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Pinnock MA, Hu Y, Bandula S, Barratt DC. Time conditioning for arbitrary contrast phase generation in interventional computed tomography. Phys Med Biol 2024; 69:115010. [PMID: 38697200 PMCID: PMC11103281 DOI: 10.1088/1361-6560/ad46dd] [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: 12/19/2023] [Revised: 04/16/2024] [Accepted: 05/01/2024] [Indexed: 05/04/2024]
Abstract
Minimally invasive ablation techniques for renal cancer are becoming more popular due to their low complication rate and rapid recovery period. Despite excellent visualisation, one drawback of the use of computed tomography (CT) in these procedures is the requirement for iodine-based contrast agents, which are associated with adverse reactions and require a higher x-ray dose. The purpose of this work is to examine the use of time information to generate synthetic contrast enhanced images at arbitrary points after contrast agent injection from non-contrast CT images acquired during renal cryoablation cases. To achieve this, we propose a new method of conditioning generative adversarial networks with normalised time stamps and demonstrate that the use of a HyperNetwork is feasible for this task, generating images of competitive quality compared to standard generative modelling techniques. We also show that reducing the receptive field can help tackle challenges in interventional CT data, offering significantly better image quality as well as better performance when generating images for a downstream segmentation task. Lastly, we show that all proposed models are robust enough to perform inference on unseen intra-procedural data, while also improving needle artefacts and generalising contrast enhancement to other clinically relevant regions and features.
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Affiliation(s)
- Mark A Pinnock
- Centre for Medical Image Computing, University College London, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - Yipeng Hu
- Centre for Medical Image Computing, University College London, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - Steve Bandula
- Centre for Medical Imaging, Division of Medicine, University College London, London, United Kingdom
- Department of Interventional Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Dean C Barratt
- Centre for Medical Image Computing, University College London, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
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Zhang Y, Yuan D, Qi K, Zhang M, Zhang W, Wei N, Li L, Lv P, Gao J, Liu J. Feasibility Analysis of Individualized Low Flow Rate Abdominal Contrast-Enhanced Computed Tomography in Chemotherapy Patients: Dual-Source Computed Tomography With Low Tube Voltage. J Comput Assist Tomogr 2024:00004728-990000000-00319. [PMID: 38693081 DOI: 10.1097/rct.0000000000001624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
PURPOSE The aim of the study is to investigate the feasibility of using dual-source computed tomography (CT) combined with low flow rate and low tube voltage for postchemotherapy image assessment in cancer patients. METHODS Ninety patients undergoing contrast-enhanced CT scans of the upper abdomen were prospectively enrolled and randomly assigned to groups A, B, and C (n = 30 each). In group A, patients underwent scans at 120 kVp with 448 mgI/kg. Patients in group B underwent scans at 100 kVp with 336 mgI/kg. Patient in group C underwent scans at 70 kVp with of 224 mgI/kg. Quantitative measurements including the CT number, standard deviation of CT number, signal-to-noise ratio, contrast-to-noise ratio, subjective reader scores, and the volume and flow rate of contrast agent were evaluated for each group. RESULTS There was no statistically significant difference in the subjective image scores within the three groups except for the kidney (all P > 0.05). Group C showed significantly higher CT values, lower noise levels, and higher signal-to-noise ratio and contrast-to-noise ratio values in the majority of the regions of interest compared to the other groups (P < 0.05). In group C, the contrast agent dose was decreased by 46% compared to group A (79.48 ± 12.24 vs 42.7 ± 8.6, P < 0.01), and the contrast agent injection rate was reduced by 22% (2.7 ± 0.41 vs 2.1 ± 0.4, P < 0.01). CONCLUSIONS The use of 70 kVp tube voltage combined with low iodine flow rates prove to be a more effective approach in solving the challenge of compromised blood vessels in postchemotherapy tumor patients, without reducing image quality and diagnostic confidence.
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Affiliation(s)
- Yicun Zhang
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Dian Yuan
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Ke Qi
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Mengyuan Zhang
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Weiting Zhang
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Nannan Wei
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | | | - Peijie Lv
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Jianbo Gao
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
| | - Jie Liu
- From the The Department of Radiology, The First Affiliated Hospital of Zhengzhou, University, Zhengzhou
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Tachibana Y, Takaji R, Shiroo T, Asayama Y. Deep-learning reconstruction with low-contrast media and low-kilovoltage peak for CT of the liver. Clin Radiol 2024; 79:e546-e553. [PMID: 38238148 DOI: 10.1016/j.crad.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 03/09/2024]
Abstract
AIM To compare images using reduced CM, low-kVp scanning and DLR reconstruction with conventional images (no CM reduction, normal tube voltage, reconstructed with HBIR. To compare images using reduced contrast media (CM), low kilovoltage peak (kVp) scanning and deep-learning reconstruction (DLR) with conventional image quality (no CM reduction, normal tube voltage, reconstructed with hybrid-type iterative reconstruction method [HBIR protocol]). MATERIALS AND METHODS A retrospective analysis was performed on 70 patients with liver disease and three-phase dynamic imaging using computed tomography (CT) from April 2020 to March 2022 at Oita University Hospital. Of these cases, 39 were reconstructed using the DLR protocol at a tube voltage of 80 kVp and CM of 300 mg iodine/kg while 31 were imaged at a tube voltage of 120 kVp with CM of 600 mg iodine/kg and were reconstructed by the usual HBIR protocol. Images from the DLR and HBIR protocols were analysed and compared based on the contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), figure-of-merit (FOM), and visual assessment. The CT dose index (CTDI)vol and size-specific dose estimates (SSDE) were compared with respect to radiation dose. RESULTS The DLR protocol was superior, with significant differences in CNR, SNR, and FOM except hepatic parenchyma in the arterial phase. For visual assessment, the DLR protocol had better values for vascular visualisation for the portal vein, image noise, and contrast enhancement of the hepatic parenchyma. Regarding comparison of the radiation dose, the DLR protocol was superior for all values of CTDIvol and SSDE, with significant differences (p<0.01; max. 52%). CONCLUSION Protocols using DLR with reduced CM and low kVp have better image quality and lower radiation dose compared to protocols using conventional HBIR.
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Affiliation(s)
- Y Tachibana
- Graduate School of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, 879-5593, Japan
| | - R Takaji
- Department of Radiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, 879-5593, Japan
| | - T Shiroo
- Radiology Department, Division of Medical Technology, Oita University Hospital, 1-1 Idaigaoka, Hasama-machi, Yufu, 879-5593, Japan
| | - Y Asayama
- Department of Radiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, 879-5593, Japan.
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Takemitsu M, Kudomi S, Takegami K, Uehara T. The effect of a pre-reconstruction process in a filtered back projection reconstruction on an image quality of a low tube voltage computed tomography. Radiol Phys Technol 2024; 17:306-314. [PMID: 38100019 DOI: 10.1007/s12194-023-00764-9] [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: 09/14/2023] [Revised: 11/07/2023] [Accepted: 11/22/2023] [Indexed: 03/01/2024]
Abstract
This study aims to evaluate the effect of pre-reconstruction process for low tube voltage computed tomography (CT) on image quality of filtered back projection (FBP) reconstruction. Small and large quality assurance water phantoms (19 and 33 cm diameter) were scanned on a third-generation dual-source CT with 70 kVp and 120 kVp at various dose levels. Image quality was assessed in terms of the noise power spectrum (NPS) and task-based transfer function (TTF). NPSs and TTFs in the small phantom were comparable between 70 and 120 kVp protocols. In the large phantom, the curves of the NPS changed and the TTF decreased even at the high-dose levels for 70 kVp protocol compared to 120 kVp protocol. Our results indicated that the pre-reconstruction process is performed in low tube voltage CT for large objects even for the FBP reconstruction and has an effect on the image quality.
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Affiliation(s)
- Masaki Takemitsu
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, 755-8505, Japan.
| | - Shohei Kudomi
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, 755-8505, Japan
| | - Kazuki Takegami
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, 755-8505, Japan
| | - Takuya Uehara
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, 755-8505, Japan
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Ippolito D, Porta M, Maino C, Riva L, Ragusi M, Giandola T, Franco PN, Cangiotti C, Gandola D, De Vito A, Talei Franzesi C, Corso R. Feasibility of Low-Dose and Low-Contrast Media Volume Approach in Computed Tomography Cardiovascular Imaging Reconstructed with Model-Based Algorithm. Tomography 2024; 10:286-298. [PMID: 38393291 PMCID: PMC10891780 DOI: 10.3390/tomography10020023] [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: 01/12/2024] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Aim: To evaluate the dose reduction and image quality of low-dose, low-contrast media volume in computed tomography (CT) examinations reconstructed with the model-based iterative reconstruction (MBIR) algorithm in comparison with the hybrid iterative (HIR) one. Methods: We prospectively enrolled a total of 401 patients referred for cardiovascular CT, evaluated with a 256-MDCT scan with a low kVp (80 kVp) reconstructed with an MBIR (study group) or a standard HIR protocol (100 kVp-control group) after injection of a fixed dose of contrast medium volume. Vessel contrast enhancement and image noise were measured by placing the region of interest (ROI) in the left ventricle, ascending aorta; left, right and circumflex coronary arteries; main, right and left pulmonary arteries; aortic arch; and abdominal aorta. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were computed. Subjective image quality obtained by consensus was assessed by using a 4-point Likert scale. Radiation dose exposure was recorded. Results: HU values of the proximal tract of all coronary arteries; main, right and left pulmonary arteries; and of the aorta were significantly higher in the study group than in the control group (p < 0.05), while the noise was significantly lower (p < 0.05). SNR and CNR values in all anatomic districts were significantly higher in the study group (p < 0.05). MBIR subjective image quality was significantly higher than HIR in CCTA and CTPA protocols (p < 0.05). Radiation dose was significantly lower in the study group (p < 0.05). Conclusions: The MBIR algorithm combined with low-kVp can help reduce radiation dose exposure, reduce noise, and increase objective and subjective image quality.
