Advantages of 70-kV CT Angiography for the Visualization of the Adamkiewicz Artery: Comparison with 120-kV Imaging

Shimoyama, Shinsuke; Nishii, Tatsuya; Watanabe, Yoshiaki; Kono, Atsushi K.; Kagawa, Kiyosumi; Takahashi, Satoru; Sugimura, Kazuro

doi:10.3174/ajnr.a5372

Cited by 17 publications

(14 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study indicated that for pediatric patients with weight less than 28 kg, the use of 70kVp tube voltage could reduce about 37% radiation dose and 44% contrast dose while obtaining images that meeting the diagnostic requirement in abdominal CT imaging. Our results are an extension to the results of previous studies for cardiac CT imaging showing that the use of 70kVp could provide images that satisfy the diagnosis requirements with a CM dose reduction of 25%-56% [17][18][19] .…”

Section: Discussionsupporting

confidence: 57%

Application of 70 kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

Sun

Yang

et al. 2021

XST

View full text Add to dashboard Cite

BACKGROUND: Low-tube voltage scanning improves CT attenuation value of contrast medium (CM). Thus, we hypothesized that 70 kVp in pediatric abdominal CT angiography (CTA) could be used to reduce both radiation and CM dose and improve patient comfort at the same time. OBJECTIVE: To evaluate the feasibility of using 70 kVp in pediatric abdominal CTA to reduce radiation dose and CM dose and improve patient care for children. MATERIALS AND METHODS: Forty-six children needing abdominal CTA were enrolled in the study group using low-dose scanning protocol with 70 kVp and 0.7–1.1 ml/kg contrast dose, and reconstructed with 50%ASIR-V. They were compared with other 46 children in control group with matching body weight and underwent conventional CT scans with 100 kVp, 1.2–1.8 ml/kg contrast dose and reconstructed using 50%ASIR. Image quality of large vessels was evaluated using a 5-point scale. CT value and standard deviation of descending aorta (Ao) was measured, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Radiation dose, contrast dose, the maximum injection pressure between the two groups were also compared. RESULTS: Score for displaying large vessels by 70 kVp images was 3.91±0.28, lower than that (4.17±0.38) of the control group (p < 0.05), but fully met the diagnostic requirements. CT value of Ao was 390.87±86.79HU in study group, which is higher than 343.93±49.94HU in control group, while there was no difference in SNR and CNR between two groups; the radiation dose, contrast dosage and injection pressure of the study group were 1.23±0.39mGy, 12.67±7.27 ml and 43.83±17.16psi, respectively, which are significantly lower than the 1.95±0.37mGy, 22.67±7.39 ml, and 77.59±19.68psi of control group. CONCLUSION: Use of 70 kVp in pediatric abdominal CTA provides diagnostic quality images while significantly reduce radiation and contrast dose, as well as injection pressure to improve patient comfort for children.

show abstract

Section: Discussionsupporting

confidence: 57%

Application of 70 kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

Sun

Yang

et al. 2021

XST

View full text Add to dashboard Cite

show abstract

“…In recent years, the radiation dose and contrast medium (CM) dose for CTA in children have decreased significantly with the application of low tube voltage and iterative reconstruction (IR) algorithms (11), and the combination of low tube voltage and IR algorithms such as the adaptive statistical iterative reconstruction-V (ASIR-V) is routinely used in our hospital. The latest research has shown that the use of low tube voltage, especially 70 kVp in chest CTA, can significantly improve image contrast (12)(13)(14). Simultaneously, the use of IR algorithms has been shown to reduce image noise (15)(16)(17) effectively, and the combination of these 2 methods can significantly reduce doses and maintain image quality.…”

Section: Introductionmentioning

confidence: 99%

Improving the image quality of pediatric chest CT angiography with low radiation dose and contrast volume using deep learning image reconstruction

