Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Chen CM, Chu SY, Hsu MY, Liao YL, Tsai HY. Low-tube-voltage (80 kVp) CT aortography using 320-row volume CT with adaptive iterative reconstruction: lower contrast medium and radiation dose. Eur Radiol 2013;24:460-8. [PMID: 24081645 DOI: 10.1007/s00330-013-3027-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 08/14/2013] [Accepted: 09/08/2013] [Indexed: 01/03/2023]

For:	Chen CM, Chu SY, Hsu MY, Liao YL, Tsai HY. Low-tube-voltage (80 kVp) CT aortography using 320-row volume CT with adaptive iterative reconstruction: lower contrast medium and radiation dose. Eur Radiol 2013;24:460-8. [PMID: 24081645 DOI: 10.1007/s00330-013-3027-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 08/14/2013] [Accepted: 09/08/2013] [Indexed: 01/03/2023]

Number

Cited by Other Article(s)

Borkowski P, Ng E, Vicaretti M, Young N. Use of ultra-low contrast dose CT aortography for the management of aortic aneurysmal disease. J Cardiothorac Surg 2024;19:582. [PMID: 39358757 PMCID: PMC11448089 DOI: 10.1186/s13019-024-03099-7] [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: 04/18/2023] [Accepted: 09/15/2024] [Indexed: 10/04/2024] Open

Abstract

PURPOSE

Computed tomography aortography (CTA) is used in the assessment of aortic pathologies and planning of surgical intervention. However, its dependence on iodinated contrast can result in development of contrast-induced acute kidney injury (CI-AKI). The potential concern of CI-AKI has spurred research into the potential of administration of low contrast volumes in CTA investigations while maintaining overall diagnostic appeal. Several studies have shown that CTA using contrast volumes as low as 30 mL (equivalent to 10.5 g of iodine) can still yield scans of diagnostic quality. We present a retrospective pilot study to evaluate the feasibility of utilising an ultra-low volume of iodinated intravenous contrast in a population of patients with severe renal insufficiency with referral from our vascular surgery unit for CTA evaluation of the thoracic and abdominal aorta.

METHODS

This retrospective pilot study examined 12 CTA scans performed with 20 mLs of iodinated contrast and assessed image quality with both quantitative and qualitative markers. All scans were performed on a Siemens SOMATOM Force dual-source CT scanner. Quantitative assessment values were measured via attenuation values at eight aortoiliac locations and used to calculate a signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) at each location. Qualitative analysis of image quality and viability for surgical intervention was obtained from subjective clinical assessment by an interventional radiologist and vascular surgeon.

RESULTS

Obtained quantitative assessment values included mean attenuation 189.9 HU, mean SNR 9.6 and mean CNR 8.0. All 12 scans demonstrated individual mean SNR values above predetermined quality thresholds while only five scans produced individual mean CNR values above threshold. Eleven of 12 scans were determined to be of sufficient quality for diagnosis and planning of surgical intervention.

CONCLUSIONS

Our results suggest that CTA utilising an ultra-low contrast dose of 20 mLs (6 g iodine) yields scans of diagnostic quality for therapeutic decision-making in vascular surgical intervention.

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Kazimierczak W, Kazimierczak N, Wilamowska J, Wojtowicz O, Nowak E, Serafin Z. Enhanced visualization in endoleak detection through iterative and AI-noise optimized spectral reconstructions. Sci Rep 2024;14:3845. [PMID: 38360941 PMCID: PMC10869818 DOI: 10.1038/s41598-024-54502-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/13/2024] [Indexed: 02/17/2024] Open

Skoog S, Sandborg M, Henriksson L, Sandstedt M, Gustafsson H, Persson A. A prospective study comparing the quality of coronary computed tomography angiography images from photon counting and energy integrating detector systems. Acta Radiol 2023;64:2957-2966. [PMID: 37735891 DOI: 10.1177/02841851231199384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]

Kazimierczak W, Nowak E, Kazimierczak N, Jankowski T, Jankowska A, Serafin Z. The value of metal artifact reduction and iterative algorithms in dual energy CT angiography in patients after complex endovascular aortic aneurysm repair. Heliyon 2023;9:e20700. [PMID: 37876478 PMCID: PMC10590777 DOI: 10.1016/j.heliyon.2023.e20700] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open

Abstract

Rationale and objectives

Evaluation of the diagnostic value of linearly blended (LB) and virtual monoenergetic images (VMI) reconstruction techniques with and without metal artifacts reduction (MAR) and of adaptive statistical iterative reconstructions (ASIR) in the assessment of target vessels after branched/fenestrated endovascular aortic repair (f/brEVAR) procedures.