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Affiliation(s)
- Davide Ippolito
- Departement of Medicine and Surgery, University of Milano-Bicocca, Piazza OMS 1, 20100 Milano, Italy;
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Marco Porta
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Cesare Maino
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Luca Riva
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Maria Ragusi
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Teresa Giandola
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Paolo Niccolò Franco
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Cecilia Cangiotti
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Davide Gandola
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Andrea De Vito
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Cammillo Talei Franzesi
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
| | - Rocco Corso
- Department of Diagnostic Radiology, Fondazione IRCCS Fondazione San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (M.P.); (L.R.); (M.R.); (T.G.); (P.N.F.); (C.C.); (D.G.); (A.D.V.); (C.T.F.); (R.C.)
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Saidu AM, Garba I, Abba M, Yahuza MA, Yusuf L, Tahir NM, Garko SS. Evaluation of image quality and radiation dose in computed tomography urography following tube voltage optimisation. Radiography (Lond) 2024; 30:301-307. [PMID: 38071938 DOI: 10.1016/j.radi.2023.11.023] [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: 09/18/2023] [Revised: 11/05/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Computed tomography urography (CTU) comprehensively evaluates the urinary tract. However, the procedure is associated with a high radiation dose due to multiple scan series and therefore requires optimisation. The study performed CTU protocol optimisation based on a reduction in tube voltage (kV) using quality assurance (QA) phantom and clinical images and evaluated image quality and radiation dose. METHODS The study was prospectively conducted on patients referred for CTU. The patients were grouped into A and B and were scanned with the standard protocol, a protocol used for the routine CTU at the CT centre before optimisation, and optimised protocol, a protocol with reduced kV respectively. The protocols were first tried on a quality assurance (QA) phantom before being applied to patients, and image quality was assessed based on signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). In addition, the clinical images were assessed based on the visibility of the anatomical criteria for CT images by five observers with >5 years of experience. The data were analysed using both visual grading characteristic (VGC) curves and statistical package for social sciences (SPSS) version 22.0. RESULTS The dose was significantly lower in the optimised protocol with a 10 % reduction in both volume computed tomography dose index and (CTDIvol) and dose length product (DLP) for the phantom images, and a 26 % reduction in CTDIvol and 28 % in DLP for the clinical images. However, there was no significant difference in image quality noted between the standard and optimised protocols based on the quantitative and qualitative image quality evaluation using both the QA phantom and clinical images. CONCLUSION The findings revealed a significant dose reduction in the optimised protocol. Further, image quality in standard and optimised protocols did not differ significantly based on quantitative and qualitative methods. IMPLICATION FOR PRACTICE kV optimisation in contrast-enhanced procedures provides dose reduction and should be encouraged in the medical imaging departments.
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Affiliation(s)
- A M Saidu
- Department of Medical Radiography, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Nigeria
| | - I Garba
- Department of Medical Radiography, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Nigeria.
| | - M Abba
- Department of Medical Radiography, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Nigeria
| | - M A Yahuza
- Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano, Nigeria
| | - L Yusuf
- Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano, Nigeria
| | - N M Tahir
- Radiology Department, Orthopaedic Hospital, Dala, Kano State Nigeria
| | - S S Garko
- Radiology Department, Orthopaedic Hospital, Dala, Kano State Nigeria
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Arao S, Masuda T, Oku T, Ono A, Okura Y. Utility of lower tube voltage scans in reducing exposure of healthcare workers within computed tomography room to scattered radiation. RADIATION PROTECTION DOSIMETRY 2023; 199:2338-2343. [PMID: 37646071 DOI: 10.1093/rpd/ncad240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/25/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
The aim of this study was to estimate the effect of tube voltage on the scattered dose in a computed tomography (CT) room. To this end, we conducted experiments using anthropomorphic phantoms and a CT scanner at different tube voltages during CT. The scattered dose was measured using an electronic pocket dosemeter at 50-cm intervals from the centre of the gantry. The structure of the CT room was measured at 57 points (28 points in the front of the gantry (on the bed side), 6 points on the side of the gantry and 23 points behind the gantry) to be up to 200 cm. We compared the scattered dose distributions between 80 and 120 kVp at heights of 50, 100 and 150 cm above the floor surface. The scattered dose was reduced by ~30% when the tube voltage was reduced from 120 to 80 kVp.
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Affiliation(s)
- Shinichi Arao
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Takayuki Oku
- Department of Diagnostic Radiology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, Hiroshima 730-8655, Japan
| | - Atsushi Ono
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Yasuhiko Okura
- Department of Clinical Radiology, Faculty of Health Sciences, Hiroshima International University, 555-36 Kurosegakuendai, Higashihiroshima, Hiroshima 739-2695, Japan
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Takai Y, Noda Y, Asano M, Kawai N, Kaga T, Tsuchida Y, Miyoshi T, Hyodo F, Kato H, Matsuo M. Deep-learning image reconstruction for 80-kVp pancreatic CT protocol: Comparison of image quality and pancreatic ductal adenocarcinoma visibility with hybrid-iterative reconstruction. Eur J Radiol 2023; 165:110960. [PMID: 37423016 DOI: 10.1016/j.ejrad.2023.110960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/19/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE To evaluate the image quality and visibility of pancreatic ductal adenocarcinoma (PDAC) in 80-kVp pancreatic CT protocol and compare them between hybrid-iterative reconstruction (IR) and deep-learning image reconstruction (DLIR) algorithms. METHOD A total of 56 patients who underwent 80-kVp pancreatic protocol CT for pancreatic disease evaluation from January 2022 to July 2022 were included in this retrospective study. Among them, 20 PDACs were observed. The CT raw data were reconstructed using 40% adaptive statistical IR-Veo (hybrid-IR group) and DLIR at medium- and high-strength levels (DLIR-M and DLIR-H groups, respectively). The CT attenuation of the abdominal aorta, pancreas, and PDAC (if present) at the pancreatic phase and those of the portal vein and liver at the portal venous phase; background noise; signal-to-noise ratio (SNR) of these anatomical structures; and tumor-to-pancreas contrast-to-noise ratio (CNR) were calculated. The confidence scores for the image noise, overall image quality, and visibility of PDAC were qualitatively assigned using a five-point scale. Quantitative and qualitative parameters were compared among the three groups using Friedman test. RESULTS The CT attenuation of all anatomical structures were comparable among the three groups (P = .26-.86), except that of the pancreas (P = .001). Background noise was lower (P <.001) and SNRs (P <.001) and tumor-to-pancreas CNR (P <.001) were higher in the DLIR-H group than those in the other two groups. The image noise, overall image quality, and visibility of PDAC were better in the DLIR-H group than in the other two groups (P <.001-.003). CONCLUSION In 80-kVp pancreatic CT protocol, DLIR at a high-strength level improved image quality and visibility of PDAC.
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Affiliation(s)
- Yukiko Takai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masashi Asano
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Tetsuro Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Yuki Tsuchida
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Toshiharu Miyoshi
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Institute for Advanced Study, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
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Dillinger D, Overhoff D, Booz C, Kaatsch HL, Piechotka J, Hagen A, Froelich MF, Vogl TJ, Waldeck S. Impact of CT Photon-Counting Virtual Monoenergetic Imaging on Visualization of Abdominal Arterial Vessels. Diagnostics (Basel) 2023; 13:diagnostics13050938. [PMID: 36900082 PMCID: PMC10000913 DOI: 10.3390/diagnostics13050938] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
PURPOSE The novel photon-counting detector (PCD) technique acquires spectral data for virtual monoenergetic imaging (VMI) in every examination. The aim of this study was the evaluation of the impact of VMI of abdominal arterial vessels on quantitative and qualitative subjective image parameters. METHODS A total of 20 patients that underwent an arterial phase computed tomography (CT) scan of the abdomen with a novel PCD CT (Siemens NAEOTOM alpha) were analyzed regarding attenuation at different energy levels in virtual monoenergetic imaging. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were calculated and compared between the different virtual monoenergetic (VME) levels with correlation to vessel diameter. In addition, subjective image parameters (overall subjective image quality, subjective image noise and vessel contrast) were evaluated. RESULTS Our research showed decreasing attenuation levels with increasing energy levels in virtual monoenergetic imaging regardless of vessel diameter. CNR showed best overall results at 60 keV, and SNR at 70 keV with no significant difference to 60 keV (p = 0.294). Subjective image quality was rated best at 70 keV for overall image quality, vessel contrast and noise. CONCLUSIONS Our data suggest that VMI at 60-70 keV provides the best objective and subjective image quality concerning vessel contrast irrespective of vessel size.
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Affiliation(s)
- Daniel Dillinger
- Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
- Correspondence:
| | - Daniel Overhoff
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Christian Booz
- Institute for Diagnostic and Interventional Radiology, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Hanns L. Kaatsch
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Joel Piechotka
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Achim Hagen
- Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Matthias F. Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Thomas J. Vogl
- Institute for Diagnostic and Interventional Radiology, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Stephan Waldeck
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
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10
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Otgonbaatar C, Ryu JK, Shin J, Kim HM, Seo JW, Shim H, Hwang DH. Deep learning reconstruction allows for usage of contrast agent of lower concentration for coronary CTA than filtered back projection and hybrid iterative reconstruction. Acta Radiol 2023; 64:1007-1017. [PMID: 35979586 DOI: 10.1177/02841851221118476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The demand for homogeneous and higher vascular contrast enhancement is critical to provide an appropriate interpretation of abnormal vascular findings in coronary computed tomography angiography (CTA). PURPOSE To evaluate the effect of various contrast media concentrations (Iohexol-370, Iohexol-300, Iohexol-240) and image reconstructions (filtered back projection [FBP], hybrid iterative reconstruction [IR], and deep learning reconstruction [DLR]) on coronary CTA. MATERIAL AND METHODS A total of 63 patients referred for coronary CTA between July and October 2021 were enrolled in this prospective study, and they randomly received one of three contrast media. CTA images were reconstructed with FBP, hybrid IR, and DLR. The CT attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for all three images. The images were subjectively evaluated by two radiologists in terms of overall image quality, artifacts, image noise, and vessel wall delineation on a 5-point Likert scale. RESULTS The application of DLR resulted in significantly lower image noise; higher CT attenuation, SNR, and CNR; and better subjective analysis among the three different concentrations of contrast media groups (P < 0.001). There was no significant difference in the CT attenuation of the left ventricle (P = 0.089) and coronary arteries (P = 0.072) between hybrid IR at Iohexol-300 and DLR at Iohexol-240. Furthermore, application of DLR to the Iohexol-240 significantly improved SNR and CNR; it achieved higher subjective scores compared with hybrid IR at Iohexol-300 (P < 0.001). CONCLUSION We suggest that using DLR with Iohexol-240 contrast media is preferable to hybrid IR with Iohexol-300 contrast media in coronary CTA.
