Adaptation of Contrast Injection Protocol to Tube Potential for Cardiovascular CT

Wang, Yajuan; Bolen, Michael A.; Sydow, Gregg; Kottha, Anjali; Soufan, Kassem; Bullen, Jennifer; Kemper, Corey; Kalafut, John F.; Halliburton, Sandra S.

doi:10.2214/ajr.13.12013

Cited by 4 publications

(3 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the CT scanner investigated in this study, the maximum tube current was 740 mA at 100 and 120 kVp, while the maximum tube current was 635 mA at 140 kVp. Additionally, prior studies have shown that the iodine contrast attenuation is lower in CCTA images acquired with a higher kilovoltage peak [ 20 , 21 , 22 ], so the 140 kVp scan is usually not used in our clinical routine practice.…”

Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index in Coronary CT Angiography Performed on a 256-Slice Multi-Detector CT Scanner

Law¹,

Guan-Lin

Yang

2022

Diagnostics

View full text Add to dashboard Cite

We aimed to investigate the effect of a patient’s body mass index (BMI) on radiation dose and image quality in prospectively ECG-triggered coronary CT angiography (CCTA) performed on a 256-slice multi-detector CT scanner. In total, 87 consecutive patients receiving CCTA examinations acquired with tube current modulation (TCM) and iterative reconstruction (IR) were enrolled in this study. The dose report recorded from the CT scanner console was used to derive the effective dose for patients. Subjective image quality scoring and objective noise measurements were conducted to quantify the impact of BMI on the image quality of CCTA. Because of the TCM technique, we expected tube current and radiation dose to increase as BMI increased. However, using TCM did not always guarantee sufficient radiation exposure to achieve consistent image quality for overweight or obese patients since the maximum X-ray tube output in milliamperes and kilovoltage peak was reached. The impact of photon starvation noise on image quality was not significant until BMI ≥ 27 kg/m2; this result could be due to IR’s noise reduction capability. Our results also suggest that using TCM with a noise index of 25 HU can reduce radiation dose without compromising image quality compared to images obtained based on the manufacturer’s default settings.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index in Coronary CT Angiography Performed on a 256-Slice Multi-Detector CT Scanner

Law¹,

Guan-Lin

Yang

2022

Diagnostics

View full text Add to dashboard Cite

show abstract

“…Multiplying Q-ICE at 85.5 kg for cohort 2 by 0.82 (52.3 HU × 0.82 = 42.9 HU) agrees well with cohort 3's Q-ICE at 85.5-kg value of 42 HU. This finding has motivated our CT protocol optimization team to consider lowering volumes for 120 kV or raising volumes for 140 kV 23 …”

Section: Discussionmentioning

confidence: 99%

“…This finding has motivated our CT protocol optimization team to consider lowering volumes for 120 kV or raising volumes for 140 kV. 23 To our knowledge, Q-ICE is the first institution-wide, automatable metric for contrast enhancement quantification. The work of Johnson et al 24 is the closest study to our work.…”

Section: Discussionmentioning

confidence: 99%

A Metric for Quantification of Iodine Contrast Enhancement (Q-ICE) in Computed Tomography

Szczykutowicz

Viggiano

Rose³

et al. 2021

J Comput Assist Tomogr

View full text Add to dashboard Cite

Background: Poor contrast enhancement is related to issues with examination execution, contrast prescription, computed tomography (CT) protocols, and patient conditions. Currently, our community has no metric to monitor true enhancement on routine single-phase examinations because this requires knowledge of both pre-and postcontrast CT number. Purpose:We propose an automatable solution to quantifying contrast enhancement without requiring a dedicated noncontrast series. Methods:The difference in CT number between a target region in an enhanced and unenhanced image defines the metric "quantification of iodine contrast enhancement" (Q-ICE). Quantification of iodine contrast enhancement uses the noncontrast bolus tracking baseline image from routine abdominal examinations, which mitigates the need for a dedicated noncontrast series. We applied this method retrospectively to 312 patient livers from 2 sites between 2017 and 2020. Each site used a weight-based contrast injection protocol for weights 60 to 113 kg and a constant volume less than 60 kg and greater than 113 kg. Hypothesis testing was performed to compare Q-ICE between sites and detect Q-ICE dependence on weight and kilovoltage (kV).Results: Mean Q-ICE differed between sites (P = 0.004) by 4.96 Hounsfield unit with 95% confidence interval (1.63-8.28), albeit this difference was roughly 2 times smaller than the SD in Q-ICE across patients at a single site. For patients between 60 and 113 kg, we did not observe evidence of Q-ICE varying with patient weight (P = 0.920 and 0.064 for 120 and 140 kV, respectively). The Q-ICE did vary with patient weight for patients less than 60 kg (P = 0.003) and greater than 113 kg (P = 0.04). We observed a roughly 10 Hounsfield unit reduction in Q-ICE liver for patients scanned with 140 versus 120 kV. We observed several underenhancing examinations with an arterial phase appearance motivating our CT protocol optimization team to consider increasing the delay for slowly enhancing patients.Conclusions: A quality metric for quantifying CT contrast enhancement was developed and suggested tangible opportunities for quality improvement and potential financial savings.

show abstract

Acquisition Protocols for Thoracic CT

Tack

Appiah

2016

Multidetector-Row CT of the Thorax

View full text Add to dashboard Cite

Adaptation of Contrast Injection Protocol to Tube Potential for Cardiovascular CT

Cited by 4 publications

References 57 publications

Effect of Body Mass Index in Coronary CT Angiography Performed on a 256-Slice Multi-Detector CT Scanner

Effect of Body Mass Index in Coronary CT Angiography Performed on a 256-Slice Multi-Detector CT Scanner

A Metric for Quantification of Iodine Contrast Enhancement (Q-ICE) in Computed Tomography

Acquisition Protocols for Thoracic CT

Contact Info

Product

Resources

About