The feasibility of low-concentration contrast and low tube voltage in computed tomography perfusion imaging: an animal study

Aim: To investigate the feasibility of low-concentration contrast (270 mg/ml) together with low tube voltage (80 kV) and adaptive iterative dose reduction (AIDR)-3D reconstruction in liver computed tomography (CT) perfusion imaging. Method: A total of 15 healthy New Zealand rabbits received two CT scans each. The first scan (control) was acquired at 100 kV and 100 mA with iopromide (370 mg/ml), while the second scan (experimental) was acquired at 80 kV and 100 mA with iodixanol (270 mg/ml) 24 h after the first scan. The obtained images were reconstructed with filtered back projection (FBP) and AIDR-3D in the control and experimental groups respectively. The perfusion parameters (hepatic artery perfusion [HAP], portal vein perfusion [PVP], hepatic perfusion index [HPI], and total liver perfusion [TLP]) and image quality (image quality score, average CT value of abdomen aorta, signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR], and figure of merit [FOM]) were compared using a paired t-test or Mann–Whitney U test between the two groups, when appropriate. The effective radiation dose and iodine intake were also recorded and compared. Results: With the exception of the FOM criteria, the image quality and perfusion parameters were not significantly different between the two groups. The effective radiation dose and iodine intake were 38.79% and 27.03% lower respectively, in the experimental group. Conclusion: Low-concentration contrast (iodixanol, 270 mg/ml) together with low tube voltage (80 kV) and AIDR-3D reconstruction help to reduce radiation dose and iodine intake without compromising perfusion parameters and image quality in liver CT perfusion imaging.

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Application of Low Tube Voltage, Low-concentration Contrast Agent Using a 320-row CT in Coronary CT Angiography: Evaluation of Image Quality, Radiation Dose and Iodine Intake

Current Medical Science ◽

10.1007/s11596-020-2162-8 ◽

2020 ◽

Vol 40 (1) ◽

pp. 178-183

Author(s):

Yue-ying Pan ◽

Shu-chang Zhou ◽

Yu-jin Wang ◽

Qian Li ◽

Ting-ting Zhu ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Contrast Agent ◽

Ct Angiography ◽

Coronary Ct Angiography ◽

Iodine Intake ◽

Tube Voltage ◽

Low Concentration ◽

Low Tube Voltage ◽

Coronary Ct

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Improvement of image quality and radiation dose of CT perfusion of the brain by means of low-tube voltage (70 KV)

European Radiology ◽

10.1007/s00330-014-3247-1 ◽

2014 ◽

Vol 24 (8) ◽

pp. 1906-1913 ◽

Cited By ~ 21

Author(s):

Zhen-lin Li ◽

Hang Li ◽

Kai Zhang ◽

Wang-jiang Li ◽

Xian Chen ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Ct Perfusion ◽

Tube Voltage ◽

Low Tube Voltage ◽

The Brain

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Simulated Radiation Dose Reduction in Whole-Body CT on a 3rd Generation Dual-Source Scanner: An Intraindividual Comparison

Diagnostics ◽

10.3390/diagnostics11010118 ◽

2021 ◽

Vol 11 (1) ◽

pp. 118

Author(s):

Andreas S. Brendlin ◽

Moritz T. Winkelmann ◽

Phuong Linh Do ◽

Vincent Schwarze ◽

Felix Peisen ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Dose Reduction ◽

Whole Body ◽

Reference Standard ◽

Diagnostic Confidence ◽

Effective Radiation Dose ◽

Intraindividual Comparison ◽

Dual Source ◽

Effective Radiation

To evaluate the effect of radiation dose reduction on image quality and diagnostic confidence in contrast-enhanced whole-body computed tomography (WBCT) staging. We randomly selected March 2016 for retrospective inclusion of 18 consecutive patients (14 female, 60 ± 15 years) with clinically indicated WBCT staging on the same 3rd generation dual-source CT. Using low-dose simulations, we created data sets with 100, 80, 60, 40, and 20% of the original radiation dose. Each set was reconstructed using filtered back projection (FBP) and Advanced Modeled Iterative Reconstruction (ADMIRE®, Siemens Healthineers, Forchheim, Germany) strength 1–5, resulting in 540 datasets total. ADMIRE 2 was the reference standard for intraindividual comparison. The effective radiation dose was calculated using commercially available software. For comparison of objective image quality, noise assessments of subcutaneous adipose tissue regions were performed automatically using the software. Three radiologists blinded to the study evaluated image quality and diagnostic confidence independently on an equidistant 5-point Likert scale (1 = poor to 5 = excellent). At 100%, the effective radiation dose in our population was 13.3 ± 9.1 mSv. At 20% radiation dose, it was possible to obtain comparably low noise levels when using ADMIRE 5 (p = 1.000, r = 0.29). We identified ADMIRE 3 at 40% radiation dose (5.3 ± 3.6 mSv) as the lowest achievable radiation dose with image quality and diagnostic confidence equal to our reference standard (p = 1.000, r > 0.4). The inter-rater agreement for this result was almost perfect (ICC ≥ 0.958, 95% CI 0.909–0.983). On a 3rd generation scanner, it is feasible to maintain good subjective image quality, diagnostic confidence, and image noise in single-energy WBCT staging at dose levels as low as 40% of the original dose (5.3 ± 3.6 mSv), when using ADMIRE 3.

