Non–Electrocardiogram-Triggered 70-kVp High-Pitch Computed Tomography Angiography of the Whole Aorta With Iterative Reconstruction

Zhang, Long Jiang; Xie, Li; Schoepf, U. Joseph; Wichmann, Julian L.; Tang, Chunbo; Zhou, Chang Sheng; Lu, Guang Ming

doi:10.1097/rct.0000000000000329

Cited by 13 publications

(4 citation statements)

References 27 publications

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“…The CTA at low tube voltages (low-kV imaging) has been investigated as a tool to increase CT attenuation and the contrast-to-noise ratio (CNR) of the aorta with the option of radiation dose and/or CM reduction 18–30 . Following these lines, automatic tube voltage selection (ATVS) has been introduced as a means to reduce radiation dose in CT depending on the imaging task and patient habitus, while maintaining image quality in terms of the CNR 31 .…”

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confidence: 99%

“…17 The CTA at low tube voltages (low-kV imaging) has been investigated as a tool to increase CT attenuation and the contrast-to-noise ratio (CNR) of the aorta with the option of radiation dose and/or CM reduction. [18][19][20][21][22][23][24][25][26][27][28][29][30] Following these lines, automatic tube voltage selection (ATVS) has been introduced as a means to reduce radiation dose in CT depending on the imaging task and patient habitus, while maintaining image quality in terms of the CNR. 31 The ATVS system has primarily been designed for radiation dose optimization by selecting the tube voltage level that offers lowest radiation dose at maintained CNR.…”

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confidence: 99%

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Computed Tomography Angiography of the Aorta—Optimization of Automatic Tube Voltage Selection Settings to Reduce Radiation Dose or Contrast Medium in a Prospective Randomized Trial

et al. 2020

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Objectives: The aim of this study was to compare the image quality of low-kV protocols with optimized automatic tube voltage selection (ATVS) settings to reduce either radiation dose or contrast medium (CM) with that of a reference protocol for computed tomography angiography (CTA) of the thoracoabdominal aorta. Materials and Methods: In this institutional review board-approved, singlecenter, prospective randomized controlled trial, 126 patients receiving CTA of the aorta were allocated to one of three computed tomography protocols: (A) reference protocol at 120 kVp and standard weight-adapted CM dose; (B) protocol at 90 kVp, reduced radiation and standard CM dose; and (C) protocol at 90 kVp, standard radiation and reduced CM dose. All three protocols were performed on a third-generation dual-source computed tomography scanner using the semimode of the ATVS system. The image-task-dependent optimization settings of the ATVS (slider level) were adjusted to level 11 (high-contrast task) for protocols A and B and level 3 (low-contrast task) for protocol C. Radiation dose parameters were assessed. The contrast-to-noise ratios (CNRs) of protocols B and C were tested for noninferiority compared with A. Subjective image quality was assessed using a 5-point Likert scale. Results: Size-specific dose estimate was 34.3% lower for protocol B compared with A (P < 0.0001). Contrast medium was 20.2% lower for protocol C compared with A (P < 0.0001). Mean CNR in B and C was noninferior to protocol A (CNR of 30.2 ± 7, 33.4 ± 6.7, and 30.5 ± 8.9 for protocols A, B, and C, respectively). There was no significant difference in overall subjective image quality among protocols (4.09 ± 0.21, 4.03 ± 0.19, and 4.08 ± 0.17 for protocols A, B, and C, respectively; P = 0.4). Conclusions: The slider settings of an ATVS system can be adjusted to optimize either radiation dose or CM at noninferior image quality in low-kV CTA of the aorta. This optimization could be used to extend future ATVS algorithms to take clinical risk factors like kidney function of individual patients into account.

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Computed Tomography Angiography of the Aorta—Optimization of Automatic Tube Voltage Selection Settings to Reduce Radiation Dose or Contrast Medium in a Prospective Randomized Trial

et al. 2020

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“…[14][15][16]43 Beeres et al 14 applied the CM volume of 90 ml in high-pitch dual-source aortic CTA and obtained good image quality. Using low kVp settings in high pitch mode, Shen et al 15 and Zhang et al 43 attempted to reduce CM dose to the weightadapted volume of 1.0 ml kg 21 (270 mgI kg 21 ) and the fixed volume of 60 ml, respectively. As for volume acquisitions, Chen et al 16 proposed the joint application of wide-volume CT and iterative reconstruction algorithm to lower the CM volume to 40 ml in aortic CTA.…”

Section: Discussionmentioning

confidence: 99%

Iterative reconstruction in single-source dual-energy CT angiography: feasibility of low and ultra-low volume contrast medium protocols

Hou

Feng

Jie

et al. 2017

The British Journal of Radiology

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“…One study showed that it was possible to reduce the CM volume in a CTA by 25% by scanning at 70-kVp using a high-pitch technique with the same diagnostic accuracy as compared with standard 120-kVp and standard volume of CM. [23] Another study showed that low tube voltage 80 kVp CTA using 50 mL of CM has the same diagnostic quality as a 120 kVp CTA using 100 mL of CM. [24] Patient body weight can use to determine the optimal Figure 8: 84-year-old female presenting to the emergency department after an unwitnessed fall and acute blood loss anemia with a concern for acute aortic injury.…”

Section: Kilovoltage (Kvp) and Masmentioning

confidence: 99%

Optimizing low contrast volume thoracic CT angiography: From the basics to the advanced

Kaproth-Joslin

Hobbs

Rajiah

et al. 2022

JCIS

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Contrast-enhanced CT angiography (CTA) is a widely used, noninvasive imaging technique for evaluating cardiovascular structures. Contrast-induced nephrotoxicity is a concern in renal disease; however, the true nephrotoxic potential of iodinated contrast media (CM) is unknown. If a renal impaired patient requires CTA, it is important to protect the kidneys from further harm by reducing total iodinated CM volume while still obtaining diagnostic quality imaging. These same reduced volume CM techniques can also be applied to nonrenal impaired patients in times of CM shortage. This educational review discusses several modifications to CTA that can be adapted to both conventional 64-slice and the newer generation CT scanners which enable subsecond acquisition with a reduced CM volume technique. Such modifications include hardware and software adjustments and changes to both the volume and flow rate of administered CM, with the goal to reduce the dose of CM without compromising diagnostic yield.

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Non–Electrocardiogram-Triggered 70-kVp High-Pitch Computed Tomography Angiography of the Whole Aorta With Iterative Reconstruction

Abstract: Non-ECG-triggered 70-kVp high-pitch aortic CTA with IR provides equivalent diagnostic image quality with 90% reduction of radiation dose and 25% reduction of contrast volume compared with standard 120-kVp CTA.

Cited by 13 publications

References 27 publications

Computed Tomography Angiography of the Aorta—Optimization of Automatic Tube Voltage Selection Settings to Reduce Radiation Dose or Contrast Medium in a Prospective Randomized Trial

Computed Tomography Angiography of the Aorta—Optimization of Automatic Tube Voltage Selection Settings to Reduce Radiation Dose or Contrast Medium in a Prospective Randomized Trial

Iterative reconstruction in single-source dual-energy CT angiography: feasibility of low and ultra-low volume contrast medium protocols

Optimizing low contrast volume thoracic CT angiography: From the basics to the advanced

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