Clinical value of dual-energy spectral imaging with adaptive statistical iterative reconstruction for reducing contrast medium dose in CT portal venography: in comparison with standard 120-kVp imaging protocol

Ma, Chunling; Chen, Xiaoxia; Lei, Yuxin; Zhang, Xirong; Jia, Yongjun; Tian, Xin; Tian, Qian

doi:10.1259/bjr.20151022

Cited by 14 publications

(8 citation statements)

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“…Previous studies have shown that the spatial resolution and image noise could be balanced at approximately 40% -50% ASiR (maintain image spatial resolution while reducing noise) (32). We selected the 50% ASiR weights used by other researchers in abdominal low-dose CT scans (33) and portal vein imaging studies (34,35). This was also the most commonly used weight in CM passes through the superior vena cava into the right heart and then goes directly to the branches of the pulmonary artery from the right heart without systemic circulation in CTPA.…”

Section: Discussionmentioning

confidence: 99%

Optimal Monochromatic Energy Levels in Dual-Energy Spectral CT Pulmonary Angiography with Low Contrast Medium Dosage

et al. 2020

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Background: The contrast medium (CM) in CT pulmonary angiography may induce adverse effects to patients, and higher CM is associated with higher rates of contrast-induced-nephropathy and mortality. Reduction of CM dosage through improvement of examination techniques may help reduce the occurrence of CM-induced adverse effects and healthcare costs. Objectives: To determine the optimal monochromatic energy levels in dual-energy spectral CT pulmonary angiography (CTPA) with low contrast dosage. Patients and Methods: Thirty patients with suspected pulmonary embolism (PE) underwent dual-energy spectral CTPA with low radiation and low contrast doses with scanning protocol of GSI-36 with 260 mA, and 25 mL contrast (350 mgI/mL) with 4.0ml/s injection speed. The monochromatic images from 60 - 80 keV (interval 5 keV) were reconstructed using a 50% adaptive statistical iterative reconstruction (50% ASiR) algorithm at 1.25 mm slice thickness. The CT attenuation and standard deviation (SD) values of the main, right, left, right lower and left lower pulmonary arteries and the back muscle at the same level were measured on 60 – 80 keV images, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated and analyzed. The subjective image quality was evaluated by two experienced radiologists using a 5-level scoring method independently. Measurements were analyzed using IBM SPSS Statistics for Windows, version 25.0. (Armonk, NY: IBM Corp.). Results: CT attenuation values of the pulmonary arteries decreased with the increase of energy level in five-energy groups, with values greater than 300 HU at 60 keV - 70 keV energies. The 65 keV image had the highest SNR, CNR and lowest SD, with significant differences compared with those of other image sets (P < 0.05). The subjective quality scores for the 65 keV image was judged to be the highest by the two radiologists, but it was not significantly different from 60 keV and 70 keV (all P > 0.05). Conclusion: The 65 keV monochromatic images provided the highest SNR, CNR and subjective scores with the lowest image noise in dual-energy spectral CTPA with low contrast dosage.

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Section: Discussionmentioning

confidence: 99%

Optimal Monochromatic Energy Levels in Dual-Energy Spectral CT Pulmonary Angiography with Low Contrast Medium Dosage

et al. 2020

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“…As the penetration of X-ray reduces with increase in the patients' body mass index ( 24 ), it has been hypothesized that the image quality in lower tube voltage may be affected in patients with higher body mass index. In case of patients with a high body mass index, the optimal CNR spectroscopy technology can provide higher quality images of the abdominal blood vessels and portal veins with the application of low dosage of contrast agent for reducing the total iodine content ( 25 26 ). In imaging patients with greater body mass indexes, the use of energy spectrum plus adaptive statistical iterative reconstruction algorithm can provide abdominal vascular images of good quality without increasing X-ray radiation and contrast dosage compared with traditional angiography ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Optimal Monochromatic Imaging of Spectral Computed Tomography Potentially Improves the Quality of Hepatic Vascular Imaging

