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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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Deak Z, Schuettoff L, Lohse AK, Fabritius M, Reidler P, Forbrig R, Kunz W, Dimitriadis K, Ricke J, Sabel B. Reduction in Radiation Exposure of CT Perfusion by Optimized Imaging Timing Using Temporal Information of the Preceding CT Angiography of the Carotid Artery in the Stroke Protocol. Diagnostics (Basel) 2022; 12:diagnostics12112853. [PMID: 36428913 PMCID: PMC9689781 DOI: 10.3390/diagnostics12112853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/05/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
(1) Background: CT perfusion (CTP) is a fast, robust and widely available but dose-exposing imaging technique for infarct core and penumbra detection. Carotid CT angiography (CTA) can precede CTP in the stroke protocol. Temporal information of the bolus tracking series of CTA could allow for better timing and a decreased number of scans in CTP, resulting in less radiation exposure, if the shortening of CTP does not alter the calculated infarct core and penumbra or the resulting perfusion maps, which are essential for further treatment decisions. (2) Methods: 66 consecutive patients with ischemic stroke proven by follow-up imaging or endovascular intervention were included in this retrospective study approved by the local ethics committee. In each case, six simulated, stepwise shortened CTP examinations were compared with the original data regarding the perfusion maps, infarct core, penumbra and endovascular treatment decision. (3) Results: In simulated CTPs with 26, 28 and 30 scans, the infarct core, penumbra and PRR values were equivalent, and the resulting clinical decision was identical to the original CTP. (4) Conclusions: The temporal information of the bolus tracking series of the carotid CTA can allow for better timing and a lower radiation exposure by eliminating unnecessary scans in CTP.
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Affiliation(s)
- Zsuzsanna Deak
- Imaging Urania, Laurenzerberg 2, 1010 Vienna, Austria
- Correspondence:
| | - Lara Schuettoff
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Ann-Kathrin Lohse
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Matthias Fabritius
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Paul Reidler
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Robert Forbrig
- Department of Neuroradiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Wolfgang Kunz
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Konstantin Dimitriadis
- Department of Neurology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Bastian Sabel
- Department of Radiology, University Hospital of Munich (LMU), Marchioninistr. 15, 81377 Munich, Germany
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Lenfant M, Comby PO, Guillen K, Galissot F, Haioun K, Thay A, Chevallier O, Ricolfi F, Loffroy R. Deep Learning-Based Reconstruction vs. Iterative Reconstruction for Quality of Low-Dose Head-and-Neck CT Angiography with Different Tube-Voltage Protocols in Emergency-Department Patients. Diagnostics (Basel) 2022; 12:1287. [PMID: 35626442 PMCID: PMC9142122 DOI: 10.3390/diagnostics12051287] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: To compare the image quality of computed tomography angiography of the supra-aortic arteries (CTSA) at different tube voltages in low doses settings with deep learning-based image reconstruction (DLR) vs. hybrid iterative reconstruction (H-IR). Methods: We retrospectively reviewed 102 patients who underwent CTSA systematically reconstructed with both DLR and H-IR. We assessed the image quality both quantitatively and qualitatively at 11 arterial segmental levels and 3 regional levels. Radiation-dose parameters were recorded and the effective dose was calculated. Eighty-six patients were eligible for analysis Of these patients, 27 were imaged with 120 kVp, 30 with 100 kVp, and 29 with 80 kVp. Results: The effective dose in 120 kVp, 100 kVp and 80 kVp was 1.5 ± 0.4 mSv, 1.1 ± 0.3 mSv and 0.68 ± 0.1 mSv, respectively (p < 0.01). Comparing 80 kVp + DLR vs. 120 and 100 kVp + H-IR CT scans, the mean overall arterial attenuation was about 64% and 34% higher (625.9 ± 118.5 HU vs. 382.3 ± 98.6 HU and 468 ± 118.5 HU; p < 0.01) without a significant difference in terms of image noise (17.7 ± 4.9 HU vs. 17.5 ± 5.2; p = 0.7 and 18.1 ± 5.4; p = 0.3) and signal-to-ratio increased by 59% and 33%, respectively (37.9 ± 12.3 vs. 23.8 ± 9.7 and 28.4 ± 12.5). This protocol also provided superior image quality in terms of qualitative parameters, compared to standard-kVp protocols with H-IR. Highest subjective image-quality grades for vascular segments close to the aorta were obtained with the 100 kVp + DLR protocol. Conclusions: DLR significantly reduced image noise and improved the overall image quality of CTSA with both low and standard tube voltages and at all vascular segments. CT that was acquired with 80 kVp and reconstructed with DLR yielded better overall image quality compared to higher kVp values with H-IR, while reducing the radiation dose by half, but it has limitations for arteries that are close to the aortic arch.
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Affiliation(s)
- Marc Lenfant
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue 7 Paul Gaffarel, BP 77908, 21079 Dijon, France; (M.L.); (P.-O.C.); (F.G.); (F.R.)
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 10 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
| | - Pierre-Olivier Comby
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue 7 Paul Gaffarel, BP 77908, 21079 Dijon, France; (M.L.); (P.-O.C.); (F.G.); (F.R.)
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 10 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
| | - Kevin Guillen
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 10 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand 13 University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France
| | - Felix Galissot
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue 7 Paul Gaffarel, BP 77908, 21079 Dijon, France; (M.L.); (P.-O.C.); (F.G.); (F.R.)
| | - Karim Haioun
- Computed Tomography Division, Canon Medical Systems France, 24 Quai Gallieni, 92150 Suresnes, France; (K.H.); (A.T.)
| | - Anthony Thay
- Computed Tomography Division, Canon Medical Systems France, 24 Quai Gallieni, 92150 Suresnes, France; (K.H.); (A.T.)
| | - Olivier Chevallier
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 10 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand 13 University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France
| | - Frédéric Ricolfi
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue 7 Paul Gaffarel, BP 77908, 21079 Dijon, France; (M.L.); (P.-O.C.); (F.G.); (F.R.)
| | - Romaric Loffroy
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 10 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand 13 University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France
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