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Affiliation(s)
- Chuluunbaatar Otgonbaatar
- Department of Radiology, 26725Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Kyun Ryu
- Medical Imaging AI Research Center, 496517Canon Medical Systems Korea, Seoul, Republic of Korea
| | - Jaemin Shin
- Department of Neurology, 58934Korea University Guro Hospital, Seoul, Republic of Korea
| | - Han Myun Kim
- Department of Radiology, 65521Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jung Wook Seo
- Department of Radiology, 119750Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Hackjoon Shim
- Medical Imaging AI Research Center, 496517Canon Medical Systems Korea, Seoul, Republic of Korea
- ConnectAI Research Center, 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae Hyun Hwang
- Department of Radiology, 65521Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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11
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Graafen D, Müller L, Halfmann M, Düber C, Hahn F, Yang Y, Emrich T, Kloeckner R. Photon-counting detector CT improves quality of arterial phase abdominal scans: A head-to-head comparison with energy-integrating CT. Eur J Radiol 2022; 156:110514. [PMID: 36108479 DOI: 10.1016/j.ejrad.2022.110514] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/26/2022] [Accepted: 09/03/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Photon-counting detector (PCD)-CT is expected to have a substantial impact on oncologic abdominal imaging. We compared subjective and objective image quality between PCD-CT and conventional energy-integrating detector (EID-)CT arterial phase abdominal scans. METHODS This study included 84 patients undergoing both types of abdominal CT. EID-CT scans were acquired with a tube voltage of 100 kVp. With PCD-CT, acquired with 120-kVp, we reconstructed polychromatic T3D images and virtual monoenergetic images (VMIs) in 10-keV intervals from 40 to 90 keV. Quantitative image analysis included noise and contrast-to-noise ratio (CNR) of hepatic vessels, kidney cortex, and hypervascular liver lesions to liver parenchyma. Three raters used a 5-point Likert scale for qualitative image analysis of image noise and contrast, lesion conspicuity, and overall image quality. Radiation dose exposure (CT dose index) was compared between the two CT types. RESULTS Mean CT dose index and effective dose were respectively 18 % and 26 % lower with PCD-CT versus EID-CT. Compared with EID-CT, CNRs of kidney cortex and vessel to liver parenchyma were significantly higher in PCD-CT VMIs at energies ≤ 60 keV and in polychromatic T3D images (p < 0.004). Overall image quality of PCD-CT VMIs at 50 and 60 keV was rated as significantly better (p < 0.01) than the EID-CT images (inter-reader agreement alpha = 0.80). Lesion conspicuity was significantly better in low-keV VMIs (p < 0.03) and worse in > 70-keV VMIs. CONCLUSIONS With low-keV VMI, PCD-CT yields significantly improved objective and subjective quality of arterial phase oncological imaging compared with EID-CT. This advantage may translate into higher diagnostic confidence and lower radiation dose protocols.
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Affiliation(s)
- D Graafen
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - L Müller
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M Halfmann
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner-Site Rhine-Main, Mainz, Germany
| | - C Düber
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - F Hahn
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Y Yang
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - T Emrich
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner-Site Rhine-Main, Mainz, Germany
| | - R Kloeckner
- Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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12
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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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13
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Saleh M, Mujtaba B, Jensen C, Aslam R, Elsayes A, Kuchana V, Bhosale P. Feasibility of half the recommended dose of IV contrast in DECT: image quality evaluation and diagnostic acceptability in cancer patients. Clin Imaging 2022; 88:59-65. [DOI: 10.1016/j.clinimag.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022]
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14
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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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15
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Hoshika M, Nakaura T, Oda S, Kidoh M, Nagayama Y, Sakabe D, Hirai T, Funama Y. Comparison of the effects of varying tube voltage and iodinated concentration on increasing the iodinated radiation dose in computed tomography. Phys Med 2022; 95:57-63. [DOI: 10.1016/j.ejmp.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/09/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
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16
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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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17
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Nautiyal A, Mondal T, Manii M, Kaushik A, Goel A, Dey SK, Mitra D. Significant reduction of radiation dose and DNA damage in 18F- FDG whole-body PET/CT study without compromising diagnostic image quality. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2021. [DOI: 10.1080/16878507.2021.1969197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Amit Nautiyal
- Institute of Nuclear Medicine & Molecular Imaging, Amri Hospitals, Dhakuria, Kolkata
- Amity Institute of Nuclear Science & Technology, Amity University Uttar Pradesh, Noida
| | - Tanmoy Mondal
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata
| | - Manu Manii
- Department of Nuclear Medicine, Quadra Medical Services Private Limited, Kolkata
| | - Aruna Kaushik
- Institute of Nuclear Medicine & Allied Sciences, Timarpur, Delhi
| | - Alpana Goel
- Amity Institute of Nuclear Science & Technology, Amity University Uttar Pradesh, Noida
| | - Subrata Kumar Dey
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata
| | - Deepanjan Mitra
- Institute of Nuclear Medicine & Molecular Imaging, Amri Hospitals, Dhakuria, Kolkata
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18
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Tamura A, Mukaida E, Ota Y, Kamata M, Abe S, Yoshioka K. Superior objective and subjective image quality of deep learning reconstruction for low-dose abdominal CT imaging in comparison with model-based iterative reconstruction and filtered back projection. Br J Radiol 2021; 94:20201357. [PMID: 34142867 PMCID: PMC8248220 DOI: 10.1259/bjr.20201357] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: This study aimed to conduct objective and subjective comparisons of image quality among abdominal computed tomography (CT) reconstructions with deep learning reconstruction (DLR) algorithms, model-based iterative reconstruction (MBIR), and filtered back projection (FBP). Methods: Datasets from consecutive patients who underwent low-dose liver CT were retrospectively identified. Images were reconstructed using DLR, MBIR, and FBP. Mean image noise and contrast-to-noise ratio (CNR) were calculated, and noise, artifacts, sharpness, and overall image quality were subjectively assessed. Dunnett’s test was used for statistical comparisons. Results: Ninety patients (67 ± 12.7 years; 63 males; mean body mass index [BMI], 25.5 kg/m2) were included. The mean noise in the abdominal aorta and hepatic parenchyma of DLR was lower than that in FBP and MBIR (p < .001). For FBP and MBIR, image noise was significantly higher for obese patients than for those with normal BMI. The CNR for the abdominal aorta and hepatic parenchyma was higher for DLR than for FBP and MBIR (p < .001). MBIR images were subjectively rated as superior to FBP images in terms of noise, artifacts, sharpness, and overall quality (p < .001). DLR images were rated as superior to MBIR images in terms of noise (p < .001) and overall quality (p = .03). Conclusions: Based on objective and subjective comparisons, the image quality of DLR was found to be superior to that of MBIR and FBP on low-dose abdominal CT. DLR was the only method for which image noise was not higher for obese patients than for those with a normal BMI. Advances in knowledge: This study provides previously unavailable information on the properties of DLR systems and their clinical utility.
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Affiliation(s)
- Akio Tamura
- Department of Radiology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Eisuke Mukaida
- Department of Radiology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Yoshitaka Ota
- Division of Central Radiology, Iwate Medical University Hospital, Iwate, Japan
| | - Masayoshi Kamata
- Division of Central Radiology, Iwate Medical University Hospital, Iwate, Japan
| | - Shun Abe
- Division of Central Radiology, Iwate Medical University Hospital, Iwate, Japan
| | - Kunihiro Yoshioka
- Department of Radiology, Iwate Medical University School of Medicine, Iwate, Japan
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19
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Euler A, Taslimi T, Eberhard M, Kobe A, Reeve K, Zimmermann A, Krauss A, Gutjahr R, Schmidt B, Alkadhi H. Computed Tomography Angiography of the Aorta-Optimization of Automatic Tube Voltage Selection Settings to Reduce Radiation Dose or Contrast Medium in a Prospective Randomized Trial. Invest Radiol 2021; 56:283-291. [PMID: 33226202 DOI: 10.1097/rli.0000000000000740] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to compare the image quality of low-kV protocols with optimized automatic tube voltage selection (ATVS) settings to reduce either radiation dose or contrast medium (CM) with that of a reference protocol for computed tomography angiography (CTA) of the thoracoabdominal aorta. MATERIALS AND METHODS In this institutional review board-approved, single-center, prospective randomized controlled trial, 126 patients receiving CTA of the aorta were allocated to one of three computed tomography protocols: (A) reference protocol at 120 kVp and standard weight-adapted CM dose; (B) protocol at 90 kVp, reduced radiation and standard CM dose; and (C) protocol at 90 kVp, standard radiation and reduced CM dose. All three protocols were performed on a third-generation dual-source computed tomography scanner using the semimode of the ATVS system. The image-task-dependent optimization settings of the ATVS (slider level) were adjusted to level 11 (high-contrast task) for protocols A and B and level 3 (low-contrast task) for protocol C. Radiation dose parameters were assessed. The contrast-to-noise ratios (CNRs) of protocols B and C were tested for noninferiority compared with A. Subjective image quality was assessed using a 5-point Likert scale. RESULTS Size-specific dose estimate was 34.3% lower for protocol B compared with A (P < 0.0001). Contrast medium was 20.2% lower for protocol C compared with A (P < 0.0001). Mean CNR in B and C was noninferior to protocol A (CNR of 30.2 ± 7, 33.4 ± 6.7, and 30.5 ± 8.9 for protocols A, B, and C, respectively). There was no significant difference in overall subjective image quality among protocols (4.09 ± 0.21, 4.03 ± 0.19, and 4.08 ± 0.17 for protocols A, B, and C, respectively; P = 0.4). CONCLUSIONS The slider settings of an ATVS system can be adjusted to optimize either radiation dose or CM at noninferior image quality in low-kV CTA of the aorta. This optimization could be used to extend future ATVS algorithms to take clinical risk factors like kidney function of individual patients into account.
