Gadolinium-Enhanced Computed Tomographic Angiography: Current Status

Rosioreanu, Alex; Alberico, Ronald A.; Litwin, Alan; Hon, Man; Grossman, Zachary D.; Katz, Douglas S.

doi:10.1067/j.cpradiol.2005.08.002

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…Although CTA scans with gadolinium-based contrast agents have already been clinically approved, suchlike examinations using EID scanners are only feasible in dual-energy mode as of now. 33 The intrinsic spectral capabilities and higher luminal attenuation of PCD-CTwould potentially allow for a broader use of this application in the future (see Supplemental Figure S3, http://links.lww.com/RLI/ A812). Even for CTA imaging with standard iodine agents, PCD scanners appear advantageous: similar to the contrast load reduction facilitated by monoenergetic reconstructions in dual-energy EID-CT, 34 the use of PCD-CT enables a substantially lower iodine dosage in vascular scans of the head and neck.…”

Section: Discussionmentioning

confidence: 99%

“…Alternative contrast media are of particular interest for patients with renal dysfunctions or allergies to iodine agents, the former being a frequent comorbidity of patients with peripheral arterial disease. Although CTA scans with gadolinium-based contrast agents have already been clinically approved, suchlike examinations using EID scanners are only feasible in dual-energy mode as of now 33 . The intrinsic spectral capabilities and higher luminal attenuation of PCD-CT would potentially allow for a broader use of this application in the future (see Supplemental Figure S3, http://links.lww.com/RLI/A812).…”

Section: Discussionmentioning

confidence: 99%

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Photon-Counting Versus Energy-Integrating Detector CT Angiography of the Lower Extremity in a Human Cadaveric Model With Continuous Extracorporeal Perfusion

et al. 2023

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Objectives Detailed visualization of the arterial runoff is mandatory for the assessment of peripheral arterial occlusive disease. This study aims to compare the performance of a first-generation photon-counting detector computed tomography (PCD-CT) to a third-generation energy-integrating detector CT (EID-CT). Materials and Methods Computed tomography angiographies of 8 upper leg arterial runoffs were performed on human cadaveric models with continuous extracorporeal perfusion. For both PCD-CT and EID-CT, radiation dose-equivalent 120 kVp acquisition protocols (low-/medium-/high-dose: CTDIVol = 3/5/10 mGy) were used. All scans were performed with standard collimation (PCD-CT: 144 × 0.4 mm; EID-CT: 96 × 0.6 mm), a pitch factor of 0.4, and a gantry rotation time of 1.0 second. Reformatting of data included the use of comparable vascular kernels (Bv 48/49), a slice thickness and increment of 1.0 mm, and a field of view of 150 × 150 mm. Eight radiologists evaluated image quality independently using a browser-based pairwise forced-choice comparison setup. Kendall concordance coefficient (W) was calculated to estimate interrater agreement. Signal-to-noise ratio and contrast-to-noise ratio (CNR) were compared based on 1-way analyses of variance and linear regression analysis. Results Low-dose PCD-CT achieved superior signal-to-noise ratio/CNR values compared with high-dose EID-CT (P < 0.001). Linear regression analysis suggested that an EID-CT scan with a CTDIVol of at least 15.5 mGy was required to match the CNR value of low-dose PCD-CT. Intraluminal contrast attenuation was higher in PCD-CT than EID-CT, irrespective of dose level (415.0 ± 31.9 HU vs 329.2 ± 29.4 HU; P < 0.001). Subjective image quality of low-dose PCD-CT was considered superior to high-dose EID-CT (P < 0.001). Interrater agreement was high (W = 0.989). Conclusions Using cadaveric models with continuous extracorporeal perfusion allows for intraindividual image quality comparisons between PCD-CT and EID-CT on variable dose levels. With superior luminal contrast attenuation and denoising in angiographies of the peripheral arterial runoff, PCD-CT displayed potential for radiation saving of up to 83% compared with EID-CT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Photon-Counting Versus Energy-Integrating Detector CT Angiography of the Lower Extremity in a Human Cadaveric Model With Continuous Extracorporeal Perfusion

et al. 2023

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“…Recently published PIOPED III study indicated MRA was technically inadequate in 25% of the 371 patients who had the test and identified 57% of the 104 patients with PE; the sensitivity and specificity of technically adequate tests were 78 and 99% [16]. Gadolinium-based contrast media has been used as an alternative to iodinated contrast agents for patients with contraindications to iodinated contrast media [17][18][19][20]. Gadolinium-enhanced CT has been used to detect nearly all cardiovascular abnormalities, such as in the aorta, pulmonary circulation, coronary artery, and circle of Willis, with diagnostic image quality and no significant side effects [21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of gadolinium-enhanced dual energy CT pulmonary angiography: a pilot study in rabbits

