CT Angiography in Patients with Peripheral Arterial Disease

Oda, Shigeto; Yoshimura, Atsushi; Honda, Kei; Iyama, Yuji; Katahira, Kentaro; Nakaura, Takeshi; Utsunomiya, Daisuke; Funama, Yoshinori; Yuki, Hideaki; Kidoh, Masafumi; Hirata, Ken‐ichi; Taguchi, Narumi; Tokuyasu, Shinichi; Yamashita, Yasuyuki

doi:10.1016/j.acra.2016.05.011

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…This is particularly the case in the presence of stenosis and vessel wall sclerosis (7,20). Approaches to solve these limitations include the optimization of scan parameters and scan conditions (11,21), additional dynamic BTK scans (10), flash cranio-caudal acquisition (22), or the use of small focal spot imaging (23). Another approach is the use of different reconstruction algorithms and parameters.…”

Section: Discussionmentioning

confidence: 99%

CT angiography of the lower limbs: combining small field of view with large matrix size and iterative reconstruction further improves image quality of below-the-knee arteries

Scheschenja,

König,

Viniol

et al. 2024

Acta Radiol

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Background Image quality and diagnostic accuracy in computed tomography angiography (CTA) reach their limits in imaging of below-the-knee vessels. Purpose To evaluate whether image quality in CTA of lower limbs is further improvable by combining side-separate reconstruction with a larger matrix size and whether resulting noise can be compromised with iterative reconstruction (IR). Material and Methods From CTA of the lower extremities of 26 patients (5 women, 21 men; mean age = 68.5 ± 10.3 years), the lower legs were reconstructed side-separately with different reconstruction algorithms and matrix sizes including filtered back projection (FBP) with a 512 × 512 matrix, FBP with a 1024 × 1024 matrix, IR (SAFIRE) with a 512 × 512 matrix, and IR (SAFIRE) with a 1024 × 1024 matrix. A total of 208 CT series were evaluated. Subjective image quality was assessed by two readers using a 5-point Likert scale. Image noise was assessed by measuring signal-to-noise and contrast-to-noise ratios. Results Subjective image quality was rated significantly higher when using a 1024 × 1024 matrix ( P < 0.001) and could further be increased with IR. Vessel sharpness was rated significantly better with a larger matrix ( P < 0.001). Visible and measured image noise was significantly higher with a 1024 × 1024 matrix but could be reduced by using IR ( P < 0.001), even to a level below FBP with a 512 × 512 matrix while reconstructing with a larger matrix ( P < 0.001). Conclusion Image quality, image noise, and vessel sharpness can be further improved in CTA of the lower extremities with side-separate reconstruction using a 1024 × 1024 matrix size and IR.

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Section: Discussionmentioning

confidence: 99%

CT angiography of the lower limbs: combining small field of view with large matrix size and iterative reconstruction further improves image quality of below-the-knee arteries

Scheschenja,

König,

Viniol

et al. 2024

Acta Radiol

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“…Third, the radiation dose was relatively high because this method needs comprehensive cardiac CT examination including dynamic CTP and CTA. If low-tube voltage scan with novel image reconstruction such as iterative model reconstruction is applied to CTA and CTP, further dose reductions can be expected [27,28]. Moreover, reduction of the sampling rate in dynamic CTP scan is also useful to reduce the radiation dose [29].…”

Section: Discussionmentioning

confidence: 99%

Coronary artery stenosis-related perfusion ratio using dynamic computed tomography myocardial perfusion imaging: a pilot for identification of hemodynamically significant coronary artery disease