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Affiliation(s)
- André Euler
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tilo Taslimi
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Eberhard
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Adrian Kobe
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Kelly Reeve
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Alexander Zimmermann
- Department of Vascular Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | | | - Hatem Alkadhi
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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20
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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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22
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Iyer VR, Ehman EC, Khandelwal A, Wells ML, Lee YS, Weber NM, Johnson MP, Yu L, McCollough CH, Fletcher JG. Image quality in abdominal CT using an iodine contrast reduction algorithm employing patient size and weight and low kV CT technique. Acta Radiol 2020; 61:1186-1195. [PMID: 31986894 DOI: 10.1177/0284185119898655] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Low tube potential-high tube current computed tomography (CT) imaging allows reduction in iodine-based contrast dose and may extend the benefit of routine contrast-enhanced CT exams to patients at risk of nephrotoxicity. PURPOSE To determine the ability of an iodine contrast reduction algorithm to maintain diagnostic image quality for contrast-enhanced abdominal CT. MATERIAL AND METHODS CT exams with iodine contrast reduction were prescribed for patients at risk for renal dysfunction. The iodine contrast reduction algorithm combines weight-based contrast volume reduction with patient width-based low tube potential selection and bolus-tracking. Control exams with routine iodine dose were selected based on weight, width, and scan protocol. Three radiologists evaluated image quality and diagnostic confidence using a 4-point scale (<2 acceptable). Another radiologist assessed contrast reduction indications and measured portal vein and liver contrast-to-noise ratios. RESULTS Forty-six contrast reduction algorithm and control exams were compared (mean creatinine 1.6 vs. 1.2 mg/dL, P ≤ 0.0001). Thirty-nine contrast reduction patients had an eGFR <60 mL/min/1.73m2 and 15 had single or transplanted kidney. Mean iodine contrast dose was lower in the contrast reduction group (20.9 vs. 39.4 g/mL, P < 0.0001). Diagnostic confidence was rated as acceptable in 95% (131/138) of contrast reduction and 100% of control exams (1.18-1.28 vs. 1.02-1.13, respectively; P > 0.06). Liver attenuation and contrast-to-noise ratio (CNR) were similar (P = 0.08), but portal vein attenuation and CNR were lower with contrast-reduction (mean 176 vs. 198 HU, P = 0.02; 13 vs. 16, P = 0.0002). CONCLUSION This size-based contrast reduction algorithm using low kV and bolus tracking reduced iodine contrast dose by 50%, while achieving acceptable image quality in 95% of exams.
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Affiliation(s)
- Veena R Iyer
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Eric C Ehman
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Yong S Lee
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew P Johnson
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Lifeng Yu
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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23
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Abdullah KA, McEntee MF, Reed WM, Kench PL. Increasing iterative reconstruction strength at low tube voltage in coronary CT angiography protocols using 3D-printed and Catphan ® 500 phantoms. J Appl Clin Med Phys 2020; 21:209-214. [PMID: 32657493 PMCID: PMC7497920 DOI: 10.1002/acm2.12977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/21/2020] [Accepted: 06/12/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose The purpose of this study was to investigate the effect of increasing iterative reconstruction (IR) algorithm strength at different tube voltages in coronary computed tomography angiography (CCTA) protocols using a three‐dimensional (3D)‐printed and Catphan® 500 phantoms. Methods A 3D‐printed cardiac insert and Catphan 500 phantoms were scanned using CCTA protocols at 120 and 100 kVp tube voltages. All CT acquisitions were reconstructed using filtered back projection (FBP) and Adaptive Statistical Iterative Reconstruction (ASIR) algorithm at 40% and 60% strengths. Image quality characteristics such as image noise, signal–noise ratio (SNR), contrast–noise ratio (CNR), high spatial resolution, and low contrast resolution were analyzed. Results There was no significant difference (P > 0.05) between 120 and 100 kVp measures for image noise for FBP vs ASIR 60% (16.6 ± 3.8 vs 16.7 ± 4.8), SNR of ASIR 40% vs ASIR 60% (27.3 ± 5.4 vs 26.4 ± 4.8), and CNR of FBP vs ASIR 40% (31.3 ± 3.9 vs 30.1 ± 4.3), respectively. Based on the Modulation Transfer Function (MTF) analysis, there was a minimal change of image quality for each tube voltage but increases when higher strengths of ASIR were used. The best measure of low contrast detectability was observed at ASIR 60% at 120 kVp. Conclusions Changing the IR strength has yielded different image quality noise characteristics. In this study, the use of 100 kVp and ASIR 60% yielded comparable image quality noise characteristics to the standard CCTA protocols using 120 kVp of ASIR 40%. A combination of 3D‐printed and Catphan® 500 phantoms could be used to perform CT dose optimization protocols.
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Affiliation(s)
- Kamarul A Abdullah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Malaysia
| | - Mark F McEntee
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Warren M Reed
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Peter L Kench
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
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Choi MH, Lee YJ, Jung SE. A LESSON FROM AUTOMATIC TUBE VOLTAGE SELECTION: FEASIBILITY OF 100 kVp IN PORTAL VENOUS PHASE ABDOMINAL CT. RADIATION PROTECTION DOSIMETRY 2020; 188:424-431. [PMID: 31998958 DOI: 10.1093/rpd/ncz302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/17/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To evaluate the relationship between ATVS-recommended tube voltage and patient body habitus and to compare radiation dose and diagnostic performance between fixed 120-kVp and ATVS protocols in portal venous phase abdomen CT. METHODS A total of 907 portal venous phase abdominal CTs were evaluated. Radiation dose in the ATVS protocol was compared according to tube voltage (80, 100 or 120 kVp). Quantitative image analysis and diagnostic performance were compared between 81 pairs of CT using ATVS and fixed 120-kVp protocols. RESULTS Most CT examinations with ATVS were performed with 80 or 100 kVp. The average reduction rate of radiation dose in the ATVS protocol was 15.4%. There was no significant difference in diagnostic performance (p = 0.388) between ATVS and fixed 120-kVp protocols. CONCLUSIONS In conclusion, ATVS frequently selected 80 or 100 kVp for portal venous phase abdominal CT without impairing the diagnostic performance, even with filtered back projection.
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Affiliation(s)
- Moon Hyung Choi
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Radioogy, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Joon Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Radioogy, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Eun Jung
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Radioogy, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Yoshida M, Nakaura T, Sentaro T, Tanoue S, Inada H, Utsunomiya D, Sakaino N, Harada K, Yamashita Y. Prospective Comparison of 70-kVp Single-Energy CT versus Dual-Energy CT: Which is More Suitable for CT Angiography with Low Contrast Media Dosage? Acad Radiol 2020; 27:e116-e122. [PMID: 31537504 DOI: 10.1016/j.acra.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES To compare the objective and subjective image qualities between single-energy computed tomography (CT) at 70 kVp and virtual monoenergetic imaging (VMI) of dual-source dual-energy CT for CT angiography with 180 mgI/kg. MATERIALS AND METHODS Total 63 patients scanned with 180 mgI/kg were randomly divided into two groups: Group A (32 patients) underwent CT angiography at 70-kVp, and Group B (31 patients) underwent dual-energy CT. VMI sets were generated at 10-keV increments between 40 and 100 keV. We calculated aortic attenuation, contrast-to-noise-ratio (CNR), signal-to-noise-ratio, figure of merit of CNR, and effective dose for each protocol. Three radiologists scored overall image quality and various arteries' visibility using a four-point scale. Quantitative and qualitative comparisons between 70 kVp and VMI with the highest CNR were performed with the two-tailed t test or Kruskal-Wallis test. RESULTS The 40-keV images offered the highest CNR among VMIs. Aortic attenuation at 70 kVp was significantly lower than that at 40 keV (p < 0.001). However, the signal-to-noise-ratio, CNR, and figure of merit of CNR were significantly higher at 70 kVp than those at 40-keV (p < 0.001, p < 0.05, and p < 0.05, respectively). The effective dose of each group was almost equal. The qualitative visibility scores for various arteries, except the ascending and upper-abdominal aorta, were also better at 70 kVp than those at 40 keV. CONCLUSION Aortic attenuation at 70 kVp with 180 mg I/kg was lower than that of VMI at 40 keV, and the objective and subjective image qualities were higher at 70 kVp than those at 40 keV.
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26
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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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27
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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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Li J, Mai Z, Zhang Z, Cui J, Yang M, Ma X, Wang Y. Chest CT screening in patients with overweight or obesity using spectral shaping at 150 kVp: compared with 120 kVp protocol and spectral shaping at 100 kVp protocol. Jpn J Radiol 2020; 38:451-457. [PMID: 32048134 DOI: 10.1007/s11604-020-00925-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 01/29/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate the image quality (IQ) and the figure of merit (FoM) of chest CT screening in patients with overweight or obesity using a tin filter for spectral shaping at 150 kVp. MATERIALS AND METHODS Patients with overweight or obesity (N = 150, body mass index ≥ 26 kg/m2) with indications for chest CT screening were prospectively enrolled and randomly divided into three groups: 120 kVp group (standard radiation dose/tube voltage, 120 kVp/CT volume does index, 4.68 mGy); Sn100 kVp group (1/10th radiation dose level/100 kVp with a tin filter/0.47 mGy); Sn150 kVp group (1/2th radiation dose level/150 kVp with a tin filter/2.34 mGy). IQ and FoMs were evaluated and compared among the three groups. RESULTS Image noise, signal-to-noise ratios and subjective IQ scores were significantly higher in the Sn150 kVp group than those in the Sn100 kVp group (all p < 0.05), but were not significantly different with those in the 120 kVp group. FoMs in the Sn150 kVp group were significantly higher than those in the 120 kVp group (all p < 0.05), but showed no statistical difference with those in the Sn100 kVp group. CONCLUSIONS Compared with scanning at 120 kVp, chest CT screening performed at 150 kVp with spectral shaping substantially reduces the radiation dose in overweight and obese patients while maintaining IQ.
