Utility of dual-energy spectral CT and low-iodine contrast medium in DIEP angiography

Gao, Zhenyue; Meng, Donghua; Lü, Hong; Yao, Bingyu; Huang, Ning; Ye, Zhaoxiang

doi:10.1111/ijcp.12855

Cited by 8 publications

(12 citation statements)

References 13 publications

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“…However, compared with group A, group D showed no difference in CT values, mainly because the increase in CT value that was caused by lowering the tube voltage can be compensated by lowering the dosage of iodine agent. 34 Meanwhile, low-tube-voltage scan protocol was associated with an increase in image noise, 35 because the penetrating power is reduced, but the image contrast can be improved. The image noise was higher in group B (17.9 6 5.4) than in group A (15.2 6 4.6), with an increase of 15.1%, and compared with group C (15.5 6 3.7), the noise of group D (18.1 6 3.8) was increased by 14.4%, consistent with Nakaura et al, 19,36 who reported that noise of the low-voltage group was much higher than that of the high-voltage group.…”

Section: Discussionmentioning

confidence: 99%

Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study

et al. 2019

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To evaluate the influence of low-concentration contrast agents and low-tube-voltage computed tomography on chest enhancement examinations, we conducted a multicenter prospective study. A total of 216 inpatients enrolled from 12 different hospitals were randomly divided into four groups: A: voltage, 120 kVp; iohexol, 350 mgI/mL; B: voltage, 100 kVp, iohexol, 350 mgI/mL; C: voltage, 120 kVp, iodixanol, 270 mgI/mL; and D: voltage, 100 kVp, iodixanol, 270 mgI/mL. Subjective image quality was assessed by two radiologists and compared by weighted kappa test. The objective image scores, scanning radiation doses, and pathological coincidence rates were analyzed. There were no significant differences in gender, age, height, weight, and body mass index between the four groups (p . 0.05). The consistency of the radiologists' ratings were good, with kappa value ranging from 0.736 (95% confidence interval: 0.54-0.933) to 0.809 (95% confidence interval: 0.65-0.968), and there was no difference in subjective image score between the four Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).groups. The computed tomography value of group D had no difference with group A. The volume computed tomography dose index, dose length product, and effective dose of group D (6.93 6 3.03, 241.55 6 104.75, and 3.38 6 1.47, respectively) were all significantly lower than those of group A (10.30 6 4.37, 359.70 6 152.65, and 5.04 6 2.14, respectively). There was no significant difference in the imaging diagnosis accuracy rate between the four groups (p . 0.05). The results indicated that low-concentration contrast agents (270 mgI/mL) and low-tube-voltage (100 kVp) computed tomography can not only decrease radiation dose but also guarantee the image quality and meet the needs of imaging diagnosis in chest enhancement examinations, which make it possible for its generalization and application.

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Section: Discussionmentioning

confidence: 99%

Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study

et al. 2019

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“…We found that more lymph nodes could be detected by spectral CT than traditional CT imaging. Monochromatic CT images at a lower keV could improve the density resolution and optimize the display of low-contrast structures (21)(22)(23). In our study, monochromatic CT images at 70 keV were selected.…”

Section: Discussionmentioning

confidence: 99%

“…Receiver operating characteristic (ROC) analysis was performed to test the diagnostic efficiency of each index. All statistical analyses were performed with SPSS 22.0 (version 22…”

Section: Statistical Analysesmentioning

confidence: 99%

Application of spectral CT imaging in evaluating lymph node metastasis in patients with gastric cancers: initial findings

et al. 2018

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Background Traditional computed tomography (CT) can predict the lymph node metastasis of gastric cancers with moderate accuracy; however, investigation of spectral CT imaging in this field is still limited. Purpose To explore the application of spectral CT imaging in evaluating lymph node metastasis in patients with gastric cancers. Material and Methods Twenty-four patients with gastric cancers prospectively underwent spectral CT imaging in the arterial phase. The short and long diameters, material concentrations, and CT values were measured and compared between lymph nodes with and without metastasis. The diagnostic performance of the CT index in identifying metastatic lymph nodes was analyzed with receiver operating characteristic (ROC) analysis. Results A total of 102 lymph nodes (77 metastatic, 25 non-metastatic) were detected on spectral CT imaging with the reference of postoperative pathologic exanimation. The short and long diameters, water/fat concentrations, CT value, and ratio between lymph nodes vs. tumors of metastatic lymph nodes were significantly higher than those of non-metastatic ones (all P < 0.05). With a cut-off of 0.785, the CT ratio of lymph node/tumor on 70-keV monochromatic images yielded an accuracy of 81.4% in differentiating lymph nodes with and without metastasis. Conclusion Spectral CT imaging detects lymph nodes more clearly, and the CT ratio of lymph node/tumor on 70-keV monochromatic images holds great potential in differentiating lymph nodes with and without metastasis, which is more accurate than size measurement.

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“…26,27 Another feature of CTA is its potential for threedimensional image processing, 28 Given CTA's main and significant disadvantage is its use of contrast and radiation, 23,24,26 there has been investigation into using lower doses of both. 29 Several studies have found that low-dose techniques achieve high-quality vascular imaging similar to conventional CTA. 29,30 Overall, CTA is an excellent resource for preoperative perforator imaging with continuing developments to mitigate the risks of iodinatedcontrast and radiation exposure.…”

Section: Computerised Tomographic Angiographymentioning

confidence: 99%

“…29 Several studies have found that low-dose techniques achieve high-quality vascular imaging similar to conventional CTA. 29,30 Overall, CTA is an excellent resource for preoperative perforator imaging with continuing developments to mitigate the risks of iodinatedcontrast and radiation exposure.…”

Section: Computerised Tomographic Angiographymentioning

confidence: 99%

Imaging of perforasome territories: the evolution of techniques

Rozen¹,

Leung²,

Chae³

et al. 2018

Australas J Plast Surg

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Background: Perforator flaps are widely used in reconstructive plastic surgery and technological advances in preoperative imaging have facilitated improvements in flap perfusion and clinical outcomes. The ‘perforasome’ concept describes the vascular territory supplied by a single arterial perforator and the imaging of these zones of perfusion has become increasingly advanced. Methods: This paper presents a qualitative analysis of the current literature on perforasome imaging. A review of the literature was performed using PubMed and Medline. Historical and background studies were also included for completeness. Results: The review identified an initial 858 records for assessment, with 52 studies formally reviewed. To date, there is largely level III and IV evidence for the available imaging techniques, although level II studies are emerging. There is currently no level I evidence for any imaging technique. Conclusion: There have been significant developments in imaging techniques since the introduction of the perforasome concept nearly a decade ago. In this review we have described the evolution of these methods over time, from simple perforator location to advanced three- and four-dimensional imaging and real-time dynamic perfusion imaging. With this progression and ongoing innovation, we believe perforasome imaging has the potential to improve outcomes in perforator flap surgery.

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Utility of dual-energy spectral CT and low-iodine contrast medium in DIEP angiography

Abstract: The combination of dual-energy spectral CT and low-iodine intake in CTA of DIEP flap examination with the optimal CNR technology can meet the requirements of clinical diagnostics, with a 22.86% reduction in total iodine intake and an 11.01% reduction in radiation dose.

Cited by 8 publications

References 13 publications

Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study

Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study

Application of spectral CT imaging in evaluating lymph node metastasis in patients with gastric cancers: initial findings

Imaging of perforasome territories: the evolution of techniques

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