CT angiography of intracranial arterial vessels: impact of tube voltage and contrast media concentration on image quality

Ramgren, Birgitta; Björkman–Burtscher, Isabella M.; Holtås, Stig; Siemund, Roger

doi:10.1258/ar.2012.120218

Cited by 16 publications

(19 citation statements)

References 11 publications

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“…Although many studies have proposed the prevention of contrast-induced nephropathy, the practical clinical settings for minimization of iodine amount have remained unchanged [8], [9], which are mainly due to the fact that a reduction in the effective iodine amount may attenuate the enhancement of vessels and consequently adversely affect diagnostic accuracy [36], [37]. By using low tube voltage technique, a better vascular enhancement can be achieved with less iodine amount.…”

Section: Discussionmentioning

confidence: 99%

CT Angiography of the Head-and-Neck Vessels Acquired with Low Tube Voltage, Low Iodine, and Iterative Image Reconstruction: Clinical Evaluation of Radiation Dose and Image Quality

Zhang

et al. 2013

PLoS ONE

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ObjectivesWe aimed to assess the effectiveness and feasibility of head-and-neck Computed Tomography Angiography (CTA) with low tube voltage and low concentration contrast media combined with iterative reconstruction algorithm.Methods92 patients were randomly divided into group A and B: patients in group A received a conventional scan with 120 kVp and contrast media of 320 mgI/ml. Patients in group B, 80 kVp and contrast media of 270 mgI/ml were used along with iterative reconstruction algorithm techniques. Image quality, radiation dose and the effectively consumed iodine amount between two groups were analyzed and compared.ResultsImage quality of CTA of head-and-neck vessels obtained from patients in group B was significantly improved quantitatively and qualitatively. In addition, CT attenuation values in group B were also significantly higher than that in group A (p<0.001). Furthermore, compared with the protocol whereby 120 kVp and 320 mgI/dl were administrated, the mean radiation dose and consumed iodine amount in protocol B were also reduced by 50% and 15.6%, respectively (p<0.001).ConclusionsWith the help of iterative reconstruction algorithm techniques, the head-and-neck CTA with diagnostic quality can be adequately acquired with low tube voltage and low concentration contrast media. This method could be potentially extended to include any part of the body to reduce the risks related to ionizing radiation.

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Section: Discussionmentioning

confidence: 99%

CT Angiography of the Head-and-Neck Vessels Acquired with Low Tube Voltage, Low Iodine, and Iterative Image Reconstruction: Clinical Evaluation of Radiation Dose and Image Quality

Zhang

et al. 2013

PLoS ONE

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“…Such lowkilovolt protocols are used in cerebral perfusion CT in the evaluation of patients with stroke 16 and in pediatric CT. 17 In phantom 18 as well as in clinical studies, it has been demonstrated that this technique can also be used in chest and abdominal imaging in adults. [19][20][21][22][23][24] Lower tube voltage in CTA results in higher noise levels on one hand, but the attenuation of iodine is increased 25,26 on the other hand. This relationship must be considered when trying to reduce radiation exposure by use of low-kilovolt scanning and to maintain image quality.…”

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confidence: 99%

“…This relationship must be considered when trying to reduce radiation exposure by use of low-kilovolt scanning and to maintain image quality. 24,27 The higher noise level in low-kilovolt scans will not be completely compensated by the higher iodine attenuation; therefore, additional adjustments of the tube current (milliampere setting) are necessary. Optimal manual adjustment of these parameters is complex, which prevented low-kilovolt scanning from general use until now.…”

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confidence: 99%

Carotid CTA: Radiation Exposure and Image Quality with the Use of Attenuation-Based, Automated Kilovolt Selection

Eller¹,

Wuest²,

Kramer³

et al. 2013

American Journal of Neuroradiology

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“…The use of relatively smaller CM volumes in combination with higher flow rates indicates an inferior importance of CM volume and TIL compared with flow rate and IDR with respect to arterial enhancement, even under emergency conditions: IDR can be manipulated by adjusting either flow rate or iodine concentration of CM [IDR (gI s 21 ) 5 flow rate (ml s 21 ) 3 iodine concentration (gI ml 21 )]. Some authors state that attenuation in CTA could be increased by using higher iodine concentrations of CM, 28 whereas others state that increasing IDR-by increasing flow rate-is the most influencing factor regarding CM enhancement. 16,29 Increasing flow rate might be preferable for optimizing CM application for CTA, since increasing iodine concentration of CM simultaneously increases CM viscosity.…”

Section: Discussionmentioning

confidence: 99%

Individually tailored contrast enhancement in CT pulmonary angiography

Hendriks

Kok

Mihl

et al. 2016

BJR

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Objective: The purpose was to evaluate individually shaped contrast media (CM) delivery in CT pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). Methods: 100 consecutive emergency patients with clinical suspicion of PE were evaluated. High-pitch CTPA was performed on a second-generation dual-source CT using the following parameters: 100 kV, 200-250 mAsref, rotation time 0.28 s, 128 3 0.6 mm col. and image reconstruction 1.0/0.8 mm (B30f). Group 1 (n 5 50) then received a fixed CM bolus (300 5 mgI ml 21, volume 5 90 ml and flow rate 5 6 ml s 21 ); Group 2 (n 5 50) received a body weightadapted CM bolus determined by dedicated contrast injection software. For analysis, groups were further subdivided into low-weight (40-75 kg) and high-weight (76-117 kg) groups. Technical image quality was graded using a four-point Likert scale (1 5 non-diagnostic; 2 5 diagnostic; 3 5 good and 4 5 excellent image quality) at the level of the pulmonary trunk and pulmonary arteries. Objective image quality analysis was performed by measuring contrast enhancement in Hounsfield units (HU) at the same levels. Attenuation levels . 180 HU were considered diagnostic. Results: All examinations were graded as diagnostic at each level. The individual minimum pulmonary attenuation was 184 and 270 HU for Group 1 and 2, respectively. Mean attenuation was as follows: Group 1: 475 6 105 HU (40-75 kg) and 402 6 115 HU (76-117 kg), p , 0.03. Group 2: 424 6 76 HU (40-75 kg) and 418 6 100 HU (76-117 kg), p 5 0.8. For Group 2, CM volumes were: 55 6 5 ml (40-75 kg) and 66 6 5 ml (76-117 kg), leading to 16-51% CM reduction. Conclusion: Even under emergency conditions, individualized CM protocols can provide diagnostic and robust image quality in CTPA for PE with a substantial reduction of CM volume for lower weight patients, compared with a fixed CM protocol. Advances in knowledge: CM volume can substantially be reduced by using individualized CM protocols in CT angiography for PE without compromising the diagnostic image quality.

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CT angiography of intracranial arterial vessels: impact of tube voltage and contrast media concentration on image quality

Abstract: The uses of highly concentrated contrast media and low tube voltage are easily performed measures to improve image quality in CTA of intracranial vessel.

Cited by 16 publications

References 11 publications

CT Angiography of the Head-and-Neck Vessels Acquired with Low Tube Voltage, Low Iodine, and Iterative Image Reconstruction: Clinical Evaluation of Radiation Dose and Image Quality

CT Angiography of the Head-and-Neck Vessels Acquired with Low Tube Voltage, Low Iodine, and Iterative Image Reconstruction: Clinical Evaluation of Radiation Dose and Image Quality

Carotid CTA: Radiation Exposure and Image Quality with the Use of Attenuation-Based, Automated Kilovolt Selection

Individually tailored contrast enhancement in CT pulmonary angiography

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