Low-dose CT angiography using ASiR-V for potential living renal donors: a prospective analysis of image quality and diagnostic accuracy
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To assess image quality and diagnostic accuracy of low-dose computed tomography (CT) angiography using adaptive statistical iterative reconstruction V (ASiR-V) for evaluating the anatomy of renal vasculature in potential living renal donors.
Materials and methods
Eighty of 100 potential living renal donors were prospectively enrolled and underwent multiphase CT angiography (e.g., unenhanced, arterial, and venous phases) to evaluate the kidney for donation. Either low-dose using ASiR-V or standard protocol was randomly applied. Image quality was analyzed qualitatively and quantitatively with contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). Renal artery and vein number, early branching vessel from renal arteries, and drainage of left-sided ascending lumbar vein to left renal vein were assessed. Reference standard for renal vasculature was surgical confirmation.
Size-specific dose estimate of low-dose CT angiography (9.5 ± 0.8 mGy) was significantly lower than standard CT angiography (22.7 ± 4.1 mGy) (p < 0.001). Thus, radiation dose was reduced by 58.2% with low-dose CT. Both CNR and SNR of low-dose CT were significantly higher than those of standard CT (p < 0.001). Between the two CT methods, image quality was similar qualitatively (p > 0.05). Of 80 participants, 44 (55.0%) underwent nephrectomy. Both CT methods accurately predicted the anatomy of renal vasculature (standard CT, 100% for all variables; low-dose CT, 96.6% for renal vessel number or early branching vessel and 85.7% for drainage of left-sided ascending lumbar vein to left renal vein; p > 0.05 for all comparisons).
Low-dose CT angiography using ASiR-V is useful to evaluate renal vasculature for potential living renal donors.
• In this prospective study, adaptive statistical iterative reconstruction V (ASiR-V) allowed 58.2% dose reduction while maintaining diagnostic image quality for renal vessels.
• As compared with the standard protocol, the dose with ASiR-V was significantly lower (9.5 ± 0.8 mGy) than with standard computed tomography (CT) angiography (22.7 ± 4.1 mGy).
• Low-dose CT using ASiR-V is useful for living donor evaluation before nephrectomy.
KeywordsKidney Computed tomography Transplantation Nephrectomy Radiation
Automatic exposure control
Adaptive statistical iterative reconstruction V
Body mass index
Computed tomography dose index volume
Filtered back projection
Size-specific dose estimate
This study was supported by a faculty grant of Research Institute of Radiological Science of Yonsei University College of Medicine 2017 (4-2017-0197). We thank Kyoung-A Um (GE Korea, deputy general manager) and Jinjoo Hong (GE Korea, deputy general manager) for providing technical information regarding ASiR-V.
This study has received funding by Research Institute of Radiological Science of Yonsei University College of Medicine.
Compliance with ethical standards
The scientific guarantor of this publication is Sung Yoon Park.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• Randomized controlled trial
• Performed at one institution
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