Journal article
Whole-Body High-Pitch CT Angiography: Strategies to Reduce Radiation Dose and Contrast Volume
American journal of roentgenology (1976), v 209(6), pp 1396-1403
Dec 2017
PMID: 28981350
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Abstract
The purpose of this study was to assess the noninferiority of dual-source high-pitch CT angiography (CTA) performed with high-concentration (iopamidol 370) low-volume (60 mL) iodinated contrast material at low voltage (100 kVp) in comparison with dual-source high-pitch CTA with standard-of-care low-concentration (iopamidol 300) standard-volume (75 mL) iodinated contrast material at high voltage (120 kVp) to determine whether use of the high-concentration low-volume method would afford a reduction in radiation dose and contrast volume without negatively affecting vascular opacification.
This study had three arms. A phantom was used to assess vascular contrast enhancement at different iodine and saline solution dilutions with iopamidol 300 or 370 to compare lower-iodination (iopamidol 300) high-voltage (120 kVp) high-pitch (120 kVp, 250 mAs) imaging with higher-iodination (iopamidol 370) low-voltage (100 kVp) high-pitch (100 kVp, 100-240 mAs) acquisition. Metal-oxide-semiconductor field-effect transistors were placed in an anthropomorphic phantom to extract organ-based radiation profiles, and ANOVA was performed. The study prospectively enrolled 150 patients: 50 patients received 75 mL iopamidol 300, and image acquisition was performed at 120 kVp and 250 mAs; 50 patients received 75 mL iopamidol 370, and acquisition was performed at 100 kVp and 240 mAs; and 50 patients received 60 mL iopamidol, and acquisition was performed at 370 at 100 kVp and 240 mAs. Vascular signal-to-noise ratio was evaluated at 18 anatomic locations. Longitudinal signal-to-noise ratio was used to assess homogeneity of contrast enhancement. Size-specific dose estimates were calculated. Statistical analyses were performed by ANOVA.
Noninferiority of high-concentration (iopamidol 370) low-voltage (100 kVp) high-pitch acquisitions compared with low-concentration (iopamidol 300) high-voltage (120 kVp) high-pitch acquisition was achieved at 170 mAs in vitro. Radiation assessment showed significant decreases in radiation dose for the 100-kVp 240-mAs protocol (p < 0.0001). Noninferior vascular contrast (p > 0.280) and luminal homogeneity (p > 0.191) were found for all high-pitch protocols. Significantly decreased radiation dose was observed for the two groups that received 60 and 75 mL of iopamidol 370 at 100 kVp and 240 mAs (p < 0.0001).
Dual-source high-pitch CTA with high-concentration (iopamidol 370) low-volume (60 mL) iodinated contrast medium and low-voltage acquisition (100 kVp) is noninferior to dual-source high-pitch CTA with low-concentration (iopamidol 300) standard-volume (75 mL) iodinated contrast material at high voltage (120 kVp) and affords simultaneous reduction in radiation dose and contrast volume without negatively affecting vascular contrast enhancement.
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Details
- Title
- Whole-Body High-Pitch CT Angiography: Strategies to Reduce Radiation Dose and Contrast Volume
- Creators
- Sebastian Manneck - University Hospital of BaselLynne M Hurwitz - Duke Medical CenterDanielle M Seaman - Duke Medical CenterTobias Heye - University Hospital of BaselDaniel T Boll - University Hospital of Basel
- Publication Details
- American journal of roentgenology (1976), v 209(6), pp 1396-1403
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiology (Radiologic Sciences)
- Web of Science ID
- WOS:000415982900046
- Scopus ID
- 2-s2.0-85035235552
- Other Identifier
- 991022138578904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Radiology, Nuclear Medicine & Medical Imaging