independent predictors for aortic enhancement were determined by multiple linear regression analysis, and after adjustment of significant predictors, independent variables for acquiring optimal aortic enhancement, ≥300 HU, were determined by multiple logistic regression analysis. RESULTS In the phantom experiment, decreased flow rate showed a significant but small descent effect (6%-9%) on simulated aortic peak enhancement. In the multiple linear regression analysis, only age was an independent predictor of aortic enhancement; there was no independent predictor for optimal age-adjusted aortic enhancement of ≥300 HU. CONCLUSIONS Decreased injection flow rate had a small influence on aortic enhancement in vitro but had no significant effect on the aortic enhancement in clinical dynamic 80-kVp CT.
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Affiliation(s)
- Hiroyuki Morisaka
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
- Diagnostic Radiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Koichiro Matsuura
- Diagnostic Radiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Haruomi Yamaguchi
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomoaki Ichikawa
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
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In Vitro Study of the Precision and Accuracy of Measurement of the Vascular Inner Diameter on Computed Tomography Angiography Using Deep Learning Image Reconstruction. J Comput Assist Tomogr 2021; 46:17-22. [DOI: 10.1097/rct.0000000000001251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dastan K, Henning MK, England A, Aalokken TM, Johansen S. An investigation into the variability of radiographers assessing body composition prior to CT contrast media administration. Radiography (Lond) 2020; 27:168-172. [PMID: 32855023 DOI: 10.1016/j.radi.2020.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/29/2020] [Accepted: 07/15/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION To evaluate and report the variability of radiographers in determining a patient's body type and using this to determine contrast media (CM) volumes for chest computed tomography (CT). METHODS This prospective study recruited 50 patients undergoing chest CT examinations. Three radiographers independently used two methods to determine patient body type and consequently CM volume. In Method 1, subjective evaluation of body type together with patient weight determined CM volume. In Method 2, patient weight along with additional criteria applied by the radiographer determined CM volume. Both the determination of body type and CM volumes were compared in terms of agreement and variability between radiographers, and between methods. RESULTS Fleiss' kappa was lower (0.583) for Method 1 when compared to Method 2 (0.926) indicating stronger agreement in the radiographer determination of body type for Method 2. Median (IQR) CM volume was 95.0 mL (85.0-110.0) for Method 1, compared to 92.5 mL (85.0-100.0) for method 2 (P < 0.001). CONCLUSION Method 2 provided greater agreement in determination of body type, and reduction of CM volumes compared to Method 1. IMPLICATIONS FOR PRACTICE Determining body type as part of a CT CM strategy can be subjective and enhanced methods are required to ensure that the most appropriate CM volumes are reliably used.
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Affiliation(s)
- K Dastan
- Directorate of Radiography, University of Salford, Salford, UK
| | - M K Henning
- Oslo University Hospital, Diagnostic and Nuclear Medicine Department, Oslo, Norway
| | - A England
- School of Allied Health Professions, Keele University, Staffordshire, UK
| | - T M Aalokken
- Oslo University Hospital, Diagnostic and Nuclear Medicine Department, Oslo, Norway; University of Oslo, Medicine Faculty, Oslo, Norway
| | - S Johansen
- Oslo Metropolitan University, Oslo, Norway; Oslo University Hospital, Cancer Treatment Department, Oslo, Norway.
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Zhang M, Hao P, Jiang C, Hao G, Li B, Hu P, Chen Q, Chen Y, Zhang A, Zhang Y, Liu Y. Personalized application of three different concentrations of iodinated contrast media in coronary computed tomography angiography. J Cell Mol Med 2020; 24:5446-5453. [PMID: 32227625 PMCID: PMC7214158 DOI: 10.1111/jcmm.15196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/24/2020] [Accepted: 03/01/2020] [Indexed: 12/12/2022] Open
Abstract
No study has evaluated the impact of different iodinated contrast media on coronary contrast enhancement, using an injection protocol according to body surface area (BSA). Thus, the present study aimed to examine the usefulness and safety of personalized application of different iodine concentrations of contrast media in coronary computed tomographic (CT) angiography with a 2nd dual-source CT scanner in eliminating differences in coronary contrast enhancement based on a BSA-adapted injection protocol of contrast media. A total of 270 enrolled participants were randomly assigned to three groups: ioversol 320, ioversol 350 and iopromide 370 (n = 90 per group). The three groups were administered contrast media at a BSA-adjusted volume and flow rate with a fixed injection time of 15 seconds, and they subsequently received a 30-mL saline flush. All patients were scanned with a prospective electrocardiogram-gated protocol in a craniocaudal direction using a second-generation 128-slice dual-source CT system. The three iodinated contrast media used in coronary CT angiography exhibited similar diagnostic quality and safety. No significant differences were found in the contrast enhancement degrees, image quality scores, radiation doses and incidences of adverse effects among the three groups. The three contrast media used in coronary CT angiography with 320, 350 and 370 mg/mL iodine, respectively, have comparable diagnostic quality and safety. However, more large-scale, multinational, multi-centre and prospective trials are warranted.
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Affiliation(s)
- Meng Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Panpan Hao
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Chenyu Jiang
- Shandong Institute of Innovation, Suzhou Institute of Biomedical Engineering and Technology Affiliated with Chinese Academy of Sciences, Jinan, China
| | - Guoxiang Hao
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences of Shandong University, Jinan, China
| | - Bin Li
- Jinan Central Hospital Affiliated with Shandong First Medical University and Shandong University, Jinan, China
| | - Peixin Hu
- Jinan Central Hospital Affiliated with Shandong First Medical University and Shandong University, Jinan, China
| | - Qingjie Chen
- First Hospital Affiliated with Xinjiang Medical University, Urumqi, China
| | - Yuguo Chen
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Aifeng Zhang
- Department of Nephrology, Brigham and Women's Hospital Affiliated with Harvard Medical School, Boston, Massachusetts
| | - Yun Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yanping Liu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
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