Low tube voltage computed tomography urography using low-concentration contrast media: Comparison of image quality in conventional computed tomography urography

Hwang, In-Kyeong; Cho, Jeong Yeon; Kim, Sang-Youn; Oh, Seung‐June; Ku, Ja Hyeon; Lee, Joongyup; Kim, Seung Hyup

doi:10.1016/j.ejrad.2015.09.010

Cited by 14 publications

(6 citation statements)

References 28 publications

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“…We defined a −0.74 score difference as a non-inferior margin to ensure that the diagnostic acceptability was greater than a score of 4 when compared with the conventional protocol score through consensus among participating radiologists according to a previous study. In the aforementioned study, the mean grades assigned by the more experienced radiologist of the two independent evaluators for the quality of images were 4.34 (± 0.65) (mean ± SD) for the LVLC-CTU protocol and 4.74 (± 0.44) for the conventional protocol ( 14 ). A sample size of 43 patients in each group could achieve 80% power to detect a non-inferiority margin difference between group means of −0.4, assuming a one-sided significance level of 2.5%.…”

Section: Methodsmentioning

confidence: 92%

“…The present study was conducted to expand on the results of a previous single-institution study ( 14 ). The results of the present study could be considered more generalizable and may support the clinical validity of LVLC-CTU.…”

Section: Discussionmentioning

confidence: 99%

“…A previous randomized controlled study demonstrated that modified CTU performed with a combination of low-tube-voltage (80 kVp), a low-iodine-concentration-contrast-medium (240 mgI/mL), and an IR algorithm was not inferior to conventional CTU in terms of diagnostic acceptability ( 14 ). However, it is uncertain whether these results are generalizable, as this previous study was performed at a single institution using a CT scanner from a single vendor in a small number of patients (n = 63).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

et al. 2018

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ObjectiveTo compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU.Materials and MethodsThis prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated.ResultsThe study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose (5.73 ± 4.04 vs. 8.43 ± 4.38 mSv) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ≥ 3), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group.ConclusionThe diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.

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Section: Methodsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

et al. 2018

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“…The SD N in this study did not increase significantly compared to conventional scanning, but SNR increased. However, in the previous study, [11,28] SD N raised and SNR decreased. This might because the selected patients in this study had BMI less than 25 kg/m 2 .…”

Section: Discussionmentioning

confidence: 65%

Computed tomography portography of patients with cirrhosis with normal body mass index

et al. 2018

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This study is to investigate the computed tomography (CT) image quality of the low- tube-voltage protocol with low contrast agent dose.CT portography was performed in 118 cirrhosis patients with body mass index (BMI) less than 25 kg/m2 under 2 protocols: Protocol A, tube voltage of 90 kVp/395 mAs and contrast agent dosage of 1.2 mL/kg, and, Protocol B, tube voltage of 120 kVp/200 mAs and contrast agent dosage of 1.5 mL/kg.The number of patients in each protocol was 59. The CT value noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in portal veins was comparatively analyzed between the 2 protocols. The subjective image quality was further assessed on 5-point scales. Radiation dose was also recorded and statistical analysis was performed.The CT value, CNR, and SNR of the images were higher at 90 kVp than those at 120 kVp (P < .05). There was no significant difference in image noise between the 2 protocols (P > .05). The CT dose index volume, dose-length product, and effective dose at 90 kVp were 18.2%, 16.0%, and 16.0% less than that at 120 kVp, respectively. There was no difference in image quality score between the 2 protocols (P > .05). The average amount of contrast agent was decreased by 17.8% when the 90 kVp protocol was used.CT portography at 90 kVp combined with low-dosage contrast agent leads to a significant reduction in radiation dose and improved SNR and CNR, without deterioration of image quality.

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“…In regards to solid organs, the feasibility of the 'double low' strategy has been reported mainly in the liver [31][32][33][34][35][36] and kidneys. 37,38 The application in pancreatic disease 39 is excluded from this review due to the final results not being associated with radiation dose reduction.…”

Section: Aorta and Branches Cta (Table 4) Ct Venography Of Deep Vementioning

confidence: 99%

Did low tube voltage CT combined with low contrast media burden protocols accomplish the goal of “double low” for patients? An overview of applications in vessels and abdominal parenchymal organs over the past 5 years

Shen

Zou

et al. 2016

Int J Clin Pract

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Low tube voltage computed tomography urography using low-concentration contrast media: Comparison of image quality in conventional computed tomography urography

Cited by 14 publications

References 28 publications

Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

Computed tomography portography of patients with cirrhosis with normal body mass index

Did low tube voltage CT combined with low contrast media burden protocols accomplish the goal of “double low” for patients? An overview of applications in vessels and abdominal parenchymal organs over the past 5 years

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