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Assessment of an advanced virtual monoenergetic reconstruction technique in cerebral and cervical angiography with third-generation dual-source CT: Feasibility of using low-concentration contrast medium

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the feasibility of low-concentration contrast media (LC-CM) in cerebral and cervical dual-energy CT angiography (DE-CTA) using an advanced monoenergetic (Mono+) reconstruction technique.

Methods

Sixty-five consecutive patients prospectively selected to undergo cerebral and cervical DE-CTA were randomised into two groups: 32 patients (63.7 ± 9.7 years) in the high-concentration contrast medium (HC-CM) group with iopromide 370 and 33 patients (60.7 ± 10.8 years) in the low-concentration contrast medium (LC-CM) group with iodixanol 270. Traditional monoenergetic (Mono) and Mono+ images from 40 to 100 keV levels (at 10-keV intervals) and the standard mixed (Mixed, 120 kVp equivalent) images were reconstructed. Subjective image quality parameters included the contrast-to-noise ratio (CNR) and objective image quality parameters were evaluated and compared between the two groups.

Results

The 40-keV Mono+ images in the LC-CM group showed comparable objective CNR (common carotid arteries: 83.7 ± 24.5 vs. 78.1 ± 23.2; internal carotid arteries: 82.2 ± 26.8 vs. 76.8 ± 24.1; middle cerebral arteries: 72.5 ± 24.6 vs. 70.6 ± 19.2; all p > 0.05) and subjective image scores (3.95 ± 0.19 vs. 3.83 ± 0.35; p > 0.05) compared with Mixed images in the HC-CM group.

Conclusion

The Mono+ reconstruction technique could reduce the concentration of iodinated CM in the diagnosis of cerebral and cervical angiography.

Key Points

• Mono+ shows decreased noise and superior CNR compared with Mono.

• The 40-keV Mono+ images show the highest CNR in the LC-CM group.

• The Mono+ reconstruction technique could reduce the concentration of iodinated CM.

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Abbreviations

AA:

Ascending aorta

CCA:

Common carotid arteries

CIN:

Contrast-induced nephropathy

CM:

Contrast medium

CNR:

Contrast-to-noise ratio

CTA:

Computed tomographic angiography

DE-CT:

Dual-energy CT

DS-CT:

Dual-source CT

HC-CM:

High-concentration contrast medium

HU:

Hounsfield units

ICA:

Internal carotid arteries

LC-CM:

Low-concentration contrast medium

MCA:

Middle cerebral arteries

Mixed:

Standard mixed

Mono:

Traditional monoenergetic

Mono+:

Advanced monoenergetic

ROI:

Region of interest

SD:

Standard deviation

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Funding

This study has received funding by the Tianjin Research Program of Application Foundation and Advanced Technology (grant 14JCZDJC57000) and National Natural Science Foundation of China (grant 81301217).

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Authors and Affiliations

  1. Department of Radiology, Tianjin Medical University General Hospital, Tianjin, 300052, China

    Lu Zhao, Fengtan Li, Zewei Zhang, Zhang Zhang, Yingjian Jiang, Xinyu Wang & Dong Li

  2. Siemens Healthineers, Beijing, 100102, China

    Jun Gu

Authors
  1. Lu Zhao
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  2. Fengtan Li
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  3. Zewei Zhang
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  4. Zhang Zhang
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  5. Yingjian Jiang
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  7. Jun Gu
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  8. Dong Li
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Corresponding author

Correspondence to Dong Li.

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Guarantor

The scientific guarantor of this publication is Dong Li.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Gu Jun is on the speakers' bureau of Siemens Healthineers, Computed Tomography division. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

Methodology

• prospective

• case-control study

• performed at one institution

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Zhao, L., Li, F., Zhang, Z. et al. Assessment of an advanced virtual monoenergetic reconstruction technique in cerebral and cervical angiography with third-generation dual-source CT: Feasibility of using low-concentration contrast medium. Eur Radiol 28, 4379–4388 (2018). https://doi.org/10.1007/s00330-018-5407-1

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  • DOI: https://doi.org/10.1007/s00330-018-5407-1

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