Materials and methods

CT scans of 28 patients were used in this study. Arterial phase of examination was obtained using a dual-energy fast-kVp switching scanner. CT numbers in the aorta, celiac trunk, superior mesenteric artery, and renal arteries were measured in the following reconstructions: LB, VMI 60 keV, VMI MAR 60 keV, VMI ASIR 60 % 60 keV. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were calculated for each reconstruction. Luminal diameters (measurements at 2 levels of stent) and subjective image quality (5-point Likert scale) were assessed (2 readers, blinded to the type of reconstruction).

Results

The highest mean values of CNR and SNR in vascular structures were obtained in VMI MAR 60 keV (CNR 12.526 ± 2.46, SNR 17.398 ± 2.52), lower in VMI 60 keV (CNR 11.508 ± 2.01, SNR 16.524 ± 2.07) and VMI ASIR (CNR 11.086 ± 1.78, SNR 15.928 ± 1.82), and the lowest in LB (CNR 6.808 ± 0.79, SNR 11.492 ± 0.79) reconstructions. There were no statistically significant differences in the measurements of the stent width between reconstructions (p > 0.05). The highest subjective image quality was obtained in the ASIR VMI (4.25 ± 0.44) and the lowest in the MAR VMI (1.57 ± 0.5) reconstruction.

Conclusion

Despite obtaining the highest values of SNR and CNR in the MAR VMI reconstruction, the subjective diagnostic value was the lowest for this technique due to significant artifacts. The type of reconstruction did not significantly affect vessel diameter measurements (p > 0.05). Iterative reconstructions raised both objective and subjective image quality.

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Higashigaito K, Mergen V, Eberhard M, Jungblut L, Hebeisen M, Rätzer S, Zanini B, Kobe A, Martini K, Euler A, Alkadhi H. CT Angiography of the Aorta Using Photon-counting Detector CT with Reduced Contrast Media Volume. Radiol Cardiothorac Imaging 2023;5:e220140. [PMID: 36860835 PMCID: PMC9969214 DOI: 10.1148/ryct.220140] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/04/2022] [Accepted: 12/14/2022] [Indexed: 01/27/2023]

Abstract

Purpose

To develop and evaluate a low-volume contrast media protocol for thoracoabdominal CT angiography (CTA) with photon-counting detector (PCD) CT.

Materials and Methods

This prospective study included consecutive participants (April-September 2021) who underwent CTA with PCD CT of the thoracoabdominal aorta and previous CTA with energy-integrating detector (EID) CT at equal radiation doses. In PCD CT, virtual monoenergetic images (VMI) were reconstructed in 5-keV intervals from 40 to 60 keV. Attenuation of the aorta, image noise, and contrast-to-noise ratio (CNR) were measured, and subjective image quality was rated by two independent readers. In the first group of participants, the same contrast media protocol was used for both scans. CNR gain in PCD CT compared with EID CT served as the reference for contrast media volume reduction in the second group. Noninferiority analysis was used to test noninferior image quality of the low-volume contrast media protocol with PCD CT.

Results

The study included 100 participants (mean age, 75 years ± 8 [SD]; 83 men). In the first group (n = 40), VMI at 50 keV provided the best trade-off between objective and subjective image quality, achieving 25% higher CNR compared with EID CT. Contrast media volume in the second group (n = 60) was reduced by 25% (52.5 mL). Mean differences in CNR and subjective image quality between EID CT and PCD CT at 50 keV were above the predefined boundaries of noninferiority (-0.54 [95% CI: -1.71, 0.62] and -0.36 [95% CI: -0.41, -0.31], respectively).

Conclusion

CTA of the aorta with PCD CT was associated with higher CNR, which was translated into a low-volume contrast media protocol demonstrating noninferior image quality compared with EID CT at the same radiation dose.Keywords: CT Angiography, CT-Spectral, Vascular, Aorta, Contrast Agents-Intravenous, Technology Assessment© RSNA, 2023See also the commentary by Dundas and Leipsic in this issue.

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Affiliation(s)

Kai Higashigaito From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Victor Mergen From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Matthias Eberhard From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Lisa Jungblut From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Monika Hebeisen From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Susan Rätzer From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Bettina Zanini From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Adrian Kobe From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Katharina Martini From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
André Euler From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
Hatem Alkadhi From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)

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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: 2.5] [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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Sharara SM, Monnin SR, Rubio M, Khouzam RN, Ragheb SR. Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain? Curr Probl Cardiol 2021;46:100766. [PMID: 33385751 DOI: 10.1016/j.cpcardiol.2020.100766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]