Yin

Gao

et al. 2018

Korean J Radiol

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ObjectiveTo investigate the efficiency of spectral computed tomography (CT) optimal monochromatic images in improving imaging quality of liver vessels.Materials and MethodsThe imaging data of 35 patients with abdominal CT angiography were retrospectively analyzed. Hepatic arteries, portal veins, and hepatic veins were reconstructed with mixed energy (quality check, QC), 70 keV and optimal monochromatic mode. Comparative parameters were analyzed including CT value, image noise (IN), contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and subjective qualitative analysis.ResultsThe optimal monochromatic value for assessment of the common hepatic artery, portal vein, and hepatic vein ranged between 49 keV and 53 keV, with a mean of 51 keV. There were statistically significant differences (p < 0.001) among the optimal monochromatic, 70 keV and QC images with regards to the hepatic vascular CT value, IN, CNR, SNR, and subjective qualitative score. CNR of the common hepatic artery in the optimal monochromatic, 70 keV and QC groups was 24.6 ± 10.9, 18.1 ± 8.3, and 11.6 ± 4.6, respectively (p < 0.001) with subjective scores of 4.7 ± 0.2, 4.0 ± 0.3, and 3.6 ± 0.4, respectively (p < 0.001). CNR of the hepatic portal vein was 6.9 ± 2.7, 4.3 ± 1.9, and 3.0 ± 2.1, respectively (p < 0.001) with subjective scores of 4.5 ± 0.3, 3.9 ± 0.4, and 3.3 ± 0.3, respectively (p < 0.001). CNR of the hepatic vein was 5.7 ± 2.3, 4.2 ± 1.9, and 2.7 ± 1.4, respectively with subjective scores of 4.3 ± 0.3, 3.8 ± 0.4, and 3.2 ± 0.3, respectively (p < 0.001).ConclusionOptimal monochromatic images can lead to improvement in the imaging parameters and optimization of the image quality of the common hepatic artery, hepatic portal vein and hepatic vein compared with conventional mixed kV and with 70 keV datasets.

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“…For example, the current state-of-the-art CT scanners provide multi-kVe spectral imaging capability or enable low kVp imaging without increasing image noise using iterative reconstruction. These scanners allow for augmented contrast enhancement relative to conventional CT for a given amount of contrast medium ( 15 16 17 18 19 20 21 22 23 24 ). As these scanners decrease the amount of contrast agent needed, injection flow rate and need for large intravenous catheters can be reduced.…”

Section: Discussionmentioning

confidence: 99%

Two Small Intravenous Catheters for High-Rate Contrast Medium Injection for Computed Tomography in Patients Lacking Superficial Veins to Accommodate a Large Catheter

et al. 2018

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ObjectiveTo prospectively investigate the feasibility of using 2 small intravenous catheters for high-rate computed tomography (CT) contrast injection in patients lacking superficial veins capable of accommodating ≤ 20-gauge catheters.Materials and MethodsSixty-eight consecutive eligible adults referred for dynamic liver CT were enrolled; 58 had previously undergone liver CT, including 8 that experienced extravasation. Two 22- or 24-gauge catheters were placed in all patients after 2–5 venipunctures, and 2 mL/kg of contrast agent (370 mg I/mL) was split-administered through both catheters to achieve total flow rate of 4 mL/s. Patients' experience and examination success rate, defined as uneventful scans completed at 4 mL/s or at < 4 mL/s achieving standard image quality in all phases, were analyzed. Quantitative hepatic signal-to-noise and hepatic vascular contrast-to-noise ratios (CNRs) were compared with 30 control examinations scanned at 4 mL/s using an 18-gauge catheter.ResultsOne case each of extravasation and severe injection pain caused the examination to be aborted. Success rate was 88.2% (60/68; 54 patients scanned at 4 mL/s, 6 at 3.5–3.9 mL/s). Fifty-five of 58 patients (94.8%) that had past CT regarded the venipuncture as more tolerable than (n = 36) or similar to (n = 19) past experiences; 45 of 58 patients (77.6%) found contrast injection less painful than (n = 35) or similar to (n = 10) past experiences. When compared with control examinations, signal-to-noise ratio was similar in all phases (p ≥ 0.502), but the hepatic arterial CNR in arterial phase was slightly inferior (p ≤ 0.047).ConclusionUsing 2 small intravenous catheters can effectively achieve high-rate CT contrast injection in patients lacking adequate superficial veins.

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Clinical value of dual-energy spectral imaging with adaptive statistical iterative reconstruction for reducing contrast medium dose in CT portal venography: in comparison with standard 120-kVp imaging protocol

Cited by 14 publications

References 7 publications

Optimal Monochromatic Energy Levels in Dual-Energy Spectral CT Pulmonary Angiography with Low Contrast Medium Dosage

Optimal Monochromatic Energy Levels in Dual-Energy Spectral CT Pulmonary Angiography with Low Contrast Medium Dosage

Optimal Monochromatic Imaging of Spectral Computed Tomography Potentially Improves the Quality of Hepatic Vascular Imaging

Two Small Intravenous Catheters for High-Rate Contrast Medium Injection for Computed Tomography in Patients Lacking Superficial Veins to Accommodate a Large Catheter

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