Effectiveness of Adaptive Statistical Iterative Reconstruction for 64-Slice Dual-Energy Computed Tomography Pulmonary Angiography in Patients With a Reduced Iodine Load

Lee, Ji Won; Lee, Geewon; Lee, Nam Kyung; Moon, Jin Il; Ju, Yun; Suh, Young Ju; Jeong, Yeon Joo

doi:10.1097/rct.0000000000000443

Cited by 15 publications

(8 citation statements)

References 24 publications

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“…Lee et al tested a twofold reduction in iodine load using dual-energy CT with rapid kVp switching in the setting of a randomized trial of CT pulmonary angiography. 10 70 keV monoenergetic images were reconstructed, which maintained CNR and improved image noise as compared with polychromatic images. Finally, Yuan et al performed a prospective, randomized controlled trial of CT pulmonary angiography with a twofold reduction in iodine load, using 50 keV image reconstructions from dual-energy CT with rapid kVp switching.…”

Section: Discussionmentioning

confidence: 99%

“…7 Spectral CT data can be generated using rapid kVp switching from a single-source CT, dualsource CT or with a dual-layer detector. There have been studies evaluating iodine load reduction in the setting of CT angiography using single-source kVp switching [9][10][11] and dual-source CT, 12,13 but these techniques require special algorithms to correct for increased artefacts and scatter that can otherwise degrade image quality. 7,14 In contrast, duallayer detector CT acquires spectral data simultaneously with all performed studies.…”

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confidence: 99%

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Quantifying potential reduction in contrast dose with monoenergetic images synthesized from dual-layer detector spectral CT

Tsang

Merchant

et al. 2017

The British Journal of Radiology

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50 keV monoenergetic images provided the best balance of improved CNR on all studies (mean 2.4-fold increase in vivo) for enhancing vessels vs image noise. A 50% reduction in contrast dose on a 50 keV image should maintain comparable or better CNR as compared with polychromatic CT in over 80% of CT studies. Advances in knowledge: Use of a novel, single-source, dual-layer detector spectral CT scanner to improve visualization of contrast-enhanced blood vessels will reduce the amount of iodinated contrast required for radiation oncology treatment planning.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Quantifying potential reduction in contrast dose with monoenergetic images synthesized from dual-layer detector spectral CT

Tsang

Merchant

et al. 2017

The British Journal of Radiology

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“…For example, the current state-of-the-art CT scanners provide multi-kVe spectral imaging capability or enable low kVp imaging without increasing image noise using iterative reconstruction. These scanners allow for augmented contrast enhancement relative to conventional CT for a given amount of contrast medium ( 15 16 17 18 19 20 21 22 23 24 ). As these scanners decrease the amount of contrast agent needed, injection flow rate and need for large intravenous catheters can be reduced.…”

Section: Discussionmentioning

confidence: 99%

Two Small Intravenous Catheters for High-Rate Contrast Medium Injection for Computed Tomography in Patients Lacking Superficial Veins to Accommodate a Large Catheter

et al. 2018

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ObjectiveTo prospectively investigate the feasibility of using 2 small intravenous catheters for high-rate computed tomography (CT) contrast injection in patients lacking superficial veins capable of accommodating ≤ 20-gauge catheters.Materials and MethodsSixty-eight consecutive eligible adults referred for dynamic liver CT were enrolled; 58 had previously undergone liver CT, including 8 that experienced extravasation. Two 22- or 24-gauge catheters were placed in all patients after 2–5 venipunctures, and 2 mL/kg of contrast agent (370 mg I/mL) was split-administered through both catheters to achieve total flow rate of 4 mL/s. Patients' experience and examination success rate, defined as uneventful scans completed at 4 mL/s or at < 4 mL/s achieving standard image quality in all phases, were analyzed. Quantitative hepatic signal-to-noise and hepatic vascular contrast-to-noise ratios (CNRs) were compared with 30 control examinations scanned at 4 mL/s using an 18-gauge catheter.ResultsOne case each of extravasation and severe injection pain caused the examination to be aborted. Success rate was 88.2% (60/68; 54 patients scanned at 4 mL/s, 6 at 3.5–3.9 mL/s). Fifty-five of 58 patients (94.8%) that had past CT regarded the venipuncture as more tolerable than (n = 36) or similar to (n = 19) past experiences; 45 of 58 patients (77.6%) found contrast injection less painful than (n = 35) or similar to (n = 10) past experiences. When compared with control examinations, signal-to-noise ratio was similar in all phases (p ≥ 0.502), but the hepatic arterial CNR in arterial phase was slightly inferior (p ≤ 0.047).ConclusionUsing 2 small intravenous catheters can effectively achieve high-rate CT contrast injection in patients lacking adequate superficial veins.