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: 30] [Impact Index Per Article: 6.0] [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
Masaru Horio Kansai Medical Hospital, Osaka, 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
Atsushi Hirayama Department of Cardiology, Osaka Police Hospital, Osaka, 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
Takamasa Miyauchi Cedars Sinai Medical Hospital, Los Angeles, CA, USA
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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Optimization of Pediatric Body CT Angiography: What Radiologists Need to Know. AJR Am J Roentgenol 2020;215:726-735. [PMID: 32755200 DOI: 10.2214/ajr.19.22273] [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: 12/17/2022]

Rajiah P. Updates in Vascular Computed Tomography. Radiol Clin North Am 2020;58:671-691. [PMID: 32471537 DOI: 10.1016/j.rcl.2020.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]

Horinouchi H, Sofue K, Nishii T, Maruyama K, Sasaki K, Gentsu T, Ueshima E, Okada T, Yamaguchi M, Sugimoto K, Murakami T. CT angiography with 15 mL contrast material injection on time-resolved imaging for endovascular abdominal aortic aneurysm repair. Eur J Radiol 2020;126:108861. [PMID: 32179423 DOI: 10.1016/j.ejrad.2020.108861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/30/2019] [Accepted: 01/29/2020] [Indexed: 10/25/2022]

Jin L, Gao Y, Shan Y, Sun Y, Li M, Wang Z. Qualitative and quantitative image analysis of 16 cm wide-coverage computed tomography compared to new-generation dual-source CT. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2020;28:527-539. [PMID: 32333574 DOI: 10.3233/xst-190624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]

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: 0.2] [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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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: 9] [Impact Index Per Article: 1.5] [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
Takamasa Miyauchi Japanese Society of Nephrology.,Cedars Sinai Medical Hospital
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: 10] [Impact Index Per Article: 1.7] [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
Masaru Horio Kansai Medical Hospital, Osaka, 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
Atsushi Hirayama Department of Cardiology, Osaka Police Hospital, Osaka, 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
Takamasa Miyauchi Cedars Sinai Medical Hospital, Los Angeles, CA, USA
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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Contrast Enhancement Boost Technique at Aortic Computed Tomography Angiography: Added Value for the Evaluation of Type II Endoleaks After Endovascular Aortic Aneurysm Repair. Acad Radiol 2019;26:1435-1440. [PMID: 30709736 DOI: 10.1016/j.acra.2019.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 11/20/2022]

Application of Artificial Intelligence–based Image Optimization for Computed Tomography Angiography of the Aorta With Low Tube Voltage and Reduced Contrast Medium Volume. J Thorac Imaging 2019;34:393-399. [DOI: 10.1097/rti.0000000000000438] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]

Contrast Volume for Preoperative CT Angiography of the Aorta Based on Patient Heart Rate and Body Surface Area: A Pilot Study. J Belg Soc Radiol 2019;103:57. [PMID: 31646268 PMCID: PMC6777198 DOI: 10.5334/jbsr.1714] [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] [Indexed: 11/20/2022] Open

Du X, Lu B, Hu D, Song B, Li K. An open label, prospective, multicenter, non-interventional study of iodixanol 270 mg I/mL for use in individuals undergoing computed tomography angiography in real-world clinical practice. Acta Radiol 2019;60:177-185. [PMID: 29886757 DOI: 10.1177/0284185118774917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]

Payton P, Eter A. Periprocedural Concerns in the Patient with Renal Disease. Clin Podiatr Med Surg 2019;36:59-82. [PMID: 30446045 DOI: 10.1016/j.cpm.2018.08.003] [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: 11/26/2022]

Son BG, Kim MJ, Park MH, Kim K, Kim J, Kim SY, Lee KJ, Choi SH, Kim AY, Park SH. Two Small Intravenous Catheters for High-Rate Contrast Medium Injection for Computed Tomography in Patients Lacking Superficial Veins to Accommodate a Large Catheter. Korean J Radiol 2018;19:489-497. [PMID: 29713227 PMCID: PMC5904476 DOI: 10.3348/kjr.2018.19.3.489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/30/2017] [Indexed: 01/29/2023] Open

Impact of Contrast Media Concentration on Low-Kilovolt Computed Tomography Angiography. Invest Radiol 2018;53:264-270. [DOI: 10.1097/rli.0000000000000437] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]

Yin XP, Gao BL, Li CY, Zuo ZW, Xu YJ, Wang JN, Liu HJ, Liang GL. Automatic spectral imaging protocol selection combined with iterative reconstruction can enhance image quality and decrease radiation and contrast dosage in abdominal CT angiography. Jpn J Radiol 2018;36:345-350. [PMID: 29616398 DOI: 10.1007/s11604-018-0734-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/28/2018] [Indexed: 10/17/2022]