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Affiliation(s)
- Jianwen Li
- Department of Radiology, The Second People's Hospital of Shizuishan, NO.246 West Youyi Street, Shizuishan, 753000, Ningxia, China
| | - Zhifeng Mai
- Department of Radiology, The Second People's Hospital of Shizuishan, NO.246 West Youyi Street, Shizuishan, 753000, Ningxia, China
| | - Zhihong Zhang
- Department of Pharmacy, The First People's Hospital of Shizuishan, NO.1 Kangle Road, Shizuishan, 753000, Ningxia, China
| | - Jiamang Cui
- Department of Radiology, The Second People's Hospital of Shizuishan, NO.246 West Youyi Street, Shizuishan, 753000, Ningxia, China
| | - Mingjie Yang
- Department of Radiology, The Second People's Hospital of Shizuishan, NO.246 West Youyi Street, Shizuishan, 753000, Ningxia, China
| | - Xia Ma
- Department of Radiology, The Second People's Hospital of Shizuishan, NO.246 West Youyi Street, Shizuishan, 753000, Ningxia, China
| | - Yan Wang
- Department of Radiology, The Second People's Hospital of Shizuishan, NO.246 West Youyi Street, Shizuishan, 753000, Ningxia, China.
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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. Reducing Radiation Dose and Improving Image Quality in CT Portal Venography Using 80 kV and Adaptive Statistical Iterative Reconstruction-V in Slender Patients. Acad Radiol 2020; 27:233-243. [PMID: 31031186 DOI: 10.1016/j.acra.2019.02.022] [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] [Received: 01/16/2019] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To explore the feasibility of reducing radiation dose and improving image quality in CT portal venography (CTPV) using 80 kV and adaptive statistical iterative reconstruction-V(ASIR-V) in slender patients in comparison with conventional protocol using 120 kV and ASIR. METHODS Sixty slender patients for enhanced abdominal CT scanning were randomly divided into group A and group B. Group A used the conventional 120 kV tube voltage, 600 mgI/kg contrast dose and reconstructed with the recommended 40% ASIR. Group B used 80 kV tube voltage, 350 mgI/kg contrast dose and reconstructed with ASIR-V from 40% to 100% with 10% interval. The CT values and standard deviation (SD) values of the main portal vein, left branch, and right branch of portal vein, liver, and erector spinae at the same level 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 5-point criterion. The contrast dose, volumetric CT dose index, and dose length product were recorded in both groups and the effective dose was calculated. RESULTS There was no significant difference in general data between the two groups (p > 0.05), the effective dose and contrast dose in group B were reduced by 63.3% (p < 0.001) and 39.7% (p < 0.001), respectively compared with group A. With the percentage of ASIR-V increased in group B, the CT values showed no significant difference, while the SD values gradually decreased and SNR values and CNR values increased accordingly. Compared with group A, group B demonstrated similar CT values (p > 0.05), while the SD values with 80% ASIR-V to 100% ASIR-V were significantly lower than those of 40% ASIR (p < 0.001), and the SNR values and CNR values with 70% ASIR-V to 100% ASIR-V were significantly higher than those of 40% ASIR (p < 0.001). The subjective image quality scores by the two radiologists had excellent consistency (kappa value>0.75, p < 0.001), and the final subjective image quality scores and the subjective scores in each of the 5 scoring categories with 60% ASIR-V to 100% ASIR-V were all significantly higher than those of 40% ASIR, and 80% ASIR-V obtained the highest subjective score among different reconstructions. CONCLUSION In CTPV, the application of 80 kV and ASIR-V reconstruction in slender patients can significantly reduce radiation dose (by 63.3%) and contrast agent dose (by 39.7%). Compared with the recommended 40% ASIR using 120 kV, ASIR-V with 80% to 100% percentages can further improve image quality and with 80% ASIR-V being the best reconstruction algorithm. ADVANCES IN KNOWLEDGE CTPV with 80 kV and ASIR-V algorithm in slender patients can significantly reduce radiation dose and contrast agent dose as well as improve image quality, compared with the conventional 120 kV protocol using 40% ASIR.
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Meng D, Cui X, Bai C, Yu Z, Xin L, Fu Y, Wang S, Du Y, Gao Z, Ye Z. Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study. Sci Prog 2020; 103:36850419892193. [PMID: 31791209 PMCID: PMC10358470 DOI: 10.1177/0036850419892193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To evaluate the influence of low-concentration contrast agents and low-tube-voltage computed tomography on chest enhancement examinations, we conducted a multicenter prospective study. A total of 216 inpatients enrolled from 12 different hospitals were randomly divided into four groups: A: voltage, 120 kVp; iohexol, 350 mgI/mL; B: voltage, 100 kVp, iohexol, 350 mgI/mL; C: voltage, 120 kVp, iodixanol, 270 mgI/mL; and D: voltage, 100 kVp, iodixanol, 270 mgI/mL. Subjective image quality was assessed by two radiologists and compared by weighted kappa test. The objective image scores, scanning radiation doses, and pathological coincidence rates were analyzed. There were no significant differences in gender, age, height, weight, and body mass index between the four groups (p > 0.05). The consistency of the radiologists' ratings were good, with kappa value ranging from 0.736 (95% confidence interval: 0.54-0.933) to 0.809 (95% confidence interval: 0.65-0.968), and there was no difference in subjective image score between the four groups. The computed tomography value of group D had no difference with group A. The volume computed tomography dose index, dose length product, and effective dose of group D (6.93 ± 3.03, 241.55 ± 104.75, and 3.38 ± 1.47, respectively) were all significantly lower than those of group A (10.30 ± 4.37, 359.70 ± 152.65, and 5.04 ± 2.14, respectively). There was no significant difference in the imaging diagnosis accuracy rate between the four groups (p > 0.05). The results indicated that low-concentration contrast agents (270 mgI/mL) and low-tube-voltage (100 kVp) computed tomography can not only decrease radiation dose but also guarantee the image quality and meet the needs of imaging diagnosis in chest enhancement examinations, which make it possible for its generalization and application.
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Affiliation(s)
- Donghua Meng
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Xiaonan Cui
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Changsen Bai
- Department of Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Zhongwen Yu
- Department of Radiology, China Resources Wuhan Iron and Steel General Hospital, Wuhan, China
| | - Lei Xin
- Department of Radiology, Shanxi Cancer Hospital, Taiyuan, China
| | - Yufei Fu
- Department of Radiology, Edong Medical Group Central Hospital, Huangshi, China
| | | | - Yu Du
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhipeng Gao
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
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31
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Ippolito D, Riva L, Talei Franzesi C, De Vito A, Cangiotti C, Crespi A, Corso R, Sironi S. Computed Tomography Angiography Combined With Knowledge-Based Iterative Algorithm for Transcatheter Aortic Valve Implantation Planning: Image Quality and Radiation Dose Exposure With Low-kV and Low-Contrast-Medium Protocol. J Comput Assist Tomogr 2020; 44:13-19. [PMID: 31939876 DOI: 10.1097/rct.0000000000000965] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol. METHODS Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups. RESULTS In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P < 0.0001). CONCLUSION Low-kV and low-CM volume CTA, combined with IMR, allows to correctly performing TAVI planning with high-quality images and significant radiation dose reduction compared with standard CTA protocol.
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Affiliation(s)
| | | | | | | | | | - Andrea Crespi
- Department of Medical Physics, "San Gerardo" Hospital, Monza
| | - Rocco Corso
- From the Department of Diagnostic Radiology, "San Gerardo" Hospital
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32
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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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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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Radiation dose and image quality of high-pitch emergency abdominal CT in obese patients using third-generation dual-source CT (DSCT). Sci Rep 2019; 9:15877. [PMID: 31685902 PMCID: PMC6828752 DOI: 10.1038/s41598-019-52454-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 10/17/2019] [Indexed: 01/01/2023] Open
Abstract
In this third-generation dual-source CT (DSCT) study, we retrospectively investigated radiation dose and image quality of portal-venous high-pitch emergency CT in 60 patients (28 female, mean age 56 years) with a body mass index (BMI) ≥ 30 kg/m2. Patients were dichotomized in groups A (median BMI 31.5 kg/m2; n = 33) and B (36.8 kg/m2; n = 27). Volumetric CT dose index (CTDIvol), size-specific dose estimate (SSDE), dose length product (DLP) and effective dose (ED) were assessed. Contrast-to-noise ratio (CNR) and dose-independent figure-of-merit (FOM) CNR were calculated. Subjective image quality was assessed using a five-point scale. Mean values of CTDIvol, SSDE as well as normalized DLP and ED were 7.6 ± 1.8 mGy, 8.0 ± 1.8 mGy, 304 ± 74 mGy * cm and 5.2 ± 1.3 mSv for group A, and 12.6 ± 3.7 mGy, 11.0 ± 2.6 mGy, 521 ± 157 mGy * cm and 8.9 ± 2.7 mSv for group B (p < 0.001). CNR of the liver and spleen as well as each calculated FOM CNR were significantly higher in group A (p < 0.001). Subjective image quality was good in both groups. In conclusion, third-generation abdominal high-pitch emergency DSCT yields good image quality in obese patients. Radiation dose increases in patients with a BMI > 36.8 kg/m2.
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Masuda T, Nakaura T, Funama Y, Sato T, Higaki T, Matsumoto Y, Yamashita Y, Imada N, Kiguchi M, Baba Y, Yamashita Y, Awai K. Contrast enhancement on 100- and 120 kVp hepatic CT scans at thin adults in a retrospective cohort study: Bayesian inference of the optimal enhancement probability. Medicine (Baltimore) 2019; 98:e17902. [PMID: 31764788 PMCID: PMC6882564 DOI: 10.1097/md.0000000000017902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To assess the probability of achieving optimal contrast enhancement in 100 kVp and 120 kVp-protocol on hepatic computed tomography (CT) scans. MATERIALS AND METHODS We enrolled 200 patients in a retrospective cohort study. Hundred patients were scanned with 120 kVp setting, and other 100 patients were scanned with 100 kVp setting. We measured the CT number in the abdominal aorta and hepatic parenchyma on unenhanced scans and hepatic arterial phase (HAP)-, and portal venous phase (PVP). The aortic enhancement at HAP and the hepatic parenchymal enhancement at PVP were compared between the two scanning protocols. Bayesian inference was used to assess the probability of achieving optimal contrast enhancement in each protocol. RESULTS The Bayesian analysis indicated that when 100 kVp-rotocol was used, the probability of achieving optimal aortic enhancement (>280 HU) was 98.8% ± 0.6%, whereas it was 88.7% ± 2.5% when 120 kVp-protocol was used. Also, the probability of achieving optimal hepatic parenchymal enhancement (>50 HU) was 95.3% ± 1.5%, whereas it was 64.7% ± 3.8% when 120 kVp-protocol was used. CONCLUSION Bayesian inference suggested that the post-test probability of optimal contrast enhancement at hepatic dynamic CT was lower under the 120 kVp than the 100 kVp-protocol.
