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European Radiology

, Volume 30, Issue 2, pp 798–805 | Cite as

Low-dose CT angiography using ASiR-V for potential living renal donors: a prospective analysis of image quality and diagnostic accuracy

  • Woong Kyu Han
  • Joon Chae Na
  • Sung Yoon ParkEmail author
Urogenital
  • 101 Downloads

Abstract

Purpose

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.

Results

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).

Conclusion

Low-dose CT angiography using ASiR-V is useful to evaluate renal vasculature for potential living renal donors.

Key Points

• 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.

Keywords

Kidney Computed tomography Transplantation Nephrectomy Radiation 

Abbreviations

AEC

Automatic exposure control

ASiR-V

Adaptive statistical iterative reconstruction V

BMI

Body mass index

CNR

Contrast-to-noise ratio

CT

Computed tomography

CTDIvol

Computed tomography dose index volume

FBP

Filtered back projection

IR

Iterative reconstruction

ROI

Region-of-interest

SNR

Signal-to-noise ratio

SSDE

Size-specific dose estimate

Notes

Acknowledgements

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.

Funding information

This study has received funding by Research Institute of Radiological Science of Yonsei University College of Medicine.

Compliance with ethical standards

Guarantor

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.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Randomized controlled trial

• Performed at one institution

Supplementary material

330_2019_6423_MOESM1_ESM.doc (32 kb)
ESM 1 (DOC 31 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of UrologyYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of RadiologyYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea

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