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: 12] [Impact Index Per Article: 1.7] [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 (FOM_CNR), 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 FOM_CNR. 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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"Pulmonary embolism diagnostics of pregnant patients: What is the recommended clinical pathway considering the clinical value and associated radiation risks of available imaging tests?". Phys Med 2017;43:178-185. [PMID: 28760505 DOI: 10.1016/j.ejmp.2017.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/13/2017] [Accepted: 07/22/2017] [Indexed: 11/20/2022] Open

Hou P, Feng X, Liu J, Zhou Y, Jiang Y, Jiang X, Gao J. Iterative reconstruction in single-source dual-energy CT angiography: feasibility of low and ultra-low volume contrast medium protocols. Br J Radiol 2017;90:20160506. [PMID: 28555508 DOI: 10.1259/bjr.20160506] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open

Ozkok S, Ozkok A. Contrast-induced acute kidney injury: A review of practical points. World J Nephrol 2017;6:86-99. [PMID: 28540198 PMCID: PMC5424439 DOI: 10.5527/wjn.v6.i3.86] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/21/2017] [Accepted: 04/19/2017] [Indexed: 02/06/2023] Open

Lin SY, Lyu SY, Su TW, Chu SY, Chen CM, Hung CF, Chang CJ, Ko PJ. Predictive Factors for Additional ProGlide Deployment in Percutaneous Endovascular Aortic Repair. J Vasc Interv Radiol 2017;28:570-575. [DOI: 10.1016/j.jvir.2016.12.1219] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 12/06/2016] [Accepted: 12/19/2016] [Indexed: 12/17/2022] Open

Prospective ECG-triggering cardiac CT for infants with complex congenital heart disease using low-dose contrast medium, low tube voltage, and adaptive statistical iterative reconstruction. Clin Radiol 2017;72:502-507. [PMID: 28267987 DOI: 10.1016/j.crad.2017.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 01/04/2017] [Accepted: 01/30/2017] [Indexed: 11/21/2022]

Abstract

AIM

To demonstrate the clinical value of prospective electrocardiography (ECG)-triggered cardiac computed tomography (CT) with low concentration contrast medium, low tube voltage, and adaptive statistic iterative reconstruction (ASIR) to reduce both radiation and contrast dose in examining infants with complex congenital heart disease (CHD).

MATERIALS AND METHODS

Forty-four consecutive infants (19 male, 25 female, age: 8.06±4.33 months, weight: 7.31±1.36 kg) with complex CHD underwent prospective ECG-triggered low-dose cardiac CT using 80 kVp and 120 mA. The contrast agent was iodixanol (270 mg iodine/ml, Visipaque, GE Healthcare, Co. Cork, Ireland). Cardiac CT images were reconstructed with 70% ASIR. The quantitative CT image quality was assessed by image noise in adipose tissue and contrast-to-noise ratio (CNR) in the aorta. The qualitative image analysis was performed on a five-point grading scale by two independent reviewers and interobserver variability was calculated. The results of 32 CT examinations were also compared with the available surgical results for diagnostic accuracy evaluation.

RESULTS

The effective dose was 0.55±0.10 mSv for the patient population. The iodine load was 3.95±0.73 g iodine. Image noise in adipose tissue was 16.24±1.42 HU and CNR in aorta was 21.90±7.10. All images were acceptable for diagnosis with an average score of 4.52±0.38 and good agreement between reviewers (kappa=0.75). Compared to the surgery results in 32 cases, CT was 97% and 88% accurate diagnosing extracardiac and intracardiac defects, respectively.

CONCLUSION

Prospective ECG-triggered cardiac CT using 80 kVp, low-concentration iodinated contrast agent (270 mg iodine/ml) and 70% ASIR reconstruction provides excellent image quality and accurate diagnosis for complex congenital heart disease in infants with reduced contrast medium dose and low radiation dose.

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Shen Y, Hu X, Zou X, Zhu D, Li Z, Hu D. Did low tube voltage CT combined with low contrast media burden protocols accomplish the goal of "double low" for patients? An overview of applications in vessels and abdominal parenchymal organs over the past 5 years. Int J Clin Pract 2016;70 Suppl 9B:B5-B15. [PMID: 27577514 DOI: 10.1111/ijcp.12861] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 06/15/2016] [Indexed: 01/29/2023] Open

Abstract

BACKGROUND

Imaging communities have already reached a consensus that the radiation dose of computed tomography (CT) should be reduced as much as reasonably achievable to lower population risks. Increasing attention is being paid to iodinated contrast media (CM) induced nephrotoxicity (CIN); a decrease in the intake of iodinated CM is required by increasingly more radiologists. Theoretically, the radiation dose varies with the tube current time and square of the tube voltage, with higher iodine contrast at low photon energies (Huda et al. [2000] Radiology, 21 7, 430-435).The use of low tube voltage is a promising strategy to reduce both the radiation dose and CM burden. The term 'double low' has been coined to describe scanning protocols that reduce radiation dose and iodine intake synchronously. These protocols are becoming increasingly popular in the clinical setting.

