Peripheral Arterial Occlusive Disease: Diagnostic Performance and Effect on Therapeutic Management of 64-Section CT Angiography

Napoli, Alessandro; Anzidei, Michele; Zaccagna, Fulvio; Marincola, Beatrice Cavallo; Zini, Chiara; Brachetti, Giulia; Cartocci, Gaia; Fanelli, Fabrizio; Catalano, Carlo; Passariello, Roberto

doi:10.1148/radiol.11103564

Cited by 68 publications

(35 citation statements)

References 30 publications

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“…We also calculated the effective radiation dose delivered for the pelvic and hip regions, since the exposure of the extremities contributes only minimally to the overall effective dose and the conversion factors for legs are not available [11], [16]. The distance from the pelvic crest to the proximal third of the thighs, including the testicles in men and vulva in women, was measured in each patient.…”

Section: Methodsmentioning

confidence: 99%

Image Quality and Radiation Dose of Lower Extremity CT Angiography Using 70 kVp, High Pitch Acquisition and Sinogram-Affirmed Iterative Reconstruction

Meinel

Zhou

et al. 2014

PLoS ONE

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ObjectivesThe purpose of this study was to assess image quality and radiation dose of lower extremity CT angiography (CTA) with 70 kVp, high pitch acquisition and sinogram-affirmed iterative reconstruction (SAFIRE).MethodsLower extremity CTAs were performed on 44 patients: 22 patients were examined using protocol A (120 kVp, pitch of 0.85 and 120 ml of contrast agent on a first-generation dual-source CT) (120 kVp group) and 22 patients were evaluated with protocol B (70 kVp, pitch of 2.2 and 80 ml of contrast agent on a second-generation dual-source CT) (70 kVp group). Images from the 120 kVp group were reconstructed with filtered back projection (FBP) and images from the 70 kVp group with SAFIRE. The attenuation, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Two radiologists subjectively assessed image quality of lower extremity arteries, plantar arterial enhancement and venous contamination of all patients. Radiation dose was compared between the two groups.ResultsHigher mean intravascular attenuation was obtained in the 70 kVp group (70 vs. 120 kVp group, 555.4±83.4 HU vs. 300.9±81.4 HU, P<0.001), as well as image noise (20.0±2.8 HU vs. 17.5±3.2 HU, P = 0.010), SNR (32.0±7.0 vs. 19.1±6.9, P<0.001) and CNR (28.1±6.6 vs 15.9±6.3, P<0.001). No difference in subjective image quality and plantar arterial enhancement was found between 120 kVp group and 70 kVp group (all P>0.05). The venous contamination score was 1.5±0.8 for 120 kVp group while no venous contamination was found in 70 kVp group. The inter-observer agreement was moderate to good for both groups (0.515∼1, P<0.001). The effective dose was lower in 70 kVp group (0.3±0.1 mSv) than in 120 kVp group (1.6±0.7 mSv)(P<0.001).ConclusionsLower extremity CTA using 70 kVp, high pitch acquisition and SAFIRE, except increasing imaging noise, allows for lower radiation dose and contrast material volume without compromising image quality.

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Section: Methodsmentioning

confidence: 99%

Image Quality and Radiation Dose of Lower Extremity CT Angiography Using 70 kVp, High Pitch Acquisition and Sinogram-Affirmed Iterative Reconstruction

Meinel

Zhou

et al. 2014

PLoS ONE

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“…New applications for CT angiography emerged, including assessment of upper extremity trauma (190), abdominal wall arterial mapping (363), lower intestinal bleeding (364), and integrity of aortic stent grafts (365). With evolution of multidetector CT systems, assessment of the lower extremity arterial system has become robust (366), supplanting the need for digital subtraction angiography in clinical decision making (367). In the search for a source of subarachnoid hemorrhage, single-row CT angiography was limited to use in the detection of cerebral arterial aneurysms 3 mm in diameter or larger (368); however, with the introduction of multidetector CT, all aneurysms were visible retrospectively despite challenges in the prospective detection of the smallest aneurysms (369).…”

Section: The Third Dimension Emerges Capabilities Expandmentioning

confidence: 99%

Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

Rubin

2014

Radiology

140

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Computed tomography (CT) has had a profound effect on the practice of medicine. Both the spectrum of clinical applications and the role that CT has played in enhancing the depth of our understanding of disease have been profound. Although almost 90 000 articles on CT have been published in peer-reviewed journals over the past 40 years, fewer than 5% of these have been published in Radiology. Nevertheless, these almost 4000 articles have provided a basis for many important medical advances. By enabling a deepened understanding of anatomy, physiology, and pathology, CT has facilitated key advances in the detection and management of disease. This article celebrates this breadth of scientific discovery and development by examining the impact that CT has had on the diagnosis, characterization, and management of a sampling of major health challenges, including stroke, vascular diseases, cancer, trauma, acute abdominal pain, and diffuse lung diseases, as related to key technical advances in CT and manifested in Radiology.

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“…A more recent single-center study evaluated the diagnostic performance of 64-slice CTA compared to DSA 35 for detection of stenosis >70% on a per segment basis. CTA had an accuracy of 98%, sensitivity of 99% and specificity of 97%.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Multimodality Imaging of Lower Extremity Peripheral Arterial Disease

Pollak

Norton

Kramer

2012

Circ: Cardiovascular Imaging

107

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Peripheral Arterial Occlusive Disease: Diagnostic Performance and Effect on Therapeutic Management of 64-Section CT Angiography

Abstract: The diagnostic performance of 64-section CT angiography is excellent in patients with clinical symptoms of PAD. The results can be used to effectively guide therapeutic decision making in these patients.

Cited by 68 publications

References 30 publications

Image Quality and Radiation Dose of Lower Extremity CT Angiography Using 70 kVp, High Pitch Acquisition and Sinogram-Affirmed Iterative Reconstruction

Image Quality and Radiation Dose of Lower Extremity CT Angiography Using 70 kVp, High Pitch Acquisition and Sinogram-Affirmed Iterative Reconstruction

Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

Multimodality Imaging of Lower Extremity Peripheral Arterial Disease

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