Zhang

Wang

Lü

et al. 2010

Int J Cardiovasc Imaging

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The purpose of this study was to evaluate the feasibility of gadolinium-enhanced dual energy CT pulmonary angiography (CTPA) to detect pulmonary embolism (PE) in rabbits. Dual energy CT was performed on phantoms composed of different dilution of gadolinium and iodinated contrast agents, CT numbers of the phantoms were measured at different tube voltages. Ten rabbits, which were subdivided into two groups receiving 3 or 5 ml/kg of gadolinium based contrast agent (n = 5 for each group), underwent baseline gadolinium-enhanced dual energy CTPA. The CT numbers of pulmonary arteries were measured. The following day, sponge gelatin was injected into femoral vein of 6 rabbits to create pulmonary emboli. The rabbit were re-imaged 2 h after sponge gelatin injection. Histopathology analysis of the lung lobes was performed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Serum creatinine levels were measured on day 1 before gadolinium contrast media injection, and on day 2 prior to PE creation. The phantoms and animal study showed that the CT numbers of gadolinium-based contrast agent and pulmonary arteries at 80 kVp were higher than those at 140 kVp and average weighted 120 kVp. In 6 rabbits, CTPA showed bilateral pulmonary artery emboli, and the reconstructed gadolinium maps showed decreased pulmonary perfusion in the corresponding lung lobes. With the histopathology results as the reference standards, CTPA and Blood flow imaging (BFI) detected PE in 14 and 14 of the 14 pulmonary lobes, 26, 24 lobes without PE, respectively, corresponding to sensitivities of 100 and 100%, and specificities of 100 and 92%, respectively. Serum creatinine level increased by 6.7 and 20.6% in the rabbits receiving 3 and 5 ml/kg gadolinium based contrast medium respectively. Histopathological analysis found no significant tubular necrosis at either gadolinium dose. Gadolinium-enhanced dual energy CT pulmonary angiography is feasible and it can simultaneously provide information on pulmonary artery and lung perfusion in a rabbit model of PE.

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“…In the clinics, correlative studies using combinations of imaging methods, most notably MR and CT imaging, are often performed on the same patient to improve the accuracy of diagnosis or assess the efficacy of treatment routines. For instance, commercially available gadolinium-containing MR agents have been used for CT imaging, but limitations associated with the dosage and costs have prevented their widespread use (123,124). Liposomebased multimodal contrast agents for CT and MRI with prolonged contrast enhancement in vivo have been proposed for cardiovascular imaging as well as image registration and guidance applications in radiation therapy (146).…”

Section: Contrast Agents For Multimodality Imagingmentioning

confidence: 99%

“…For the tissue targets, liver, spleen, lymph nodes and the blood pool, efficient contrast-enhancing compounds have been described that utilize different active transport systems or passive diffusion-limiting molecular sizes. The agents include water-soluble metal chelates (122)(123)(124), iodinated polymeric compounds, and contrast-agent-carrying liposomes (125)(126)(127).…”

Section: Contrast Agents Molecular Probes and Tracersmentioning

confidence: 99%

In Vivo mouse imaging and spectroscopy in drug discovery

et al. 2007

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Imaging modalities such as micro-computed tomography (micro-CT), micro-positron emission tomography (micro-PET), high-resolution MRI, optical imaging, and high-resolution ultrasound have become invaluable tools in preclinical pharmaceutical research. They can be used to non-invasively investigate, in vivo, rodent biology and metabolism, disease models, and pharmacokinetics and pharmacodynamics of drugs. The advantages and limitations of each approach usually determine its application, and therefore a small-rodent imaging laboratory in a pharmaceutical environment should ideally provide access to several techniques. In this paper we aim to illustrate how these techniques may be used to obtain meaningful information for the phenotyping of transgenic mice and for the analysis of compounds in murine models of disease.

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Gadolinium-Enhanced Computed Tomographic Angiography: Current Status

Cited by 10 publications

References 29 publications

Photon-Counting Versus Energy-Integrating Detector CT Angiography of the Lower Extremity in a Human Cadaveric Model With Continuous Extracorporeal Perfusion

Photon-Counting Versus Energy-Integrating Detector CT Angiography of the Lower Extremity in a Human Cadaveric Model With Continuous Extracorporeal Perfusion

Feasibility of gadolinium-enhanced dual energy CT pulmonary angiography: a pilot study in rabbits

In Vivo mouse imaging and spectroscopy in drug discovery

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