PURPOSE

The aim of this review was to describe all original studies using the 'double low' strategy in the last 5 years.

METHODS

We searched an online electronic database (PubMed) from January 2011 to December 2015 for original studies published on the relationship of low tube voltage with low radiation dose and low iodine contrast media burden in patients undergoing CT scans. Studies that failed to reduce radiation dose or iodine CM burden were excluded in this study.

RESULTS

Thirty-seven studies aimed at reducing radiation dose using low tube voltage combined with iodine CM reduced protocols were included in this study. Most studies evaluated conditions associated with arteries. Four were cerebral and neck computed tomography angiography (CTA) studies, 15 were pulmonary CTA (pCTA) and coronary CTA (cCTA) studies, one concerned myocardial perfusion, five studies focused on the thoracic and abdominal aorta, and one investigated renal arteries. Three studies consisted of CT venography (CTV) of the pelvis and lower extremities. Six publications examined the liver, and two focused on the kidney.

CONCLUSION

Overall, this review demonstrates that the low tube voltage CT protocol is a powerful tool to reduce the radiation dose in CTA, especially with pCTA and cCTA.

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Wang X, Zhong Y, Hu L, Xue L, Shi M, Qiu H, Li J. A prospective evaluation of the contrast, radiation dose and image quality of contrast-enhanced CT scans of paediatric abdomens using a low-concentration iodinated contrast agent and low tube voltage combined with 70% ASIR algorithm. Int J Clin Pract 2016;70 Suppl 9B:B16-21. [PMID: 27577509 DOI: 10.1111/ijcp.12853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 06/15/2016] [Indexed: 10/21/2022] Open

Abstract

PURPOSE

To quantitatively and subjectively assess the image quality of and radiation dose for an abdominal enhanced computed tomography (CT) scan with a low tube voltage and a low concentration of iodinated contrast agent in children.

METHODS

Forty-eight patients were randomised to one of the two following protocols: Group A (n=24, mean age 46.96±44.65 months, mean weight 15.71±9.11 kg, BMI 16.48±2.40 kg/m(2) ) and Group B (n=24, mean age 41.33±44.59 months, mean weight 18.15±17.67 kg, BMI 17.50±3.73 kg/m(2) ). Group A: 80 kVp tube voltage, 270 mg iodine (I)/mL contrast agent (Visipaque, GE Healthcare) and images were reconstructed using 70% adaptive statistical iterative reconstruction (ASIR). Group B: 100 kVp tube voltage, 370 mg I/mL contrast agent (Iopamiro, Bracco) and images were reconstructed using 50% ASIR. The volume of the contrast agent was 1.30 mL/kg in both Groups A and B. The degree of enhancement and noise in the abdominal aorta (AO) in the arterial phase (AP) and the portal vein (PV) in the portal venous phase (PVP) was measured; while the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for the AO and PV were calculated. A 5-point scale was used to subjectively evaluate the image quality and image noise by two radiologists with more than 10 years of experience. Dose-length product (DLP) (mGy-cm) and CTDIvol (mGy) were calculated. Objective measurements and subjective quality scores for the two groups were compared using paired t-tests and Mann-Whitney U tests, respectively.

RESULTS

There was no significant difference in age, weight or body mass index (BMI) between the two groups (all P>.5). The iodine load in Group A (5517.3±3197.2 mg I) was 37% lower than that in Group B (8772.1±8474.6 mg I), although there was no significant difference between them (P=.111). The DLP and the CT dose index (CTDIvol ) for Group A were also lower than for Group B, but were not statistically significantly different (DLP, 104 mGy-cm±45.81 vs 224.5 mGy-cm±45.83; CTDIvol, 1.44 mGy±0.50 vs 2.08 mGy±1.87, all P>.05). The mean arterial and portal venous enhancement (255.33 HU±83.42, 146.41 HU±23.45, respectively), noise (AP 14.96 HU±2.09, PVP 16.30 HU±3.21), CNRs (AO 14.54±7.12, PV 5.07±1.73) and SNRs (AO 20.76±6.76, PV 12.43±3.24) for Group A were similar to Group B (enhancement: 226.55 HU±77.71, 138.69 HU±33.22; noise: 14.92 HU±3.12, 15.36 HU±3.48; CNRs: 12.96±7.14, 5.16±2.28; SNRs: 19.13±7.30, 12.69±4.22; all P>.05). The mean scores of the quality of the AP and PVP images in Group B were 4.31±0.53 and 4.35±0.52, respectively, while the scores obtained in Group A were 4.29±0.51 and 4.25±0.51; there were no statistically significant differences between the two groups.

