Contrast agent and radiation dose reduction in abdominal CT by a combination of low tube voltage and advanced image reconstruction algorithms

Buls, Nico; Gompel, Gert Van; Cauteren, Toon Van; Nieboer, Koenraad; Willekens, Inneke; Verfaillie, Guy; Evans, Paul M.; Macholl, Sven; Newton, Ben B.; Mey, Johan De

doi:10.1007/s00330-014-3510-5

Cited by 58 publications

(40 citation statements)

References 34 publications

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“…Intravenous administration of a nonionic iodinated contrast agent (1 mL/kg of iopromide, Ultravist 370; Bayer Healthcare, Berlin, Germany) at a rate of 2–4 mL/sec was used to visualize the index tumor in all patients, followed by a saline flush of approximately 30- to 40-mL [29, 30]. A bolus-tracking program (Smart-Prep; GE Healthcare) was used to commence diagnostic scans after contrast media injection, which was started 20 seconds after reaching the 100 HU contrast enhancement threshold [29] at the mid-phase of the breath–hold, mimicking shallow breathing under conscious sedation, with three pairs of sterile, passive, fiducial markers placed on the skin of the lower chest [31].…”

Section: Methodsmentioning

confidence: 99%

Switching Monopolar Radiofrequency Ablation Using a Separable Cluster Electrode in Patients with Hepatocellular Carcinoma: A Prospective Study

Choi

Lee

et al. 2016

PLoS ONE

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ObjectiveThis study was conducted to evaluate the outcomes of multi-channel switching RFA using a separable cluster electrode in patients with HCC.MethodsFrom November 2011 to July 2013, 79 patients with 98 HCCs < 5 cm were enrolled and treated with RFA using a multi-channel switching radiofrequency system and a separable cluster electrode under the guidance of a real-time fusion imaging system. The primary and secondary endpoints were the 3-year local tumor progression (LTP) rate and recurrence-free survival (RFS) rate, respectively. For post hoc analyses, LTP, RFS, and major complication rates were retrospectively compared with a historical control group treated with RFA using the same radiofrequency system but with multiple internally-cooled electrodes.ResultsThe technique success rate of the 98 tumors was 100%. Cumulative 1-year, 2-year, and 3-year LTP rates were 3.4%, 6.9%, and 12.4%, respectively. For patient-level data, cumulative 1-year, 2-year, and 3-year RFS rates were 83.9%, 68.6%, and 45.4%, respectively. On post hoc analyses, none of the baseline characteristics showed a significant difference between the separable cluster electrode and multiple internally-cooled electrodes group. Cumulative LTP and RFS rates of the two groups also showed no significant difference (p = 0.401 and p = 0.881, respectively). Finally, major complication rates of the separable cluster electrode group (5.0%, 4/79) and multiple internally-cooled electrodes group (5.9%, 4/74) were also comparable (p = 1.000).ConclusionSwitching monopolar RFA using a separable cluster electrode is a feasible and efficient technique for the treatment of HCCs smaller than 5 cm, providing comparable local tumor control to multiple internally-cooled electrodes.Trial RegistrationClinicalTrials.gov NCT02745483

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Section: Methodsmentioning

confidence: 99%

Switching Monopolar Radiofrequency Ablation Using a Separable Cluster Electrode in Patients with Hepatocellular Carcinoma: A Prospective Study

Choi

Lee

et al. 2016

PLoS ONE

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“…The specific combinations of contrast media iodine concentration and tube voltage (320 mg I/mL at 120 kVp for the standard of care versus 160 and 200 mg I/mL at, respectively, 80 and 100 kVp for the study protocols) used in this study were selected from previous research in abdominal CT [19–21]. Based on these experiences and on literature [22], we selected a 60% blending level of ASiR reconstruction for this CCTA study.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Combining a Low-Tube Voltage Acquisition with Iterative Reconstruction on Total Iodine Dose in Coronary CT Angiography

