Comparison of four contrast medium delivery protocols in low-iodine and low-radiation dose CT angiography of the aorta

Chen, P.-A.; Huang, Eric Yi-Hsiu; Chen, K.-T.; Chen, Y.-C.; Yi, Hana; Chuo, Chiung Chen; Wu, Fu-Zong; Wu, Ming-Chen

doi:10.1016/j.crad.2020.06.017

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…However, large doses of radiation and contrast media are often required to obtain high image quality [15]. Therefore, it is of vital importance to develop a dual low-dose standardized abdominal CTA scanning program [16][17][18]. For CTA examination, CNR is the most critical evaluation index [19], which is mainly positively correlated with the degree of vascular enhancement and negatively correlated with image noise intensity.…”

Section: Discussionmentioning

confidence: 99%

A Feasibility Study to Evaluate Replacing Conventional Computed Tomography at 120 KVP with Low Radiation Dose and Low Iodine Intake Based on Body Mass Index-Adapted Abdominal Computed Tomography Angiography in 291 Patients

et al. 2023

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Background:This feasibility study aimed to evaluate replacing conventional computed tomography at 120 kVp with low radiation and low iodine dose based on body mass index (BMI)-adapted abdominal computed tomography angiography in 291 patients. Material/Methods:A total of 291 abdominal CTA patients were divided into 3 individualized kVp groups according to their BMI: A1 with 70 kVp (n=57), A2 with 80 kVp (n=49), and A3 with 100 kVp (n=48); and 3 conventional 120 kVp groups: B1 (n=40), B2 (n=53), and B3 (n=44) BMI-matched with group A. The contrast media was 300 mgI/kg for group A and 500 mgI/kg for group B. The CT values and SD of the abdominal aorta and the erector spinae were measured, and the contrast-to-noise ratio (CNR) and figure-of-merit (FOM) were calculated. Imaging quality, radiation, and contrast media dosage were evaluated. Results:The CT and CNR of abdominal aorta in groups A1 and A2 were higher than those in groups B1 and B2 (P<0.05), but there was no significant difference between groups A3 and B3 (P>0.05). FOM of the abdominal aorta in group A was higher than that in group B (P<0.05). Compared with groups B1, B2, and B3, the radiation doses of A1, A2, and A3 groups decreased by 70.61%, 56.72%, and 31.87%, and contrast intake decreased by 39.94%, 38.74%, and 35.09%, respectively (P<0.05). Conclusions:BMI-based individualized kVp abdominal CTA imaging significantly reduced overall radiation dose and contrast media intake while providing excellent image quality.

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Section: Discussionmentioning

confidence: 99%

A Feasibility Study to Evaluate Replacing Conventional Computed Tomography at 120 KVP with Low Radiation Dose and Low Iodine Intake Based on Body Mass Index-Adapted Abdominal Computed Tomography Angiography in 291 Patients

et al. 2023

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Section: Introductionmentioning

confidence: 99%

“…If the patient's body habitus permits, the tube voltage can be reduced from 120 kVp to as low as 70 kVp, and the iodine load can also be decreased to 200 mg I/kg [7,8]. However, the generalizability of many low-dose CT protocols to the wider patient population remains uncertain, as studies have often excluded obese patients, omitted weight and BMI, or separately optimized either radiation or iodine dose [7,[9][10][11][12][13]. A recent study showed that double-low aortic CT at 70-80 kVp and an iodine load of 200 mg I/kg can reliably detect endoleaks after endovascular repair, albeit by excluding examinations with poor image quality and not recording patient BMI [9].…”

Section: Introductionmentioning

confidence: 99%

BMI-Adapted Double Low-Dose Dual-Source Aortic CT for Endoleak Detection after Endovascular Repair: A Prospective Intra-Individual Diagnostic Accuracy Study