CONCLUSION

The scanning protocol using a low tube voltage (80 kVp) together with 70% ASIR and a low-concentration iodinated contrast agent (270 mg I/mL) enables a 37% reduction in iodine load and a 30% reduction in radiation dose while maintaining compatible image quality.

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Performance of adaptive iterative dose reduction 3D integrated with automatic tube current modulation in radiation dose and image noise reduction compared with filtered-back projection for 80-kVp abdominal CT: Anthropomorphic phantom and patient study. Eur J Radiol 2016;85:1666-72. [DOI: 10.1016/j.ejrad.2016.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/04/2016] [Accepted: 07/11/2016] [Indexed: 01/16/2023]

Low contrast medium-volume third-generation dual-source computed tomography angiography for transcatheter aortic valve replacement planning. Eur Radiol 2016;27:1944-1953. [PMID: 27553939 DOI: 10.1007/s00330-016-4537-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 06/13/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]

Abstract

PURPOSE

To investigate feasibility, image quality and safety of low-tube-voltage, low-contrast-volume comprehensive cardiac and aortoiliac CT angiography (CTA) for planning transcatheter aortic valve replacement (TAVR).

MATERIALS AND METHODS

Forty consecutive TAVR candidates prospectively underwent combined CTA of the aortic root and vascular access route (270 mgI/ml iodixanol). Patients were assigned to group A (second-generation dual-source CT [DSCT], 100 kV, 60 ml contrast, 4.0 ml/s flow rate) or group B (third-generation DSCT, 70 kV, 40 ml contrast, 2.5 ml/s flow rate). Vascular attenuation, noise, signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were compared. Subjective image quality was assessed by two observers. Estimated glomerular filtration (eGFR) at CTA and follow-up were measured.

RESULTS

Besides a higher body-mass-index in group B (24.8±3.8 kg/m² vs. 28.1±5.4 kg/m², P=0.0339), patient characteristics between groups were similar (P≥0.0922). Aortoiliac SNR (P=0.0003) was higher in group B. Cardiac SNR (P=0.0003) and CNR (P=0.0181) were higher in group A. Subjective image quality was similar (P≥0.213) except for aortoiliac image noise (4.42 vs. 4.12, P=0.0374). TAVR-planning measurements were successfully obtained in all patients. There were no significant changes in eGFR among and between groups during follow-up (P≥0.302).

CONCLUSION

TAVR candidates can be safely and effectively evaluated by a comprehensive CTA protocol with low contrast volume using low-tube-voltage acquisition.

KEY POINTS

• Third-generation dual-source CT facilitates low-tube-voltage acquisition. • TAVR planning can be performed with reduced contrast volume and radiation dose. • TAVR-planning CT did not result in changes in creatinine levels at follow-up. • TAVR candidates can be safely evaluated by comprehensive low-tube-voltage CT angiography.

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Using 80 kVp on a 320-row scanner for hepatic multiphasic CT reduces the contrast dose by 50 % in patients at risk for contrast-induced nephropathy. Eur Radiol 2016;27:812-820. [PMID: 27240454 DOI: 10.1007/s00330-016-4435-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/17/2016] [Accepted: 05/20/2016] [Indexed: 12/13/2022]

Shuman WP, Chan KT, Busey JM, Mitsumori LM, Koprowicz KM. Dual-energy CT Aortography with 50% Reduced Iodine Dose Versus Single-energy CT Aortography with Standard Iodine Dose. Acad Radiol 2016;23:611-8. [PMID: 26897602 DOI: 10.1016/j.acra.2015.12.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/15/2015] [Accepted: 12/21/2015] [Indexed: 12/23/2022]

Lv P, Liu J, Chai Y, Yan X, Gao J, Dong J. Automatic spectral imaging protocol selection and iterative reconstruction in abdominal CT with reduced contrast agent dose: initial experience. Eur Radiol 2016;27:374-383. [PMID: 27097790 DOI: 10.1007/s00330-016-4349-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/21/2016] [Accepted: 03/29/2016] [Indexed: 01/10/2023]

Kok M, de Haan MW, Mihl C, Eijsvoogel NG, Hendriks BM, Sailer AM, Derks K, Schnerr RS, Schurink GWH, Wildberger JE, Das M. Individualized CT Angiography Protocols for the Evaluation of the Aorta: A Feasibility Study. J Vasc Interv Radiol 2016;27:531-8. [DOI: 10.1016/j.jvir.2016.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/02/2016] [Accepted: 01/02/2016] [Indexed: 01/16/2023] Open

Boos J, Kröpil P, Lanzman RS, Aissa J, Schleich C, Heusch P, Sawicki LM, Antoch G, Thomas C. CT pulmonary angiography: simultaneous low-pitch dual-source acquisition mode with 70 kVp and 40 ml of contrast medium and comparison with high-pitch spiral dual-source acquisition with automated tube potential selection. Br J Radiol 2016;89:20151059. [PMID: 27007972 DOI: 10.1259/bjr.20151059] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open

Abstract

OBJECTIVE

To assess the feasibility of a 70-kVp CT pulmonary angiography (CTPA) protocol using simultaneous dual-source (SimDS) acquisition mode with 40 ml of contrast medium (CM) and comparison with a high-pitch spiral dual-source (SpiralDS) acquisition protocol with automated tube potential selection (ATPS).