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Affiliation(s)
- Takanori Masuda
- Department of Radiological Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto
| | - Tomoyasu Sato
- Department of Diagnostic Radiology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku
| | - Toru Higaki
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoriaki Matsumoto
- Department of Radiological Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima
| | - Yukari Yamashita
- Department of Radiological Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima
| | - Naoyuki Imada
- Department of Radiological Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima
| | - Masao Kiguchi
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasutaka Baba
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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36
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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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Komiyama R, Ohira S, Kanayama N, Karino T, Washio H, Ueda Y, Miyazaki M, Teshima T. Volumetric modulated arc therapy treatment planning based on virtual monochromatic images for head and neck cancer: effect of the contrast-enhanced agent on dose distribution. J Appl Clin Med Phys 2019; 20:144-152. [PMID: 31633869 PMCID: PMC6839366 DOI: 10.1002/acm2.12752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/01/2019] [Accepted: 09/24/2019] [Indexed: 12/14/2022] Open
Abstract
Virtual monochromatic images (VMIs) at a lower energy level can improve image quality but the computed tomography (CT) number of iodine contained in the contrast‐enhanced agent is dramatically increased. We assessed the effect of the use of contrast‐enhanced agent on the dose distributions in volumetric modulated arc therapy (VMAT) planning for head and neck cancer (HNC). Based on the VMIs at 40 keV (VMI40keV), 60 keV(VMI60keV), and 77 keV (VMI77keV) of a tissue characterization phantom, lookup tables (LUTs) were created. VMAT plans were generated for 15 HNC patients based on contrast‐enhanced‐ (CE‐) VMIs at 40‐, 60‐, and 77 keV using the corresponding LUTs, and the doses were recalculated based on the noncontrast‐enhanced‐ (nCE‐) VMIs. For all structures, the difference in CT numbers owing to the contrast‐enhanced agent was prominent as the energy level of the VMI decreased, and the mean differences in CT number between CE‐ and nCE‐VMI was the largest for the clinical target volume (CTV) (125.3, 55.9, and 33.1 HU for VMI40keV, VMI60keV, and VMI77keV, respectively). The mean difference of the dosimetric parameters (D99%, D50%, D1%, Dmean, and D0.1cc) for CTV and OARs was <1% in the treatment plans based on all VMIs. The maximum difference was observed for CTV in VMI40keV (2.4%), VMI60keV (1.9%), and VMI77keV (1.5%) plans. The effect of the contrast‐enhanced agent was larger in the VMAT plans based on the VMI at a lower energy level for HNC patients. This effect is not desirable in a treatment planning procedure.
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Affiliation(s)
- Riho Komiyama
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shingo Ohira
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan.,Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naoyuki Kanayama
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tsukasa Karino
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hayate Washio
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoshihiro Ueda
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Masayoshi Miyazaki
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Teruki Teshima
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
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Hinzpeter R, Eberhard M, Gutjahr R, Reeve K, Pfammatter T, Lachat M, Schmidt B, Flohr TG, Kolb B, Alkadhi H. CT Angiography of the Aorta: Contrast Timing by Using a Fixed versus a Patient-specific Trigger Delay. Radiology 2019; 291:531-538. [DOI: 10.1148/radiol.2019182223] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Ricarda Hinzpeter
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Matthias Eberhard
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Ralf Gutjahr
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Kelly Reeve
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Thomas Pfammatter
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Mario Lachat
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Bernhard Schmidt
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Thomas G. Flohr
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Beate Kolb
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
| | - Hatem Alkadhi
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistr 100, CH-8091 Zurich, Switzerland (R.H., M.E., T.P., B.K., H.A.); Siemens Healthcare, Forchheim, Germany (R.G., B.S., T.G.F.); Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland (K.R.); and Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland (M.L.)
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You SK, Choi YH, Cheon JE, Kim WS, Kim IO, Lee SM, Cho HH. Effect of low tube voltage and low iodine concentration abdominal CT on image quality and radiation dose in children: preliminary study. Abdom Radiol (NY) 2019; 44:1928-1935. [PMID: 30683980 DOI: 10.1007/s00261-019-01896-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the image quality of a double-low protocol (low tube voltage and low iodine concentration) for abdominal CT in children. MATERIALS AND METHODS The double-low protocol was compared to the conventional protocol in pediatric patients weighing less than 40 kg from May 2016 to December 2016. Double-low protocol (Group A, n = 18): tube voltage, 70 kVp; and iodine concentration,: 250 mgI/mL versus Conventional protocol (Group B, n = 13): tube voltage, 80-100 kVp; and iodine concentration, 350 mgI/mL. Mean attenuation, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were compared between the two groups. Image contrast, noise, beam-hardening artifacts, and overall image quality were subjectively scored. Reader performance for correctly differentiating two groups by visual assessment was evaluated. Radiation dose and total iodine load were recorded. RESULTS The mean attenuations of the portal vein and liver and the mean image noise in Group A were higher than in Group B (p = 0.04, 0.03, 0.004, respectively). The mean SNR and CNR of the main portal vein and liver were lower in Group A without any statistically significant difference. There were no statistically significant differences between the two groups in qualitative analysis (image contrast, image noise, and overall image quality) with substantial agreement between the reviewers (weighted kappa values; 0.59-0.76). Significantly diminished radiation dose and iodine load were observed in Group A compared with Group B (25.0%, 36.8% reduction; p = 0.007, 0.006, respectively). CONCLUSION The double-low protocol was feasible for pediatric abdominal CT and reduced both radiation dose and iodine load, while maintaining image quality.
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Ippolito D, Riva L, Talei Franzesi CR, Cangiotti C, De Vito A, Di Gennaro F, D'andrea G, Crespi A, Sironi S. Diagnostic efficacy of model-based iterative reconstruction algorithm in an assessment of coronary artery in comparison with standard hybrid-Iterative reconstruction algorithm: dose reduction and image quality. LA RADIOLOGIA MEDICA 2019; 124:350-359. [PMID: 30539411 DOI: 10.1007/s11547-018-0964-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/25/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate the image quality and radiation dose exposure of low-dose coronary CTA (cCTA) study, reconstructed with the new model-based iterative reconstruction algorithm (IMR), compared with standard hybrid-iterative reconstruction (iDose4) cCTA in patients with suspected coronary artery disease. MATERIALS AND METHODS Ninety-eight patients with an indication for coronary CT study were prospectively enrolled. Fifty-two patients (study group) underwent 256-MDCT low-dose cCTA (80 kV; automated-mAs; 60 mL of CM, 350 mgL/mL) with prospective ECG-triggering acquisition and IMR. A control group of 46 patients underwent 256-MDCT standard prospective ECG-gated protocol (100 kV; automated-mAs; 70 mL of CM, 400 mgL/mL; iDose4). Subjective and objective image quality (attenuation value, SD, SNR and CNR) were evaluated by two radiologists subjectively. Radiation dose exposure was quantified as DLP, CTDIvol and ED. RESULTS Mean values of mAs were significantly lower for IMR-cCTA (167 ± 62 mAs) compared to iDose-cCTA (278 ± 55 mAs), p < 0.001. With a significant reduction of 38% in radiation dose exposure (DLP: IMR-cCTA 91.7 ± 26 mGy cm vs. iDose-cCTA 148.6 ± 35 mGy cm; p value < 0.001), despite the use of different CM, we found higher mean attenuation values of the coronary arteries in IMR group compared to iDose4 (mean density in LAD: 491HU IMR-cCTA vs. 443HU iDose-cCTA; p = 0.03). We observed a significant higher value of SNR and CNR in study group due to a lower noise level. Qualitative analysis did not reveal any significant differences between the two groups (p = 0.23). CONCLUSIONS Low-dose cCTA study combined with IMR reconstruction allows to correctly evaluate coronary arteries disease, offering high-quality images and significant radiation dose exposure reduction (38%), as compared to standard cCTA protocol.
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Affiliation(s)
- Davide Ippolito
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy.
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.
| | - Luca Riva
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy
| | - Cammillo R Talei Franzesi
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy
| | - Cecilia Cangiotti
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy
| | - Andrea De Vito
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy
| | - Filiberto Di Gennaro
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Gabriele D'andrea
- Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Andrea Crespi
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy
- Department of Medical Physics, San Gerardo Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Sandro Sironi
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy
- Department of Diagnostic Radiology, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
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Svensson A, Thor D, Fischer MA, Brismar T. Dual source abdominal computed tomography: the effect of reduced X-ray tube voltage and intravenous contrast media dosage in patients with reduced renal function. Acta Radiol 2019; 60:293-300. [PMID: 29933715 DOI: 10.1177/0284185118783213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND X-ray tube voltage (kVp) reduction increases intravenous contrast medium (CM) attenuation at computed tomography (CT), but tube output limits its use in large patients. PURPOSE To evaluate the feasibility and image quality of reducing CM dose by low kVp and using dual X-ray source at liver CT. MATERIAL AND METHODS Patients with estimated glomerular filtration rate (eGFR) < 45 mL/min (n = 43) aged 60-91 years (75 ± 7.7), weighing 42-114 kg (75 ± 15) were prospectively scanned using a reduced CM dose of 0.25 or 0.3 g iodine (I)/kg with 70 or 80 kVp respectively, using either single-source or dual-source CT depending on patient size. Liver contrast-to-noise ratio (CNR), liver noise, and muscle noise were quantitatively compared with those of 43 consecutive patients aged > 65 years with eGFR > 45 mL/min scanned using a standard abdominal protocol at 120 kVp after receiving 0.5 gI/kg. RESULTS There was no statistically significant difference in CNR, liver noise, or muscle noise at reduced CM protocols compared to the standard protocol: CNR was 4.6 (95% CI = 4.2-5.0) vs. 5.0 (95% CI = 4.5-5.5), liver noise was 11.1 (95% CI = 10.7-11.6) vs. 11.0 (95% CI = 10.5-11.6), muscle noise was 11.7 (95% CI = 11.2-12.1) vs. 10.8 (95% CI = 10.1-11.4). The mean SSDE was 70% higher with the reduced CM protocol. CONCLUSION CM dosage can be reduced by 40-50% with maintained measured noise and CNR in patients with BMIs of 15-36 kg/m2 by lowering the tube voltage and dual-source CT scanning of the liver.
