Monochromatic image reconstruction by dual energy imaging allows half iodine load computed tomography coronary angiography

Carrascosa, Patrícia; Leipsic, Jonathon; Capuñay, Carlos; Deviggiano, Alejandro; Vallejos, Javier; Goldsmit, Alejandro; Rodríguez-Granillo, Gastón A.

doi:10.1016/j.ejrad.2015.06.019

Cited by 45 publications

(34 citation statements)

References 26 publications

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“…Several studies have recently reported that the radiation dose can be reduced to the 2-4 mSv level in CCTA using DECT. 14,15) Our results have extended this further, with dose reductions of 25-62% compared with all above mentioned radiation levels.…”

Section: Discussionsupporting

confidence: 59%

“…However, our findings are somewhat in contrast with previously published studies, that showed optimized results at slightly higher mono-energetic values (60 keV). 14,15) One possible reason could be due to significant increases in noise at lower mono-energetic levels along with the CT attenuation enhancement, thereby causing a reduction in image SNR and CNR. But in our study, the image noise remained consistent even at lower keVs, thus contributing to better performances of 40-50 keV compared with higher keV levels.…”

Section: Discussionmentioning

confidence: 99%

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Low Dose and Low Contrast Medium Coronary CT Angiography Using Dual-Layer Spectral Detector CT

Zhao

et al. 2019

Int. Heart J.

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The aim of the present study was to investigate the performance of low keV mono-energetic reconstructions in spectral coronary computed tomography angiography (CCTA) using spectral detector CT (SDCT) with reduced contrast media and radiation dose. Sixty patients were randomly assigned to Groups A and B (both n = 30) to undergo CCTA on a dual-layer SDCT with tube voltage 120 kVp and 100 kVp (average tube current: 108.5 and 73.8 mAs, respectively), with contrast media volume of 36 mL used in both groups. The mono-energetic 40-80 keV and conventional 120 kVp images in Group A and conventional 100 kVp images in Group B were reconstructed. Quantitative and qualitative image quality (IQ) were evaluated in the aortic root and distal segments of the coronary arteries. The patient characteristics were not significantly different between the two groups (all P !0.47), nor was the effective radiation dose (1.5 ± 0.3 and 1.4 ± 0.3 mSv, P = 0.20). The quantitative IQ in aorta and coronary arteries of mono-energetic 40-60 keV was superior to conventional 120 kVp and 100 kVp images (all P < 0.05). The noise in spectral images was lower compared to conventional images (all P < 0.01). The subjective IQ score of 40-50 keV images was not significantly different from that of 100 kVp images (P > 0.8). The mono-energetic 40-50 keV reconstructions from spectral CCTA using SDCT provide improved IQ compared to conventional techniques while facilitating reduced radiation dose and contrast media.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Low Dose and Low Contrast Medium Coronary CT Angiography Using Dual-Layer Spectral Detector CT

Zhao

et al. 2019

Int. Heart J.

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“…In recent years, a contrast media reduction method using virtual monochromatic X-ray imaging by dual energy CT has been reported [189][190][191][192][193][194] in which virtual monochromatic X-ray images are generated based on dual energy data and it is possible to virtually represent a CT image of an arbitrary single energy level [effective energy (keV)]. The lower the single energy, the higher the CT value of the iodine contrast media.…”

Section: Rationale Cq6-4mentioning

confidence: 99%

Guideline on the use of iodinated contrast media in patients with kidney disease 2018

et al. 2019

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“…5) (14). Virtual low energy monoenergetic images have been shown to boost vascular contrast in several vascular beds (15)(16)(17). The necessary measurements can be made from the virtual monoenergetic images permitting imaging with equivalent radiation dose but lower contrast dose compared with standard single energy CT.…”

Section: Assessment Before Transcatheter Aortic Valve Implantation (Tmentioning

confidence: 99%

“…Opportunities exist for lowering radiation dose with spectral detectors compared with standard detectors primarily through eliminating one phase of a multiphase study, salvaging a suboptimal study that might otherwise need repeating, or obviating the need for follow-up imaging. As with other DECT technologies, the opportunity exists for reducing contrast load with SDCT and exploiting the higher attenuation of iodine at lower energies (5,(14)(15)(16)(17). This has (27) Incidental lesion characterization Characterization of incidental nodules, and masses, particularly in Virtual unenhanced, iodine map kidneys, adrenals and lungs (28) CT, computed tomography; CTA, CT angiography; TAVI, transcatheter aortic valve implantation.…”

Section: Impact On Contrast Dose and Radiation Dosementioning

confidence: 99%

Spectral detector CT for cardiovascular applications

Rajiah¹,

Abbara²,

Halliburton³

2017

Diagn Interv Radiol

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In spectral computed tomography (CT), multiple spectrally distinct attenuation data sets are obtained from the same scan, which enables material composition analysis not possible with conventional CT. Dual-energy CT (DECT), where a low and high energy data set are obtained, is currently available in clinical practice using the following approaches: a) Dual source technology: two x-ray tube/detector systems separated by approximately 90 o and operated at different tube potentials (1) (Fig. 1a); b) Rapid tube potential switching technology: the potential applied across a single x-ray tube is switched rapidly between a high and low setting (1, 2) (Fig. 1b); c) Dual-spin technology: the same anatomical region is scanned twice during two consecutive rotations, once with a high potential applied across the x-ray tube and once with a low potential applied (1) (Fig. 1c); d) Split-beam technology: the spectrum emitted from a single tube is split into high and low energy spectra (3).Spectral detector CT (SDCT) (IQon, Philips Healthcare) is a novel technology introduced for clinical DECT data acquisition. A single potential is applied across a single x-ray tube and two layers of detectors separate low and high energy data: the top layer absorbs low energy photons and the bottom layer absorbs high energy photons (Fig. 1d). In addition to conventional (polyenergetic) images, projection data simultaneously obtained from both detector layers can also be utilized to generate spectral images. The spectral images useful for cardiovascular assessment include virtual monoenergetic images (Fig. 2a), iodine density maps (Fig. 2b), virtual unenhanced images (Fig. 2c), and effective atomic number (Z effective ) images (Fig. 2d). An important feature of SDCT technology is that spectral information is available in all patients without a priori selection of a special protocol or exposure to additional radiation. Images are available at full field-of-view and a minimum rotation time of 0.27 seconds (s) with complete temporal and spatial registration.In this paper, we present our initial clinical experience based on the acquisition of data from over 200 patients who underwent cardiovascular studies (i.e., cardiac, aorta, pulmonary veins, pulmonary arteries) using SDCT including the impact of this technology on radiation dose and contrast dose. The creation of spectral images from spectral data is discussed and the utility of these images is demonstrated for specific cardiovascular applications. 187From the Department of Radiology (P.R. ABSTRACTSpectral detector computed tomography (SDCT) is a novel technology that uses two layers of detectors to simultaneously collect low and high energy data. Spectral data is used to generate conventional polyenergetic images as well as dedicated spectral images including virtual monoenergetic and material composition (iodine-only, virtual unenhanced, effective atomic number) images. This paper provides an overview of SDCT technology and a description of some spectral image types. The potential utility o...

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Monochromatic image reconstruction by dual energy imaging allows half iodine load computed tomography coronary angiography

Cited by 45 publications

References 26 publications

Low Dose and Low Contrast Medium Coronary CT Angiography Using Dual-Layer Spectral Detector CT

Low Dose and Low Contrast Medium Coronary CT Angiography Using Dual-Layer Spectral Detector CT

Guideline on the use of iodinated contrast media in patients with kidney disease 2018

Spectral detector CT for cardiovascular applications

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