Optimization of Multi–Detector Row CT Urography: Effect of Compression, Saline Administration, and Prolongation of Acquisition Delay

Caoili, Elaine M.; Inampudi, Prasuna; Cohan, Richard H.; Ellis, James H.

doi:10.1148/radiol.2351031085

Cited by 95 publications

(105 citation statements)

References 13 publications

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“…[15] In another study Caoili et al confirmed that compression could improve distension and opacification of the ICS and the proximal ureter, however none of the differences were statistically significant. [6] Our results showed no significant change in opacification for chosen maneuvers if location was chosen as a cofactor. Anatomically given the location is a significant parameter if taken as a covariate, the distal ureter is the most challenging segment to opacify.…”

Section: Discussionmentioning

confidence: 47%

“…Representative CTU protocols contain either a three-phase acquisition with a single-bolus injection or a two-phase acquisition with a two bolus-injection (split-bolus). [6][7][8][9][10] Our scan protocol consists of an unenhanced scan (scan 1), followed by a split-bolus phase (scan 2), as advocated by different study groups. [4,[11][12][13] Scan 2 was followed by supportive maneuvers and a late phase CT (scan 3).…”

Section: Discussionmentioning

confidence: 99%

“…10 min after the first IV injection of contrast medium, the third scan was obtained, as a longer time delay has been described as preferable regarding distension and opacification of the distal urinary tract. [6,14] Patients were placed randomly into one of the three maneuver groups. After the split-bolus CT (scan 2) we could demonstrate that no significant difference exists among the groups regarding distention and opacification.…”

Section: Discussionmentioning

confidence: 99%

“…This method is already well established in IVU and has been evaluated by many investigators in CT. [3][4][5][6]8] External compression is not as straight forward implementable compared to Valsalva maneuvers and it is even impractical in patients suffering from abdominal pain, recent abdominal surgery or known abdominal aortic aneurysm.…”

Section: Discussionmentioning

confidence: 99%

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CT-Urography: Comparison of different methods for increasing the intra-abdominal pressure

Hage

Boll²,

Brantner³

et al. 2018

IJDI

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Objective: Investigating the influence of increasing the intraabdominal pressure by Valsalva maneuvers and/or abdominal compression to reach best visualization of the entire urinary tract in computed tomography urography (CTU). Methods: After split-bolus technique, Valsalva maneuvers, compression or a combination of both were applied in 60 patients before late phase images were acquired. The degree of opacification and distension of three segments of the urinary tract were evaluated. Results: After split-bolus CT no significant difference among the groups regarding distention and opacification. A significant increase in distension and opacification was found during Valsalva and the combination of Valsalva and compression. Conclusions: A CTU protocol including a late phase scan with prior application of compression, Valsalva maneuvers or a combination of both showed beneficial effects for the distension and opacification, a significant difference was found by taking location as a covariate.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

CT-Urography: Comparison of different methods for increasing the intra-abdominal pressure

Hage

Boll²,

Brantner³

et al. 2018

IJDI

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“…It has been shown that CT urography outperforms ultrasound, excretory urography, and radiography in the evaluation of renal parenchymal masses and urinary tract calculi (4) . Radiation doses associated with CT urography have been measured to be anywhere from 1.5–2 times the dose of standard urography (5) with effective doses as high as 35 mSv reported for some CT urography studies (6) …”

Section: Introductionmentioning

confidence: 99%

Dose reduction in CT urography and vasculature phantom studies using model‐based iterative reconstruction

Page

Wei²,

Kundra

et al. 2016

J Applied Clin Med Phys

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To evaluate the feasibility of radiation dose reduction using model‐based iterative reconstruction (MBIR) for evaluating the ureters and vasculature in a phantom, a tissue‐equivalent CT dose phantom was scanned using a 64‐channel CT scanner. Tubes of varying diameters filled with different dilutions of a contrast agent, simulating ureters or vessels, were inserted into the center of the phantom. Each combination was scanned using an existing renal protocol at 140 kVp or 120 kVp, yielding a display volumetric CT dose index (CTDIvol) of 24 mGy. The scans were repeated using reduced scan techniques to achieve lower radiation doses down to 0.8 mGy. The images were reconstructed using filtered back‐projection (FBP) and model‐based iterative reconstruction (MBIR). The noise and contrast‐to‐noise ratio (CNR) was measured for each contrast object. Comparisons between the two reconstruction methods at different dose levels were evaluated using a factorial design. At each CTDIvol the measured image noise was lower using MBIR compared to FBP (p<0.0001). At low doses, the percent change in measured image noise between FBP and MBIR was larger. For the 12 mm object simulating a ureter or large vessel with an HU of 600, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was greater than the CNR of FBP at a CTIDvol of 24 mGy (p<0.0001). For the 5 mm object simulating a medium‐sized vessel with a HU of 250, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was equivalent to that of FBP at a CTDIvol of 24 mGy. For the 2 mm, 100 HU object simulating a small vessel, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was equivalent to that of FBP at a CTDIvol of 24 mGy. Low‐dose (3.6 mGy) CT imaging of vasculature and ureter phantoms using MBIR results in similar noise and CNR compared to FBP at approximately one‐sixth the dose. This suggests that, using MBIR, a one milliSievert exam of the ureters and vasculature may be clinically possible whilst still maintaining adequate image qualityPACS number(s): 87.57.‐s, 87.57.Q‐, 87.57.C‐, 87.57.nf, 87.57.cj, 87.57.cm

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Computed Tomography of Urologic Malignancies

Raman¹,

Fishman²

2017

Management of Urologic Cancer

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Optimization of Multi–Detector Row CT Urography: Effect of Compression, Saline Administration, and Prolongation of Acquisition Delay

Cited by 95 publications

References 13 publications

CT-Urography: Comparison of different methods for increasing the intra-abdominal pressure

CT-Urography: Comparison of different methods for increasing the intra-abdominal pressure

Dose reduction in CT urography and vasculature phantom studies using model‐based iterative reconstruction

Computed Tomography of Urologic Malignancies

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