Kuwahara

Tanabe

Kurata

et al. 2019

Cardiovasc Interv and Ther

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The purpose of this study was to evaluate the feasibility of the stenosis-related quantitative perfusion ratio (QPR) for detecting hemodynamically significant coronary artery disease (CAD). Twenty-seven patients were retrospectively enrolled. All patients underwent dynamic myocardial computed tomography perfusion (CTP) and coronary computed tomography angiography (CTA) before invasive coronary angiography (ICA) measuring the fractional flow reserve (FFR). Coronary lesions with FFR ≤ 0.8 were defined as hemodynamically significant CAD. The myocardial blood flow (MBF) was calculated using dynamic CTP data, and CT-QPR was calculated as the CT-MBF relative to the reference CT-MBF. The stenosis-related CT-MBF and QPR were calculated using Voronoi diagram-based myocardial segmentation from coronary CTA data. The relationships between FFR and stenosis-related CT-MBF or QPR and the diagnostic performance of the stenosis-related CT-MBF and QPR were evaluated. Of 81 vessels, FFR was measured in 39 vessels, and 20 vessels (51%) in 15 patients were diagnosed as hemodynamically significant CAD. The stenosis-related CT-QPR showed better correlation (r = 0.70, p < 0.05) than CT-MBF (r = 0.56, p < 0.05). Sensitivity and specificity for detecting hemodynamically significant CAD were 95% and 58% for CT-MBF, and 95% and 90% for CT-QPR, respectively. The area under the receiver operating characteristic curve for the CT-QPR was significantly higher than that for the CT-MBF (0.94 vs. 0.79; p < 0.05). The stenosis-related CT-QPR derived from dynamic myocardial CTP and coronary CTA showed a better correlation with FFR and a higher diagnostic performance for detecting hemodynamically significant CAD than the stenosis-related CT-MBF.

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“…Low tube voltage with standard convolution filtered back projection (FBP) reconstruction algorithm can allow for reduced radiation dose and increased vessel density in patients undergoing contrast-enhanced CT, but it cannot compensate for high image noise in dose-saving strategies [ 1 , 17 ]. Compared with FBP reconstruction, adaptive statistical iterative reconstruction (ASIR) can reduce the quantum noise and improve the image quality [ 14 , 17 – 21 ]. The purpose of the current study was to prospectively evaluate whether low-concentration CM (270 mg/mL) with low tube voltage (100-kVp) and 40% ASIR (ASIR 40 ) reconstruction could reduce the radiation dose without decreasing the image quality in renal artery CTA.…”

Section: Introductionmentioning

confidence: 99%

Low-Dose Scanning Technology Combined with Low-Concentration Contrast Material in Renal Computed Tomography Angiography (CTA): A Preliminary Study

Su-lan

Shi

et al. 2017

Med Sci Monit

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BackgroundThis study is to investigate the feasibility of low iodine concentration contrast material (CM) combined with low tube voltage and adaptive statistical iterative reconstruction (ASIR) in renal computed tomography angiography (CTA).Material/MethodsA total of 136 patients were enrolled in this prospective trial, and randomly divided into two groups: group A (n=68) and group B (n=68). Group A received 120-kVp and iopromide (370 mg/mL) with filtered back projection (FBP) reconstruction, and group B received 100-kVp and iodixanol (270 mg/mL) with ASIR 40% (ASIR40). An equal iodine dose (300 mg/kg body weight) and the same iodine delivery rate (1,500 mg I/s) were given to all patients. Density, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured, and the image quality and visualization of renal arteries were scored. Dose-length product (DLP) and CT dose index volume (CTDIvol) were recorded, and effective doses (ED) were calculated.ResultsThere was no significant difference in image noise between groups A and B (p>0.05). The vessel attenuation, SNR, and CNR were significantly higher in group B than group A (all p<0.05). The subjective image quality and visualization of renal artery branches were similar in these two groups (p>0.05). Compared with group A, the CTDIvol, DLP, and ED in group B were decreased by 38.58%, 37.24%, and 37.24%, respectively (p=0.000).ConclusionsCompared with 120-kVp with FBP reconstruction, the protocol of 100-kVp with ASIRP40 reconstruction provided high-quality renal CTA results, which allowed for reduced iodine concentration and decreased radiation dose.

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CT Angiography in Patients with Peripheral Arterial Disease

Cited by 6 publications

References 19 publications

CT angiography of the lower limbs: combining small field of view with large matrix size and iterative reconstruction further improves image quality of below-the-knee arteries

CT angiography of the lower limbs: combining small field of view with large matrix size and iterative reconstruction further improves image quality of below-the-knee arteries

Coronary artery stenosis-related perfusion ratio using dynamic computed tomography myocardial perfusion imaging: a pilot for identification of hemodynamically significant coronary artery disease

Low-Dose Scanning Technology Combined with Low-Concentration Contrast Material in Renal Computed Tomography Angiography (CTA): A Preliminary Study

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