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“…To buy a new CT scanner is a huge investment for a radiology department and buying a new CT scanner takes often years of budget planning as well as discussions with hospital managers and manufacturers. To date, techniques frequently in use are: automated tube potential selection, iterative reconstruction algorithms, high-pitch CT imaging, and low-kV imaging ( 14 – 17 ). In particular, low-kV imaging is often used in combination with some of the mentioned other techniques, especially iterative reconstruction algorithms to reduce image noise ( 10 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

Low-dose CT pulmonary angiography on a 15-year-old CT scanner: a feasibility study

Kaup

Gruber‐Rouh

Scholtz

et al. 2016

Acta Radiologica Open

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BackgroundComputed tomography (CT) low-dose (LD) imaging is used to lower radiation exposure, especially in vascular imaging; in current literature, this is mostly on latest generation high-end CT systems.PurposeTo evaluate the effects of reduced tube current on objective and subjective image quality of a 15-year-old 16-slice CT system for pulmonary angiography (CTPA).Material and MethodsCTPA scans from 60 prospectively randomized patients (28 men, 32 women) were examined in this study on a 15-year-old 16-slice CT scanner system. Standard CT (SD) settings were 100 kV and 150 mAs, LD settings were 100 kV and 50 mAs. Attenuation of the pulmonary trunk, various anatomic landmarks, and image noise were quantitatively measured; contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR) were calculated. Three independent blinded radiologists subjectively rated each image series using a 5-point grading scale.ResultsCT dose index (CTDI) in the LD series was 66.46% lower compared to the SD settings (2.49 ± 0.55 mGy versus 7.42 ± 1.17 mGy). Attenuation of the pulmonary trunk showed similar results for both series (SD 409.55 ± 91.04 HU; LD 380.43 HU ± 93.11 HU; P = 0.768). Subjective image analysis showed no significant differences between SD and LD settings regarding the suitability for detection of central and peripheral PE (central SD/LD, 4.88; intra-class correlation coefficients [ICC], 0.894/4.83; ICC, 0.745; peripheral SD/LD, 4.70; ICC, 0.943/4.57; ICC, 0.919; all P > 0.4).ConclusionThe LD protocol, on a 15-year-old CT scanner system without current high-end hardware or post-processing tools, led to a dose reduction of approximately 67% with similar subjective image quality and delineation of central and peripheral pulmonary arteries.

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Effectiveness of Adaptive Statistical Iterative Reconstruction for 64-Slice Dual-Energy Computed Tomography Pulmonary Angiography in Patients With a Reduced Iodine Load

Abstract: The ASIR technique tends to improve the image quality of VMS imaging. Dual-energy computed tomography pulmonary angiography with ASIR can reduce contrast medium volume and produce images of comparable quality with those of standard CTPA.

Cited by 15 publications

References 24 publications

Quantifying potential reduction in contrast dose with monoenergetic images synthesized from dual-layer detector spectral CT

Quantifying potential reduction in contrast dose with monoenergetic images synthesized from dual-layer detector spectral CT

Two Small Intravenous Catheters for High-Rate Contrast Medium Injection for Computed Tomography in Patients Lacking Superficial Veins to Accommodate a Large Catheter

Low-dose CT pulmonary angiography on a 15-year-old CT scanner: a feasibility study

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