Reducing contrast medium volume and tube voltage in CT angiography of the pulmonary artery

Mourits, M.; Nijhof, W.H.; Leuken, Maarten H van; Jager, Gerrit J.; Rutten, M.J.C.M.

doi:10.1016/j.crad.2016.03.005

Cited by 28 publications

(19 citation statements)

References 24 publications

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“…Our results are in agreement with Mourits M.M. et al [10]; in fact, they highlight that low-tube-voltage CTA using 50 of ml of CM is not inferior to CTA qt 120 kV using 100 ml of CM. Concerning the quantitative analysis, if Yamamuro et al [5], using a 64-slice multidetector CT, assumed that an optimal CT density in the coronary arteries had to be considered to be more than 250 to 350 HU, in our study we did not select an optimal density in the aorta, because we considered that it was not necessary due to the great dimension of the vessel: our parameter was concerned with the variation of density through the vessel.…”

Section: Discussionsupporting

confidence: 83%

Low Radiation and Contrast Medium Dose in 64- Slices Multidtector Ct Angiography of Thoracic Aorta

Molfetta¹,

Monte²,

Guerrisi³

et al. 2017

RadJ

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Abstract. The evaluation of chronic aortic diseases, many protocols of low radiation dose and low medium iodine contrast dose are performed. The main aim of this study is to give a preliminary evaluation of dose reduction and iodine dose reduction. In our hospital, from February 2013 to November 2016 we selected 150 patients divided into two groups: 60 for our study and a control group of 90 cases. All CT examinations were performed with a 64-MDCT scan (Optima-CT GE Healtcare). Tube voltage was reduced in our study (80 kVp versus 120 in our standard) with automated current modulation system in both groups. Concerning the iodine dose reduction, in the study groups it was strongly reduced (40 cc of 370 mg/ml versus 90 cc of 370 mg/ml): a mechanical power injector was used to administer the contrast material via catheters (20-gauge) placed in the antecubital vein at a flow rate of 4.5 ml/sec. Two radiologists qualitatively graded the image quality of all cases, defining the walls and the enhancement of the lumen of the aorta. On the basis of the criteria reported in the literature, a five-point subjective scale was used to grade image quality, from excellent (1) to non-diagnostic quality (5). The reasons for the degraded image quality were due to high BMI and consisted especially in low signal/noise ratio, and in two cases it was due to the suboptimal contrast enhancement owing to poor bolus timing. In the cases of low signal/noise ratio, a smooth filter was applied to reduce the noise. The results of this study provide useful information about the reduction of the radiation dose and the medium iodine contrast. The diagnostic quality of the scan performed with a low dose of iodine and radiation overlays with the scans performed with the standard protocol. The study groups revealed a strong reduction dose in terms of DLP, and the quality of images was similar to the control group.

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Section: Discussionsupporting

confidence: 83%

Low Radiation and Contrast Medium Dose in 64- Slices Multidtector Ct Angiography of Thoracic Aorta

Molfetta¹,

Monte²,

Guerrisi³

et al. 2017

RadJ

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“…IMA is not uncommon, accounting for approximately 25% of the total number of patients with IC rupture; however, it can cause severe SAH. CTA has been clinically used as a routine means of diagnosing IA owing to its high speed and effective diagnosis ; ‐ ; however, it is also controversial because of its radiation problems, as well as the detection rate of IMA . It is therefore necessary to further discuss the feasibility of L‐CTA in displaying IMA.…”

Section: Discussionmentioning

confidence: 99%

“…Although magnetic resonance angiography (MRA) is a radiation‐free alternative for the diagnosis of IA, and MRA imaging has been developed in recent years, its results may be affected owing to long acquisition times, flow empty phenomena, and SAH patients' disturbance‐induced movement artifacts. Computed tomography angiography (CTA) plays an increasingly important role in screen suspected IA patients, and has been widely used as a routine diagnostic tool for IA . However, the accuracies of CTA in diagnosing intracranial micro‐aneurysms (IMA) vary from 61% to 98.2%; moreover, the detection rate of IMA when CTA is utilized is controversial, yet the detection rate of IMA is an important indicator for judging CTA's sensitivity.…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography angiography (CTA) plays an increasingly important role in screen suspected IA patients, and has been widely used as a routine diagnostic tool for IA . However, the accuracies of CTA in diagnosing intracranial micro‐aneurysms (IMA) vary from 61% to 98.2%; moreover, the detection rate of IMA when CTA is utilized is controversial, yet the detection rate of IMA is an important indicator for judging CTA's sensitivity. In addition, the radiation dose of CT scanning is also a matter of concern .…”

Section: Introductionmentioning

confidence: 99%

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Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Duan

Liu

et al. 2017

Int J Imaging Syst Tech

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The aim of this study was to investigate the diagnostic values of low tube voltage cerebral computed tomography (CT) angiography (L‐CTA, 100 kV) of intracranial micro‐aneurysms (IMA, maximum diameter ≤3 mm). The clinical and imaging data of a total of 59 IMA patients confirmed by 3D rotational angiography (3DRA) or surgery were retrospectively analyzed; their L‐CTA data were compared with those of IMA and 3DRA so as to investigate the diagnostic sensitivity, specificity, and accuracy of IMA, as well as to objectively evaluate the related radiation dose. Based on the results of 3DRA, 65 cases of IMA and a total of 70 aneurysms, including 65 micro‐aneurysms, were found in the 59 cases. L‐CTA detected a total of 64 IMA, including six multiple cases of IMA, as well as three false positive cases and four missed cases. Compared with the 3DRA (gold standard), the diagnostic sensitivity, specificity, and accuracy of L‐CTA toward IMA were 93.85%, 99.56%, and 99.08%, respectively, and the associations of aneurysm size measured by L‐CTA and 3DRA were good. Compared with conventional CTA, the effective dose of L‐CTA was reduced by 36.23%. L‐CTA has high diagnostic sensitivity toward IMA, and can effectively reduce the radiation dose, so it is worth implementing.

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“…ponentially reduce radiation exposure as said above, allow an intensification of vessel density due to the increase of photoelectric effect of X-ray attenuation at lower tube voltages for structures of high atomic number, such as iodine (7). Thus, at a practical level, augmented noise at low radiation doses can be circumvented by raising intravascular contrast enhancement by means of a low kV setting and high-iodine concentration low-volume CM injection (17)(18)(19).…”

Section: Increasing Contrastmentioning

confidence: 99%

Tailoring protocols for chest CT applications: when and how?

Iezzi

Larici²,

Franchi³

et al. 2017

Diagn Interv Radiol

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Reducing contrast medium volume and tube voltage in CT angiography of the pulmonary artery

Cited by 28 publications

References 24 publications

Low Radiation and Contrast Medium Dose in 64- Slices Multidtector Ct Angiography of Thoracic Aorta

Low Radiation and Contrast Medium Dose in 64- Slices Multidtector Ct Angiography of Thoracic Aorta

Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Tailoring protocols for chest CT applications: when and how?

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