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Reducing cranial computed tomography effective radiation dose by 30% using adaptive iterative dose reduction

Proceedings of Singapore Healthcare ◽

10.1177/2010105816651655 ◽

2016 ◽

Vol 25 (4) ◽

pp. 230-234

Author(s):

Wai-Yung Yu ◽

Thye Sin Ho ◽

Henry Ko ◽

Wai-Yee Chan ◽

Serene Ong ◽

...

Keyword(s):

Computed Tomography ◽

Image Quality ◽

Radiation Dose ◽

Dose Reduction ◽

Diagnostic Image Quality ◽

Radiation Doses ◽

Effective Radiation Dose ◽

Diagnostic Image ◽

Ct Head ◽

Effective Radiation

Introduction: The use of computed tomography (CT) imaging as a diagnostic modality is increasing rapidly and CT is the dominant contributor to diagnostic medical radiation exposure. The aim of this project was to reduce the effective radiation dose to patients undergoing cranial CT examination, while maintaining diagnostic image quality. Methods: Data from a total of 1003, 132 and 27 patients were examined for three protocols: CT head, CT angiography (CTA), and CT perfusion (CTP), respectively. Following installation of adaptive iterative dose reduction (AIDR) 3D software, tube current was lowered in consecutive cycles, in a stepwise manner and effective radiation doses measured at each step. Results: Baseline effective radiation doses for CT head, CTA and CTP were 1.80, 3.60 and 3.96 mSv, at currents of 300, 280 and 130–150 mA, respectively. Using AIDR 3D and final reduced currents of 160, 190 and 70–100 mA for CT head, CTA and CTP gave effective doses of 1.29, 3.18 and 2.76 mSv, respectively. Conclusion: We demonstrated that satisfactory reductions in the effective radiation dose for CT head (28.3%), CTA (11.6%) and CTP (30.1%) can be achieved without sacrificing diagnostic image quality. We have also shown that iterative reconstruction techniques such as AIDR 3D can be effectively used to help reduce effective radiation dose. The dose reductions were performed within a short period and can be easily achievable, even in busy departments.

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An open label, prospective, multicenter, non-interventional study of iodixanol 270 mg I/mL for use in individuals undergoing computed tomography angiography in real-world clinical practice

Acta Radiologica ◽

10.1177/0284185118774917 ◽

2018 ◽

Vol 60 (2) ◽

pp. 177-185

Author(s):

Xiangying Du ◽

Bin Lu ◽

Daoyu Hu ◽

Bin Song ◽

Kuncheng Li

Keyword(s):

Computed Tomography ◽

Image Quality ◽

Radiation Dose ◽

Iterative Reconstruction ◽

Computed Tomography Angiography ◽

Pulmonary Arteries ◽

Open Label ◽

Tube Voltage ◽

Effective Radiation Dose ◽

Noise Ratio

Background Concern about radiation exposure is leading to an increasing interest in low-concentration contrast medium administration. Purpose To evaluate the image quality and safety profile after administration of iodixanol 270 mg I/mL at 100-kVp tube voltage with iterative reconstruction in subjects undergoing computed tomography angiography (CTA). Material and Methods Patients who completed CTA examination using iodixanol 270 mg I/mL and 100-kVp tube voltage along with iterative reconstruction for coronary, aortic, head and neck, renal, or pulmonary arteries were included. Image quality was qualitatively and quantitatively evaluated. Incidence of adverse events (AEs) and adverse drug reactions (ADRs) within seven days and radiation dose were also analyzed. Results A total of 4513 individuals in 42 centers in China were enrolled, among which 4367 were included in efficacy analysis. The mean image quality score was 4.8 ± 0.45 across all arteries (all above 4.6) and 99.7% of the individuals’ images were classified as evaluable. The CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the regions of interest (ROIs) were 431.79 ± 99.018, 18.29 ± 11.947, and 28.21 ± 19.535 HU, respectively. Of all the participants, 68 (1.5%) and 65 (1.4%) experienced AEs and ADRs, respectively. No serious AEs or AEs leading to discontinuation occurred. The average effective radiation dose was 3.13 ± 2.550 mSv. Conclusion Iodixanol 270 mg I/mL in combination with 100-kVp tube voltage and iterative reconstruction could be safely applied in CTA and yield high-quality and evaluable images with reduced radiation dose.

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