METHODS

Following the introduction of a new 70-kVp/40-ml SimDS-CTPA protocol in December 2014 for all patients with a body mass index (BMI) below 35 kg m(-2), the first 35 patients were retrospectively included in this study and assigned to Group A (BMI: 27 ± 4 kg m(-2), age: 66 ± 15 years). The last 35 patients with a BMI below 35 kg m(-2) who had received SpiralDS-CTPA with ATPS were included for comparison (Group B) (70 ml CM; BMI: 27 ± 4 kg m(-2), age: 68 ± 16 years). Subjective image quality (image quality) was assessed by two radiologists (from 1, non-diagnostic, to 4, excellent). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), volumetric CT dose index (CTDIvol), dose-length product (DLP) and effective dose were assessed.

RESULTS

All examinations were of diagnostic image quality. Subjective image quality, SNR and CNR were comparable between Groups A and B (3.7 ± 0.6 vs 3.7 ± 0.5, 14.6 ± 6.0 vs 13.9 ± 3.7 and 12.4 ± 5.7 vs 11.6 ± 3.3, respectively; p > 0.05). CTDIvol, DLP and effective dose were significantly lower in Group A than in Group B (4.5 ± 1.6 vs 7.5 ± 2.1 mGy, 143.3 ± 44.8 vs 278.3 ± 79.44 mGy cm and 2.0 ± 0.6 vs 3.9 ± 1.1 mSv, respectively; p < 0.05).

CONCLUSION

70-kVp SimDS-CTPA with 40 ml of CM is feasible and provides diagnostic image quality, while radiation dose and CM can be reduced by almost 50% and 40%, respectively, compared with a SpiralDS-CTPA protocol with ATPS.

ADVANCES IN KNOWLEDGE

70-kVp SimDS-CTPA with 40 ml of CM is feasible in patients with a BMI up to 35 kg m(-2) and can help reduce radiation exposure and CM in these patients.

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Boos J, Aissa J, Lanzman RS, Heusch P, Schimmöller L, Schleich C, Thomas C, Antoch G, Kröpil P. CT angiography of the aorta using 80 kVp in combination with sinogram-affirmed iterative reconstruction and automated tube current modulation: Effects on image quality and radiation dose. J Med Imaging Radiat Oncol 2016;60:187-93. [DOI: 10.1111/1754-9485.12425] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 11/04/2015] [Indexed: 01/16/2023]

Shimonobo T, Funama Y, Utsunomiya D, Nakaura T, Oda S, Kiguchi M, Masuda T, Sakabe D, Yamashita Y, Awai K. Low-tube-voltage selection for non-contrast-enhanced CT: Comparison of the radiation dose in pediatric and adult phantoms. Phys Med 2016;32:197-201. [DOI: 10.1016/j.ejmp.2015.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 11/30/2015] [Accepted: 12/11/2015] [Indexed: 11/30/2022] Open

Macchi M, Floridi C, Strocchi S, Fontana F, Mangini M, Piacentino F, Duka E, Donati AV, Fugazzola C. Role of low dose CT angiography in the follow-up after endovascular aneurysm repair of abdominal aorta. Acta Radiol 2015;56:1471-8. [PMID: 25487715 DOI: 10.1177/0284185114560210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 10/14/2014] [Indexed: 11/15/2022]

Chang K, Heisler M, Mahesh M, Baird G, Mayo-Smith W. CT colonography at low tube potential: using iterative reconstruction to decrease noise. Clin Radiol 2015;70:981-8. [DOI: 10.1016/j.crad.2015.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 03/24/2015] [Accepted: 05/12/2015] [Indexed: 01/15/2023]

Possible Contrast Media Reduction with Low keV Monoenergetic Images in the Detection of Focal Liver Lesions: A Dual-Energy CT Animal Study. PLoS One 2015. [PMID: 26203652 PMCID: PMC4512723 DOI: 10.1371/journal.pone.0133170] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open

Optimizing Contrast Media Injection Protocols in State-of-the Art Computed Tomographic Angiography. Invest Radiol 2015;50:161-7. [DOI: 10.1097/rli.0000000000000119] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]