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Affiliation(s)
- Anders Svensson
- Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Daniel Thor
- Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm Sweden
| | - Michael A Fischer
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Torkel Brismar
- Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
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Talei Franzesi CR, Ippolito D, Riva L, Fior D, Cangiotti C, Sironi S. Diagnostic value of iterative reconstruction algorithm in low kV CT angiography (CTA) with low contrast medium volume for transcatheter aortic valve implantation (TAVI) planning: image quality and radiation dose exposure. Br J Radiol 2018; 91:20170802. [PMID: 30074831 PMCID: PMC6319841 DOI: 10.1259/bjr.20170802] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE: To evaluate image quality and radiation dose exposure of low-kV (100 kV) and low contrast medium (CM) volume CT angiography (CTA) in patients candidate to Transcatheter Aortic Valve Implantation (TAVI), in comparison with standard CTA protocol. METHODS: 79 patients candidate for TAVI were prospectively enrolled in this study and examined with 256-MDCT. 42 patients were evaluated using study-group protocol (100 kV; whole-body retrospective ECG-gating; with 50 ml of CM; iterative reconstruction algorithm) while 37 patients underwent a standard CTA study (120 kV; ECG-gating for chest; 100 ml of CM; FBP reconstruction). Overall image quality was evaluated using a 4-point scale. Vascular enhancement (HU) was then assessed in each patient by manually drawing multiple ROIs in lumen of 7 segments of the whole aorta. The radiation dose exposure of both groups was calculated and all data were compared and statistically analyzed. RESULTS: On low-kV protocol, higher mean attenuation values were achieved in all the measurements as compared to standard protocol. There were no significant differences in the image quality evaluation in both groups. Mean radiation dose value of study group was significantly lower than in control group (reduction of 20%). CONCLUSION: Low kV and low CM volume CTA protocols allow TAVI planning to be carried out with high quality images and a significant reduction in the radiation dose as compared to the standard CTA protocol. ADVANCES IN KNOWLEDGE: Low-kV CTA for pre-operative assessment of patients candidates for TAVI, permits to achieve a significant reduction of radiation dose exposure and contrast medium volume, reducing the risk of contrast induced nephropathy.
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Van Cauteren T, Van Gompel G, Nieboer KH, Willekens I, Evans P, Macholl S, Droogmans S, de Mey J, Buls N. Improved enhancement in CT angiography with reduced contrast media iodine concentrations at constant iodine dose. Sci Rep 2018; 8:17493. [PMID: 30504863 PMCID: PMC6269421 DOI: 10.1038/s41598-018-35918-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/09/2018] [Indexed: 11/09/2022] Open
Abstract
The study objective is to investigate the impact of a wide range of contrast media (CM) iodine concentrations on CT enhancement at constant total iodine dose (TID) and iodine delivery rate (IDR). Seven injection protocols, based on different iodine concentrations ranging from 120 to 370 mg I/mL, were assessed on 4 minipigs at a constant TID of 320 mg I/kg and IDR of 0.64 g I/s. Dynamic images were acquired on a clinical 64-slice MDCT scanner for 120 s with the abdominal aorta, vena cava inferior and liver parenchyma in the field-of-view. Maximal enhancement, time-to-peak and peak width were assessed. The enhancement curve characteristics were correlated with CM iodine concentration. In particular, CM with lower iodine concentrations yielded a significant increased maximal enhancement and peak width compared to the standard-of-care concentrations: e.g. in the aorta, 245 HU maximal enhancement and 9.2 s peak width with the 320 mg I/mL iodine concentration increased to 291 HU and 16.1 s with 160 mg I/mL. When maintaining a constant TID and IDR, by compensating injection rate and volume, injection of a CM with reduced iodine concentration results in a diagnostically beneficial higher maximal enhancement and longer enhancement peak duration.
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Affiliation(s)
- Toon Van Cauteren
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Gert Van Gompel
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Koenraad H Nieboer
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Inneke Willekens
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Paul Evans
- Departement of Imaging R&D, GE Healthcare Life Sciences, Amersham, Buckinghamshire, England
| | - Sven Macholl
- Departement of Imaging R&D, GE Healthcare Life Sciences, Amersham, Buckinghamshire, England
| | - Steven Droogmans
- Departement of Cardiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Johan de Mey
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Nico Buls
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
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Liu S, Sheng H, Shi H, Li W, Fan J, He J, Sun H. Computed tomography portography of patients with cirrhosis with normal body mass index: Comparison between low-tube-voltage CT with low contrast agent dose and conventional CT. Medicine (Baltimore) 2018; 97:e13141. [PMID: 30508890 PMCID: PMC6283149 DOI: 10.1097/md.0000000000013141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study is to investigate the computed tomography (CT) image quality of the low- tube-voltage protocol with low contrast agent dose.CT portography was performed in 118 cirrhosis patients with body mass index (BMI) less than 25 kg/m under 2 protocols: Protocol A, tube voltage of 90 kVp/395 mAs and contrast agent dosage of 1.2 mL/kg, and, Protocol B, tube voltage of 120 kVp/200 mAs and contrast agent dosage of 1.5 mL/kg.The number of patients in each protocol was 59. The CT value noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in portal veins was comparatively analyzed between the 2 protocols. The subjective image quality was further assessed on 5-point scales. Radiation dose was also recorded and statistical analysis was performed.The CT value, CNR, and SNR of the images were higher at 90 kVp than those at 120 kVp (P < .05). There was no significant difference in image noise between the 2 protocols (P > .05). The CT dose index volume, dose-length product, and effective dose at 90 kVp were 18.2%, 16.0%, and 16.0% less than that at 120 kVp, respectively. There was no difference in image quality score between the 2 protocols (P > .05). The average amount of contrast agent was decreased by 17.8% when the 90 kVp protocol was used.CT portography at 90 kVp combined with low-dosage contrast agent leads to a significant reduction in radiation dose and improved SNR and CNR, without deterioration of image quality.
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Affiliation(s)
- Sulan Liu
- Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University
| | - Huaqiang Sheng
- Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University
| | - Hao Shi
- Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University
| | - Wei Li
- Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University
| | - Jingli Fan
- Institute of Endemic Disease Prevention and Control of Shandong Province
| | - Jingzhen He
- Department of Radiology, Qilu Hospital Affiliated to Shandong University, Jinan, China
| | - Hongjun Sun
- Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University
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Kim SY, Cho JY, Lee J, Hwang SI, Moon MH, Lee EJ, Hong SS, Kim CK, Kim KA, Park SB, Sung DJ, Kim Y, Kim YM, Jung SI, Rha SE, Kim DW, Lee H, Shim Y, Hwang I, Woo S, Choi HJ. Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography. Korean J Radiol 2018; 19:1119-1129. [PMID: 30386143 PMCID: PMC6201985 DOI: 10.3348/kjr.2018.19.6.1119] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/07/2018] [Indexed: 01/29/2023] Open
Abstract
Objective To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. Materials and Methods This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. Results The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose (5.73 ± 4.04 vs. 8.43 ± 4.38 mSv) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ≥ 3), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. Conclusion The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.
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Affiliation(s)
- Sang Youn Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jeong Yeon Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Radiation Medicine and Kidney Research Institute, Seoul National University, Seoul 03080, Korea
| | - Joongyub Lee
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sung Il Hwang
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13621, Korea
| | - Min Hoan Moon
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea
| | - Eun Ju Lee
- Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon 16499, Korea
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Chan Kyo Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Kyeong Ah Kim
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea
| | - Deuk Jae Sung
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea
| | - Yongsoo Kim
- Department of Radiology, Hanyang University Guri Hospital, Guri 11923, Korea
| | - You Me Kim
- Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, Korea
| | - Sung Il Jung
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Dong Won Kim
- Department of Radiology, Dong-A University College of Medicine, Busan 49201, Korea
| | - Hyun Lee
- Department of Radiology, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
| | - Youngsup Shim
- Department of Radiology, Gachon University, Gil Medical Center, Incheon 21565, Korea
| | - Inpyeong Hwang
- Department of Radiology, Cheongyang-gun Health Center and County Hospital, Cheongyang 33324, Korea
| | - Sungmin Woo
- Department of Radiology, Armed Forces Daejeon Hospital, Daejeon 34059, Korea
| | - Hyuck Jae Choi
- Department of Radiology, Sheikh Khalifa Specialty Hospital, Ras al Khaimah, UAE
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Araki K, Yoshizako T, Yoshida R, Tada K, Kitagaki H. Low-voltage (80-kVp) abdominopelvic computed tomography allows 60% contrast dose reduction in patients at risk of contrast-induced nephropathy. Clin Imaging 2018; 51:352-355. [PMID: 29982133 DOI: 10.1016/j.clinimag.2018.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/16/2018] [Accepted: 05/31/2018] [Indexed: 01/29/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the quality of image in abdominopelvic late phase computed tomography (CT) with a low tube voltage plus low dose contrast medium (CM) protocol (80-kVp, 60% CM). A compared with the conventional protocol (120-kVp, 100% CM) B in the same patients. MATERIAL AND METHODS This study included with 22 patients {36 to 77 kg (mean: 55.5 kg)} who had renal insufficiency and had experience of performance conventional CT without renal insufficiency during pre-18 months. The CT value of the portal vein, liver parenchyma, abdominal aorta, psoas muscle was measured. The estimated mean CNR (contrast-to-noise ratios), FOM (figure of merit), DLP (dose length product) and ED (effective dose) were compared between protocol A and B. Moreover, two radiologists assessed the visual quality of the CT images. RESULTS The mean DLP and ED in the protocol B was about 50% lower than that in the protocol A (p < 0.01). The mean CT value of the portal vein and abdominal aorta in the protocol B were significantly higher than that in the protocol A (p < 0.01). All of the FOM in the protocol B was significantly higher than that in the protocol A (p < 0.01). However, there was no significant difference in the mean CNR and visual quality between protocol A and B. CONCLUSION Performance of abdominopelvic CT using a low tube voltage plus reduced CM dose (80-kVp, 60% CM) achieved reduction of the radiation dose without impairing image quality in relatively light weight group. CLINICAL RELEVANCE/APPLICATION In abdominopelvic CT, protocol of low tube voltage (80-kVp) plus iodine dose reduction (60%) is able to provide the same quality of traditional protocols, also able to reducing radiation exposure (50%).