Cauteren

Gompel

Tanaka

et al. 2017

BioMed Research International

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Objectives To assess the impact of combining low-tube voltage acquisition with iterative reconstruction (IR) techniques on the iodine dose in coronary CTA. Methods Three minipigs underwent CCTA to compare a standard of care protocol with two alternative study protocols combining low-tube voltage and low iodine dose with IR. Image quality was evaluated objectively by the CT value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the main coronary arteries and aorta and subjectively by expert reading. Statistics were performed by Mann–Whitney U test and Chi-square analysis. Results Despite reduced iodine dose, both study protocols maintained CT values, SNR, and CNR compared to the standard of care protocol. Expert readings confirmed these findings; all scans were perceived to be of at least diagnostically acceptable quality on all evaluated parameters allowing image interpretation. No statistical differences were observed (all p values > 0.11), except for streak artifacts (p = 0.02) which were considered to be more severe, although acceptable, with the 80 kVp protocol. Conclusions Reduced tube voltage in combination with IR allows a total iodine dose reduction between 37 and 50%, by using contrast media with low iodine concentrations of 200 and 160 mg I/mL, while maintaining image quality.

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“…Iterative reconstruction (IR) methods are developed to reduce image noise by performing a recursive search for the best estimate, so they can provide a similar image quality at higher noise levels compared with FBP. Consequently, applying IR techniques is considered to be one of the strategies for reducing radiation dose in CT . However, these dose reduction strategies would affect the image performance of CT in terms of contrast, spatial resolution, and noise pattern, and thus may impact the CAC scores.…”

Section: Introductionmentioning

confidence: 99%

Optimization of HU threshold for coronary artery calcium scans reconstructed at 0.5‐mm slice thickness using iterative reconstruction

Hou

Tsujioka

Yang

2019

J Applied Clin Med Phys

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Purpose This work investigated the simultaneous influence of tube voltage, tube current, body size, and HU threshold on calcium scoring reconstructed at 0.5‐mm slice thickness using iterative reconstruction (IR) through multivariate analysis. Regression results were used to optimize the HU threshold to calibrate the resulting Agatston scores to be consistent with those obtained from the conventional protocol. Methods A thorax phantom set simulating three different body sizes was used in this study. A total of 14 coronary artery calcium (CAC) protocols were studied, including 1 conventional protocol reconstructed at 3‐mm slice thickness, 1 FBP protocol, and 12 statistical IR protocols (3 kVp values*4 SD values) reconstructed at 0.5‐mm slice thickness. Three HU thresholds were applied for calcium identification, including 130, 150, and 170 HU. A multiple linear regression method was used to analyze the impact of kVp, SD, body size, and HU threshold on the Agatston scores of three calcification densities for IR‐reconstructed CAC scans acquired with 0.5‐mm slice thickness. Results Each regression relationship has R2 larger than 0.80, indicating a good fit to the data. Based on the regression models, the HU thresholds as a function of SD estimated to ensure the quantification accuracy of calcium scores for 120‐, 100‐, and 80‐kVp CAC scans reconstructed at 0.5‐mm slice thickness using IR for three different body sizes were proposed. Our results indicate that the HU threshold should be adjusted according to the imaging condition, whereas a 130‐HU threshold is appropriate for 120‐kVp CAC scans acquired with SD = 55 for body size of 24.5 cm. Conclusion The optimized HU thresholds were proposed for CAC scans reconstructed at 0.5‐mm slice thickness using IR. Our study results may provide a potential strategy to improve the reliability of calcium scoring by reducing partial volume effect while keeping radiation dose as low as reasonably achievable.

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Contrast agent and radiation dose reduction in abdominal CT by a combination of low tube voltage and advanced image reconstruction algorithms

Cited by 58 publications

References 34 publications

Switching Monopolar Radiofrequency Ablation Using a Separable Cluster Electrode in Patients with Hepatocellular Carcinoma: A Prospective Study

Switching Monopolar Radiofrequency Ablation Using a Separable Cluster Electrode in Patients with Hepatocellular Carcinoma: A Prospective Study

The Impact of Combining a Low-Tube Voltage Acquisition with Iterative Reconstruction on Total Iodine Dose in Coronary CT Angiography

Optimization of HU threshold for coronary artery calcium scans reconstructed at 0.5‐mm slice thickness using iterative reconstruction

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