Dual source abdominal computed tomography: the effect of reduced X-ray tube voltage and intravenous contrast media dosage in patients with reduced renal function.


Journal

Acta radiologica (Stockholm, Sweden : 1987)
ISSN: 1600-0455
Titre abrégé: Acta Radiol
Pays: England
ID NLM: 8706123

Informations de publication

Date de publication:
Mar 2019
Historique:
pubmed: 24 6 2018
medline: 27 2 2019
entrez: 24 6 2018
Statut: ppublish

Résumé

X-ray tube voltage (kVp) reduction increases intravenous contrast medium (CM) attenuation at computed tomography (CT), but tube output limits its use in large patients. To evaluate the feasibility and image quality of reducing CM dose by low kVp and using dual X-ray source at liver CT. Patients with estimated glomerular filtration rate (eGFR) < 45 mL/min (n = 43) aged 60-91 years (75 ± 7.7), weighing 42-114 kg (75 ± 15) were prospectively scanned using a reduced CM dose of 0.25 or 0.3 g iodine (I)/kg with 70 or 80 kVp respectively, using either single-source or dual-source CT depending on patient size. Liver contrast-to-noise ratio (CNR), liver noise, and muscle noise were quantitatively compared with those of 43 consecutive patients aged > 65 years with eGFR > 45 mL/min scanned using a standard abdominal protocol at 120 kVp after receiving 0.5 gI/kg. There was no statistically significant difference in CNR, liver noise, or muscle noise at reduced CM protocols compared to the standard protocol: CNR was 4.6 (95% CI = 4.2-5.0) vs. 5.0 (95% CI = 4.5-5.5), liver noise was 11.1 (95% CI = 10.7-11.6) vs. 11.0 (95% CI = 10.5-11.6), muscle noise was 11.7 (95% CI = 11.2-12.1) vs. 10.8 (95% CI = 10.1-11.4). The mean SSDE was 70% higher with the reduced CM protocol. CM dosage can be reduced by 40-50% with maintained measured noise and CNR in patients with BMIs of 15-36 kg/m

Sections du résumé

BACKGROUND BACKGROUND
X-ray tube voltage (kVp) reduction increases intravenous contrast medium (CM) attenuation at computed tomography (CT), but tube output limits its use in large patients.
PURPOSE OBJECTIVE
To evaluate the feasibility and image quality of reducing CM dose by low kVp and using dual X-ray source at liver CT.
MATERIAL AND METHODS METHODS
Patients with estimated glomerular filtration rate (eGFR) < 45 mL/min (n = 43) aged 60-91 years (75 ± 7.7), weighing 42-114 kg (75 ± 15) were prospectively scanned using a reduced CM dose of 0.25 or 0.3 g iodine (I)/kg with 70 or 80 kVp respectively, using either single-source or dual-source CT depending on patient size. Liver contrast-to-noise ratio (CNR), liver noise, and muscle noise were quantitatively compared with those of 43 consecutive patients aged > 65 years with eGFR > 45 mL/min scanned using a standard abdominal protocol at 120 kVp after receiving 0.5 gI/kg.
RESULTS RESULTS
There was no statistically significant difference in CNR, liver noise, or muscle noise at reduced CM protocols compared to the standard protocol: CNR was 4.6 (95% CI = 4.2-5.0) vs. 5.0 (95% CI = 4.5-5.5), liver noise was 11.1 (95% CI = 10.7-11.6) vs. 11.0 (95% CI = 10.5-11.6), muscle noise was 11.7 (95% CI = 11.2-12.1) vs. 10.8 (95% CI = 10.1-11.4). The mean SSDE was 70% higher with the reduced CM protocol.
CONCLUSION CONCLUSIONS
CM dosage can be reduced by 40-50% with maintained measured noise and CNR in patients with BMIs of 15-36 kg/m

Identifiants

pubmed: 29933715
doi: 10.1177/0284185118783213
doi:

Substances chimiques

Contrast Media 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

293-300

Auteurs

Anders Svensson (A)

1 Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden.
2 Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden.

Daniel Thor (D)

1 Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden.
3 Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm Sweden.

Michael A Fischer (MA)

4 Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.

Torkel Brismar (T)

1 Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden.
2 Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden.

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