Sun

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: Chest CT angiography (CTA) is a common clinical examination technique for children.Iterative reconstruction algorithms are often used to reduce image noise but encounter limitations under low dose conditions. Deep learning-based image reconstruction algorithms have been developed to overcome these limitations. We assessed the quantitative and qualitative image quality of thin-slice chest CTA in children acquired with low radiation dose and contrast volume by using a deep learning image reconstruction (DLIR) algorithm.Methods: A total of 33 children underwent chest CTA with 70 kVp and automatic tube current modulation for noise indices of 11-15 based on their age and contrast volume of 0.8-1.2 mL/kg. Images were reconstructed with 50% and 100% adaptive statistical iterative reconstruction-V (ASIR-V) and highsetting DLIR (DLIR-H) at 0.625 mm slice thickness. Two radiologists evaluated images in consensus for overall image noise, artery margin, and artery contrast separately on a 5-point scale (5, excellent; 4, good; 3, acceptable; 2, sub-acceptable, and 1, not acceptable). The CT value and image noise of the descending aorta and back muscle were measured. Radiation dose and contrast volume was recorded. Results:The volume CT dose index, dose length product, and contrast volume were 1.37±0.29 mGy, 35.43±10.59 mGy•cm, and 25.43±13.32 mL, respectively. The image noises (in HU) of the aorta with DLIR-H (19.24±5.77) and 100% ASIR-V (20.45±6.93) were not significantly different (P>0.05) and were substantially lower than 50% ASIR-V (29.45±7.59) (P<0.001). The 100% ASIR-V images had oversmoothed artery margins, but only the DLIR-H images provided acceptable scores on all 3 aspects of the qualitative image quality evaluation.Conclusions: It is feasible to improve the image quality of a low radiation dose and contrast volume chest CTA in children using the high-setting DLIR algorithm.

show abstract

“…Their results seem to be superior to those of our study. However, accurate localisation of the AKA may not have been established because previous studies [8,[13][14][15] did not conduct spinal conventional selective angiography. The most reliable way to visualise the AKA is with conventional selective arterial angiography [16].…”

Section: Discussionmentioning

confidence: 99%

Detection of the artery of Adamkiewicz using multidetector row computed tomography in patients with spinal arteriovenous shunt disease

et al. 2020

View full text Add to dashboard Cite

Purpose: To plan a treatment strategy for a spinal arteriovenous shunt (SAVS), identifying the artery of Adamkiewicz (AKA) and its origin is indispensable. However, detecting the AKA is very difficult in patients with an SAVS when using computed tomography angiography (CTA) by the usual method to find the hairpin curved artery because dilated drainage veins nearly always coexist with the hairpin curved AKA. We designed a method to identify the AKA by focusing on the diameter and pathway of the anterior radiculomedullary arteries (RMAs). Material and methods: Seven consecutive patients with an SAVS were surveyed. They underwent contrast-enhanced CTA and conventional angiography from January 2009 to December 2012. Two readers evaluated the CTA images and assumed that the AKA was the artery that ran through the anterior portion of the neural foramen and continued to pass on the ventral side of the spinal cord. Results: Among the seven patients, nine AKAs were detected with conventional angiography. When using our method, seven AKAs and six AKAs were identified on CTA by Reader 1 and Reader 2, respectively. The average sensitivity was 72.3%, and the specificity, accuracy, positive predictive value, and negative predictive value were sufficiently high (i.e. > 85%) for both readers. The kappa value for detecting the AKA was 0.98. Conclusions: Detecting the origin of the AKA with CTA is challenging in patients with an SAVS. However, focusing on the diameter and pathway of the RMAs may allow successful identification.

show abstract

Advantages of 70-kV CT Angiography for the Visualization of the Adamkiewicz Artery: Comparison with 120-kV Imaging

Abstract: Seventy-kilovolt CTA has substantial advantages for the identification of the Adamkiewicz artery before aortic repair, with a significantly lower radiation exposure and superior image quality than 120-kV CTA.

Cited by 17 publications

References 28 publications

Application of 70 kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

Application of 70 kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

Improving the image quality of pediatric chest CT angiography with low radiation dose and contrast volume using deep learning image reconstruction

Detection of the artery of Adamkiewicz using multidetector row computed tomography in patients with spinal arteriovenous shunt disease

Contact Info

Product

Resources

About