Adaptation of contrast injection protocol to tube potential for cardiovascular CT. AJR Am J Roentgenol 2014;203:1181-91. [PMID: 25415695 DOI: 10.2214/ajr.13.12013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]

Shin CI, Kim SH, Lee ES, Lee DH, Hwang EJ, Chung SY, Lee JM, Han JK, Choi BI. Ultra-low peak voltage CT colonography: effect of iterative reconstruction algorithms on performance of radiologists who use anthropomorphic colonic phantoms. Radiology 2014;273:759-71. [PMID: 25010640 DOI: 10.1148/radiol.14140192] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]

Abstract

PURPOSE

To analyze the effect of a decrease in computed tomographic (CT) colonographic voltage, from 100 and 120 kVp to 80 kVp and reconstructed with filtered back projection ( FBP filtered back projection ), on radiation dose, image noise, and diagnostic performance in anthropomorphic phantoms and to assess the effect of iterative reconstruction ( IR iterative reconstruction ) algorithms on radiologists' performance for 80-kVp CT colonography.

MATERIALS AND METHODS

Seven colon phantoms with 68 simulated polyps (≥6 mm) were scanned at three peak voltage settings (80, 100, 120 kVp) and 10 mAs. Images were reconstructed by using FBP filtered back projection , hybrid statistic-based IR iterative reconstruction , and knowledge-based IR iterative reconstruction algorithms. Effective radiation dose, image noise, and per-polyp sensitivity were recorded and compared by two reviewers with Friedman test, repeated measures analysis of variance, and McNemar test.

RESULTS

Median size-specific dose estimate and effective radiation dose of 80-kVp CT colonography was 0.231 mGy and 0.167 mSv, respectively, which was lower than with 100- and 120-kVp CT colonography, with significant difference between 80 and 120 kVp (P = .0005). Image noise (202.0 HU) at 80-kVp FBP filtered back projection CT colonography was significantly higher than at 100-kVp FBP filtered back projection (139.1 HU) and 120-kVp FBP filtered back projection (120.4 HU) (P < .0001). Per-polyp sensitivity (reviewer 1, 14.7% [10 of 68]; reviewer 2, 7.4% [five of 68]) at 80-kVp FBP filtered back projection was significantly lower than at 100-kVp FBP filtered back projection (reviewer 1, 57.4% [39 of 68]; reviewer 2, 39.7% [27 of 68]) and 120-kVp FBP filtered back projection (reviewer 1, 85.3% [58 of 68]; reviewer 2, 83.8% [57 of 68]) (P < .0001). With statistic-based IR iterative reconstruction , image noise at 80 kVp decreased significantly (52.8% [106.7 HU of 202.0 HU]) compared with that at 80-kVp FBP filtered back projection (P < .0001), but per-polyp sensitivity (reviewer 1, 79.4% [54 of 68]; reviewer 2, 66.2% [45 of 68]) at 80-kVp statistic-based IR iterative reconstruction remained significantly lower than at 100-kVp statistic-based IR iterative reconstruction (reviewer 1, 95.6% [65 of 68]; reviewer 2, 86.8% [59 of 68]) (P = .001) and 120-kVp statistic-based IR iterative reconstruction (reviewer 1, 98.5% [67 of 68]; reviewer 2, 89.7% [61 of 68]) (P < .001). For knowledge-based IR iterative reconstruction , per-polyp sensitivity at 80 kVp was improved to 98.5% (67 of 68) and 94.1% (64 of 68), not significantly different from that at 100 kVp (reviewer 1, 100% [68 of 68]; reviewer 2, 95.6% [65 of 68]) and 120 kVp (reviewer 1, 100% [68 of 68]; reviewer 2, 95.6% [65 of 68]) (P > .999).

CONCLUSION

A decrease in tube voltage to 80 kVp caused reduction in radiation dose (0.166 mSv) with deterioration in image noise and per-polyp sensitivity. By using a knowledge-based IR iterative reconstruction algorithm, radiologists' performance of 80-kVp CT colonography was acceptable and on par with that at 100- or 120-kVp CT colonography.

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Szucs-Farkas Z, Megyeri B, Christe A, Vock P, Heverhagen JT, Schindera ST. Prospective randomised comparison of diagnostic confidence and image quality with normal-dose and low-dose CT pulmonary angiography at various body weights. Eur Radiol 2014;24:1868-77. [DOI: 10.1007/s00330-014-3208-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/14/2014] [Accepted: 04/28/2014] [Indexed: 01/23/2023]

Kikuchi Y, Oyama-Manabe N, Naya M, Manabe O, Tomiyama Y, Sasaki T, Katoh C, Kudo K, Tamaki N, Shirato H. Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with 15O-H2O PET. Eur Radiol 2014;24:1547-56. [DOI: 10.1007/s00330-014-3164-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/10/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]