Melzig,

Hartmann,

Steuwe

et al. 2024

Diagnostics

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Purpose: To assess the diagnostic accuracy of BMI-adapted, low-radiation and low-iodine dose, dual-source aortic CT for endoleak detection in non-obese and obese patients following endovascular aortic repair. Methods: In this prospective single-center study, patients referred for follow-up CT after endovascular repair with a history of at least one standard triphasic (native, arterial and delayed phase) routine CT protocol were enrolled. Patients were divided into two groups and allocated to a BMI-adapted (group A, BMI < 30 kg/m2; group B, BMI ≥ 30 kg/m2) double low-dose CT (DLCT) protocol comprising single-energy arterial and dual-energy delayed phase series with virtual non-contrast (VNC) reconstructions. An in-patient comparison of the DLCT and routine CT protocol as reference standard was performed regarding differences in diagnostic accuracy, radiation dose, and image quality. Results: Seventy-five patients were included in the study (mean age 73 ± 8 years, 63 (84%) male). Endoleaks were diagnosed in 20 (26.7%) patients, 11 of 53 (20.8%) in group A and 9 of 22 (40.9%) in group B. Two radiologists achieved an overall diagnostic accuracy of 98.7% and 97.3% for endoleak detection, with 100% in group A and 95.5% and 90.9% in group B. All examinations were diagnostic. The DLCT protocol reduced the effective dose from 10.0 ± 3.6 mSv to 6.1 ± 1.5 mSv (p < 0.001) and the total iodine dose from 31.5 g to 14.5 g in group A and to 17.4 g in group B. Conclusion: Optimized double low-dose dual-source aortic CT with VNC, arterial and delayed phase images demonstrated high diagnostic accuracy for endoleak detection and significant radiation and iodine dose reductions in both obese and non-obese patients compared to the reference standard of triple phase, standard radiation and iodine dose aortic CT.

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“…Double-low CT aortography (DLCTA) of the aorta, a protocol with low tube voltage and a low amount of contrast agent, is increasingly used in aortic CTA. The tube voltage ranges from 70 to 100 kVp, with an iodine load of 200–300 mgI/kg, as in previous studies [ 13 , 14 , 15 , 16 , 17 , 18 ]. An earlier report showed that DLCTA of the whole aorta using 70 kVp and 200 mg I/kg can provide sufficient CTA attenuation when using an optimal contrast medium delivery protocol for diagnosis and is thus feasible in clinical practice [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…The tube voltage ranges from 70 to 100 kVp, with an iodine load of 200–300 mgI/kg, as in previous studies [ 13 , 14 , 15 , 16 , 17 , 18 ]. An earlier report showed that DLCTA of the whole aorta using 70 kVp and 200 mg I/kg can provide sufficient CTA attenuation when using an optimal contrast medium delivery protocol for diagnosis and is thus feasible in clinical practice [ 17 ]. However, whether DLCTA could reliably detect the presence of endoleak in patients who received TEVAR or EVAR is not clear.…”

Section: Introductionmentioning

confidence: 99%

Can Low-Iodine, Low-Radiation-Dose CT Aortogram Reliably Detect Endoleak after Endovascular Aneurysm Repair of the Aorta?

et al. 2023

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Objective: Double-low CT aortography (DLCTA) is increasingly used in follow-up studies of aortic aneurysm after endovascular aneurysm repair (EVAR). However, whether DLCTA can reliably detect the presence of endoleak is not clear. Methods: From February 2014 to October 2019, patients who received EVAR, underwent CT surveillance, and had at least one standard CTA protocol (120 kVp, 400 mg I/kg) and one DLCTA (70–80 kVp, 200 mg I/kg) were included. The integrated findings of the standard CTA and sequential change were considered as the reference standard for the presence of endoleak. Results: In all, 36 patients received TEVAR and 24 patients received EVAR; 62 standard CTA and 167 DLCTA results were analyzed. There were 2 type I (3.3%) and 12 type II (20.0%) endoleaks in 14 patients (23.3%). The performance of DLCTA in the diagnosis of endoleak reached 100% accuracy compared to that of standard CTA in case of the correction of CT findings by an expert second reading. Compared to the standard CTA, DLCTA scan reduced the radiation dose by 71% and the iodine dose by 50%. Conclusions: DLCTA with 70–80 kVp and 200 mg I/kg can reliably detect the presence of endoleak after TEVAR/EVAR.

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Comparison of four contrast medium delivery protocols in low-iodine and low-radiation dose CT angiography of the aorta

Cited by 6 publications

References 23 publications

A Feasibility Study to Evaluate Replacing Conventional Computed Tomography at 120 KVP with Low Radiation Dose and Low Iodine Intake Based on Body Mass Index-Adapted Abdominal Computed Tomography Angiography in 291 Patients

A Feasibility Study to Evaluate Replacing Conventional Computed Tomography at 120 KVP with Low Radiation Dose and Low Iodine Intake Based on Body Mass Index-Adapted Abdominal Computed Tomography Angiography in 291 Patients

BMI-Adapted Double Low-Dose Dual-Source Aortic CT for Endoleak Detection after Endovascular Repair: A Prospective Intra-Individual Diagnostic Accuracy Study

Can Low-Iodine, Low-Radiation-Dose CT Aortogram Reliably Detect Endoleak after Endovascular Aneurysm Repair of the Aorta?

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