Application of 80-kVp tube voltage, low-concentration contrast agent and iterative reconstruction in coronary CT angiography: evaluation of image quality and radiation dose

Wu, Qiyong; Wang, Yong; Kai, Huihua; Wang, Tao; Tang, Xiaoqiang; Wang, Xiaoqin; Pan, Changjie

doi:10.1111/ijcp.12852

Cited by 17 publications

(15 citation statements)

References 19 publications

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“…Computed tomography angiography (CTA) plays an increasingly important role in screen suspected IA patients, and has been widely used as a routine diagnostic tool for IA . However, the accuracies of CTA in diagnosing intracranial micro‐aneurysms (IMA) vary from 61% to 98.2%; moreover, the detection rate of IMA when CTA is utilized is controversial, yet the detection rate of IMA is an important indicator for judging CTA's sensitivity. In addition, the radiation dose of CT scanning is also a matter of concern .…”

Section: Introductionmentioning

confidence: 99%

Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Duan

Liu

et al. 2017

Int J Imaging Syst Tech

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The aim of this study was to investigate the diagnostic values of low tube voltage cerebral computed tomography (CT) angiography (L‐CTA, 100 kV) of intracranial micro‐aneurysms (IMA, maximum diameter ≤3 mm). The clinical and imaging data of a total of 59 IMA patients confirmed by 3D rotational angiography (3DRA) or surgery were retrospectively analyzed; their L‐CTA data were compared with those of IMA and 3DRA so as to investigate the diagnostic sensitivity, specificity, and accuracy of IMA, as well as to objectively evaluate the related radiation dose. Based on the results of 3DRA, 65 cases of IMA and a total of 70 aneurysms, including 65 micro‐aneurysms, were found in the 59 cases. L‐CTA detected a total of 64 IMA, including six multiple cases of IMA, as well as three false positive cases and four missed cases. Compared with the 3DRA (gold standard), the diagnostic sensitivity, specificity, and accuracy of L‐CTA toward IMA were 93.85%, 99.56%, and 99.08%, respectively, and the associations of aneurysm size measured by L‐CTA and 3DRA were good. Compared with conventional CTA, the effective dose of L‐CTA was reduced by 36.23%. L‐CTA has high diagnostic sensitivity toward IMA, and can effectively reduce the radiation dose, so it is worth implementing.

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Section: Introductionmentioning

confidence: 99%

Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Duan

Liu

et al. 2017

Int J Imaging Syst Tech

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“…The visual assessment of image quality showed comparable image quality without significant differences between the quality of CT scan images acquired before and after the parameter change. This is also the case for signal-to-noise ratio as a parameter for the objective assessment of image quality which has already become established in previous studies in various regions for the evaluation of CT scan images [21,22]. Based on the results of the visual and objective evaluation of image quality and with respect to the slightly lower values compared to the new DRLs, a further dose reduction based on suitable parameter changes is possible as long as diagnostic image quality according to the ALARA principle can be ensured.…”

Section: Discussionmentioning

confidence: 92%

Optimization of Whole-Body CT Examinations of Polytrauma Patients in Comparison with the Current Diagnostic Reference Levels

Schäfer

Rudolph

Kolodziej³

et al. 2019

Fortschr Röntgenstr

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Purpose Evaluation of the dose values of a polytrauma whole-body CT examination used in clinical practice with regard to the 2016 updated diagnostic reference levels and reduction of the mean exposure levels using simple optimization steps. Materials and Methods In each case, 100 exposure values before and after dose optimization were compared with the old and new diagnostic reference levels. The grayscale values and the signal-to-noise ratio (SNR) were determined for the lung, the aortic arch and the liver. A visual assessment of the image quality was performed by two radiologists on the basis of a Likert scale (0 – non-diagnostic, 1 – poor visualization, 2 – moderate visualization, 3 – good visualization, 4 – excellent visualization) for CT examinations both before and after optimization. Results The acquired exposure values after dose optimization were below the old and new diagnostic reference levels (1319.98 ± 463.16 mGy · cm) while the mean value of the exposure values before optimization (1774.96 ± 608.78 mGy · cm) exceeded the current diagnostic reference levels. The measured grayscale values (HU) were (before versus after optimization): lung – 833 HU vs. – 827 HU (p = 0.43), aortic arch 341 HU vs. 343 HU (p = 0.70) and liver 68 HU vs. 67 HU (p = 0.35). After dose optimization the SNR in the lung was minimally higher, while it was minimally lower in the two other regions than before the optimization. Visual assessment of the image quality showed almost identical values with 3.85 evaluation points before and 3.82 evaluation points after dose optimization (p = 0.57). Conclusion Due to the updating of the diagnostic reference levels, an analysis of the own exposure values is necessary in order to be able to detect high values promptly and to initiate appropriate measures for dose reduction. Appropriate adaptation of the examination parameters with consideration of the necessary image quality allows a significant reduction of the radiation exposure in most cases, also on CT devices of older generations. Key Points: Citation Format

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“…The combination of high attenuation in low-kVp scans with low noise levels due to increased tube current output and additional IR result in increased contrast (14,18) ( Figure 5). Thus, low tube-voltage scans combined with IR allow reduced iodine CM volumes or concentrations to achieve 120-kVp equal image noise and contrast (19). Reduced iodine concentration CM (270 mgl/mL) in 100-kVp scans result in similar vessel attenuation than standard iodine concentration (370 mgl/mL) in 120-kVp scans (20,21).…”

Section: Advances In Ct Techniquementioning

confidence: 99%

Advances in cardiac CT contrast injection and acquisition protocols

Scholtz

Ghoshhajra

2017

Cardiovasc. Diagn. Ther.

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Cardiac computed tomography (CT) imaging has become an important part of modern cardiovascular care. Coronary CT angiography (CTA) is the first choice imaging modality for non-invasive visualization of coronary artery stenosis. In addition, cardiac CT does not only provide anatomical evaluation, but also functional and valvular assessment, and myocardial perfusion evaluation. In this article we outline the factors which influence contrast enhancement, give an overview of current contrast injection and acquisition protocols, with focus on current emerging topics such as pre-transcatheter aortic valve replacement (TAVR) planning, cardiac CT for congenital heart disease (CHD) patients, and myocardial CT perfusion (CTP). Further, we point out areas where we see potential for future improvements in cardiac CT imaging based on a closer interaction between CT scanner settings and contrast injection protocols to tailor injections to patient- and exam-specific factors.

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Application of 80-kVp tube voltage, low-concentration contrast agent and iterative reconstruction in coronary CT angiography: evaluation of image quality and radiation dose

Abstract: Coronary CTA conducted with a low tube voltage of 80 kVp, a low-concentration CM and IR without heart rate control can achieve images of similar quality to those obtained using standard procedures, significantly reducing the associated radiation dose and iodine intake.

Cited by 17 publications

References 19 publications

Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Optimization of Whole-Body CT Examinations of Polytrauma Patients in Comparison with the Current Diagnostic Reference Levels

Advances in cardiac CT contrast injection and acquisition protocols

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