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Affiliation(s)
- Kazumi Araki
- Department of Radiology, Shimane University Faculty of Medicine, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan
| | - Takeshi Yoshizako
- Department of Radiology, Shimane University Faculty of Medicine, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan.
| | - Rika Yoshida
- Department of Radiology, Shimane University Faculty of Medicine, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan
| | - Keiji Tada
- Department of Radiology, Shimane University Hospital, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan
| | - Hajime Kitagaki
- Department of Radiology, Shimane University Faculty of Medicine, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan
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Hou P, Feng X, Liu J, Wang X, Jiang Y, Dong L, Gao J. Low Tube Voltage and Iterative Model Reconstruction in Follow-up CT Angiography After Thoracic Endovascular Aortic Repair: Ultra-low Radiation Exposure and Contrast Medium Dose. Acad Radiol 2018; 25:494-501. [PMID: 29249576 DOI: 10.1016/j.acra.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/31/2017] [Accepted: 11/03/2017] [Indexed: 12/27/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to investigate the feasibility of reducing radiation exposure and contrast medium (CM) dose in follow-up computed tomography angiography (CTA) after thoracic endovascular aortic repair (TEVAR) using low tube voltage and knowledge-based iterative model reconstruction (IMR). MATERIALS AND METHODS Thirty-six patients that required follow-up CTA after TEVAR were included in this intra-individual study. The conventional protocol with standard tube voltage of 120 kVp and CM volume of 70 mL was applied in the first follow-up CTA of all the patients (control group A). The ultra-low CM dose protocol with low tube voltage of 80 kVp and weight-adapted CM volume of 0.4 mL/kg was utilized in the second follow-up CTA (study group B). Set A.FBP (group A filtered back-projection) contained images for group A that were reconstructed through FBP method. Three sets (B.FBP, B.HIR, and B.IMR) for group B were reconstructed using three methods, FBP, hybrid iterative reconstruction (HIR), and IMR, respectively. Objective measurements including aortic attenuations, image noise, contrast-to-noise ratios (CNRs), and figure of merit of CNR (FOMCNR), and subjective rating scores of the four image sets were compared. RESULTS Compared to the images in set A.FBP, the images in set B.IMR had better quality in terms of equivalent attenuation values, equivalent subjective scores, lower noise, higher or equivalent CNRs, and higher FOMCNR. The quality of images in sets B.FBP and B.HIR was unacceptable. The radiation exposure and CM dose in group B were 1.94 mGy and 28 ± 5 mL, respectively, representing reductions of 77.6% (P < .001) and 60% (P < .001) as compared to those in group A. CONCLUSIONS In follow-up examinations after TEVAR, CTA with ultra-low radiation exposure and CM dose is feasible using low tube voltage and IMR for nonobese patients.
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Affiliation(s)
- Ping Hou
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, Henan Province 450052, China
| | - Xiangnan Feng
- School of Economics and Management, Southwest Jiaotong University, Chengdu, China
| | - Jie Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, Henan Province 450052, China
| | - Xiaopeng Wang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, Henan Province 450052, China
| | - Yaojun Jiang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, Henan Province 450052, China
| | - Leigang Dong
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, Henan Province 450052, China
| | - Jianbo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, Henan Province 450052, China.
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Tan SK, Yeong CH, Raja Aman RRA, Ng KH, Abdul Aziz YF, Chee KH, Sun Z. Low tube voltage prospectively ECG-triggered coronary CT angiography: a systematic review of image quality and radiation dose. Br J Radiol 2018; 91:20170874. [PMID: 29493261 DOI: 10.1259/bjr.20170874] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study aimed (1) to perform a systematic review on scanning parameters and contrast medium (CM) reduction methods used in prospectively electrocardiography (ECG-triggered low tube voltage coronary CT angiography (CCTA), (2) to compare the achievable dose reduction and image quality and (3) to propose appropriate scanning techniques and CM administration methods. METHODS A systematic search was performed in PubMed, the Cochrane library, CINAHL, Web of Science, ScienceDirect and Scopus, where 20 studies were selected for analysis of scanning parameters and CM reduction methods. RESULTS The mean effective dose (HE) ranged from 0.31 to 2.75 mSv at 80 kVp, 0.69 to 6.29 mSv at 100 kVp and 1.53 to 10.7 mSv at 120 kVp. Radiation dose reductions of 38 to 83% at 80 kVp and 3 to 80% at 100 kVp could be achieved with preserved image quality. Similar vessel contrast enhancement to 120 kVp could be obtained by applying iodine delivery rate (IDR) of 1.35 to 1.45 g s-1 with total iodine dose (TID) of between 10.9 and 16.2 g at 80 kVp and IDR of 1.08 to 1.70 g s-1 with TID of between 18.9 and 20.9 g at 100 kVp. CONCLUSION This systematic review found that radiation doses could be reduced to a rate of 38 to 83% at 80 kVp, and 3 to 80% at 100 kVp without compromising the image quality. Advances in knowledge: The suggested appropriate scanning parameters and CM reduction methods can be used to help users in achieving diagnostic image quality with reduced radiation dose.
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Affiliation(s)
- Sock Keow Tan
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Chai Hong Yeong
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | | | - Kwan Hoong Ng
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Yang Faridah Abdul Aziz
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Kok Han Chee
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.,2 Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Zhonghua Sun
- 3 Department of Medical Radiation Sciences, Curtin University , Perth, WA , Australia
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Feng C, Zhu D, Zou X, Li A, Hu X, Li Z, Hu D. The combination of a reduction in contrast agent dose with low tube voltage and an adaptive statistical iterative reconstruction algorithm in CT enterography: Effects on image quality and radiation dose. Medicine (Baltimore) 2018; 97:e0151. [PMID: 29561422 PMCID: PMC5895339 DOI: 10.1097/md.0000000000010151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
To investigate the subjective and quantitative image quality and radiation exposure of CT enterography (CTE) examination performed at low tube voltage and low concentration of contrast agent with adaptive statistical iterative reconstruction (ASIR) algorithm, compared with conventional CTE.One hundred thirty-seven patients with suspected or proved gastrointestinal diseases underwent contrast enhanced CTE in a multidetector computed tomography (MDCT) scanner. All cases were assigned to 2 groups. Group A (n = 79) underwent CT with low tube voltage based on patient body mass index (BMI) (BMI < 23 kg/m, 80 kVp; BMI ≥ 23 kg/m, 100 kVp) and low concentration of contrast agent (270 mg I/mL), the images were reconstructed with standard filtered back projection (FBP) algorithm and 50% ASIR algorithm. Group B (n = 58) underwent conventional CTE with 120 kVp and 350 mg I/mL contrast agent, the images were reconstructed with FBP algorithm. The computed tomography dose index volume (CTDIvol), dose length product (DLP), effective dose (ED), and total iodine dosage were calculated and compared. The CT values, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of the normal bowel wall, gastrointestinal lesions, and mesenteric vessels were assessed and compared. The subjective image quality was assessed independently and blindly by 2 radiologists using a 5-point Likert scale.The differences of values for CTDIvol (8.64 ± 2.72 vs 11.55 ± 3.95, P < .001), ED (6.34 ± 2.24 vs 8.52 ± 3.02, P < .001), and DLP (422.6 ± 149.40 vs 568.30 ± 213.90, P < .001) were significant between group A and group B, with a reduction of 25.2%, 25.7%, and 25.7% in group A, respectively. The total iodine dosage in group A was reduced by 26.1%. The subjective image quality did not differ between the 2 groups (P > .05) and all image quality scores were greater than or equal to 3 (moderate). Fifty percent ASIR-A group images provided lower image noise, but similar or higher quantitative image quality in comparison with FBP-B group images.Compared with the conventional protocol, CTE performed at low tube voltage, low concentration of contrast agent with 50% ASIR algorithm produce a diagnostically acceptable image quality with a mean ED of 6.34 mSv and a total iodine dose reduction of 26.1%.
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The feasibility of low-concentration contrast and low tube voltage in computed tomography perfusion imaging: an animal study. Biosci Rep 2018; 38:BSR20170977. [PMID: 29208767 PMCID: PMC6435459 DOI: 10.1042/bsr20170977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/23/2017] [Accepted: 12/04/2017] [Indexed: 11/24/2022] Open
Abstract
Aim: To investigate the feasibility of low-concentration contrast (270 mg/ml) together with low tube voltage (80 kV) and adaptive iterative dose reduction (AIDR)-3D reconstruction in liver computed tomography (CT) perfusion imaging. Method: A total of 15 healthy New Zealand rabbits received two CT scans each. The first scan (control) was acquired at 100 kV and 100 mA with iopromide (370 mg/ml), while the second scan (experimental) was acquired at 80 kV and 100 mA with iodixanol (270 mg/ml) 24 h after the first scan. The obtained images were reconstructed with filtered back projection (FBP) and AIDR-3D in the control and experimental groups respectively. The perfusion parameters (hepatic artery perfusion [HAP], portal vein perfusion [PVP], hepatic perfusion index [HPI], and total liver perfusion [TLP]) and image quality (image quality score, average CT value of abdomen aorta, signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR], and figure of merit [FOM]) were compared using a paired t-test or Mann–Whitney U test between the two groups, when appropriate. The effective radiation dose and iodine intake were also recorded and compared. Results: With the exception of the FOM criteria, the image quality and perfusion parameters were not significantly different between the two groups. The effective radiation dose and iodine intake were 38.79% and 27.03% lower respectively, in the experimental group. Conclusion: Low-concentration contrast (iodixanol, 270 mg/ml) together with low tube voltage (80 kV) and AIDR-3D reconstruction help to reduce radiation dose and iodine intake without compromising perfusion parameters and image quality in liver CT perfusion imaging.
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