Skip to main content

Advertisement

SpringerLink
Log in

Image quality in dual-source multiphasic dynamic computed tomography of the abdomen: evaluating the effects of a low tube voltage (70 kVp) in combination with contrast dose reduction

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the image quality of multiphasic (arterial, portal, and equilibrium phases) dynamic computed tomography (CT) of the abdomen obtained by a low tube voltage (70kVp) in combination with a half-dose iodine load using low-concentration contrast agent in high tube output dual-source CT with a standard tube voltage (120kVp) and full-dose iodine load using the same group of adult patients.

Methods

Fifty-five patients who underwent both low-tube-voltage (70kVp) abdominal CT with a half-dose iodine load and standard-tube-voltage (120kVp) CT with a full-dose iodine load were analyzed. The mean CT values and signal-to-noise ratio (SNR) of the liver, aorta and portal veins were quantitatively assessed. In addition, the contrast enhancement of the abdominal organs and overall image quality were qualitatively evaluated.

Results

The mean CT values and SNR of the liver parenchyma were significantly higher in 70-kVp protocol than in 120-kVp protocol in all 3 phases (p = 0.018 ~  < 0.001). Regarding the qualitative analysis, the overall image quality in the 70-kVp protocol was significantly better than in the 120-kVp protocol in all 3 phases (p < 0.001). In addition, the contrast enhancement scores of the liver parenchyma and hepatic vein in the equilibrium phase were also significantly higher in the 70-kVp protocol than in the 120-kVp protocol (p < 0.001).

Conclusion

A low tube voltage (70kVp) in combination with a half-dose iodine load using a low-concentration contrast agent and an iterative reconstruction algorithm in high tube output dual-source CT may improve the contrast enhancement and image quality in multiphasic dynamic CT of the abdomen in patients under 71 kg of body weight.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

CT:

Computed tomography

CM:

Contrast medium

ROI:

Region of interest

AP:

Arterial phase

PVP:

Portal venous phase

EP:

Equilibrium phase

SD:

Standard deviation

CNR:

Contrast-to-noise ratio

SNR:

Signal-to-noise ratio

FOM:

Figure of merit

References

  1. McDonald JS, McDonald RJ, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Risk of intravenous contrast material-mediated acute kidney injury: a propensity score-matched study stratified by baseline-estimated glomerular filtration rate. Radiology. 2014;271(1):65-73.

    Article  Google Scholar 

  2. Launay-Vacher V, Oudard S, Janus N, et al. Prevalence of Renal Insufficiency in cancer patients and implications for anticancer drug management: the renal insufficiency and anticancer medications (IRMA) study. Cancer. 2007;110(6):1376-84.

    Article  CAS  Google Scholar 

  3. Garcia-Compean D, Jaquez-Quintana JO, Maldonado-Garza H. Hepatogenous diabetes. Current views of an ancient problem. Annals of Hepatology. 2009;8(1):13–20.

  4. Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. European radiology. 2011;21(12):2527-41.

    Article  Google Scholar 

  5. Cicin I, Erdogan B, Gulsen E, et al. Incidence of contrast-induced nephropathy in hospitalised patients with cancer. European radiology. 2014;24(1):184-90.

    Article  Google Scholar 

  6. Hunsaker AR, Oliva IB, Cai T, et al. Contrast opacification using a reduced volume of iodinated contrast material and low peak kilovoltage in pulmonary CT angiography: Objective and subjective evaluation. AJR American journal of roentgenology. 2010;195(2):W118-24.

    Article  Google Scholar 

  7. Huda W. Dose and image quality in CT. Pediatric radiology. 2002;32(10):709–13; discussion 51–4.

  8. Thor D, Brismar TB, Fischer MA. Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study. Medical physics. 2015;42(9):5100-9.

    Article  Google Scholar 

  9. Schindera ST, Nelson RC, Mukundan S, Jr., et al. Hypervascular liver tumors: low tube voltage, high tube current multi-detector row CT for enhanced detection--phantom study. Radiology. 2008;246(1):125-32.

    Article  Google Scholar 

  10. Noda Y, Kanematsu M, Goshima S, et al. Reducing iodine load in hepatic CT for patients with chronic liver disease with a combination of low-tube-voltage and adaptive statistical iterative reconstruction. European journal of radiology. 2015;84(1):11-8.

    Article  Google Scholar 

  11. Botsikas D, Barnaure I, Terraz S, Becker CD, Kalovidouri A, Montet X. Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction. World journal of radiology. 2016;8(7):693-9.

    Article  Google Scholar 

  12. Araki K, Yoshizako T, Yoshida R, Tada K, Kitagaki H. Low-voltage (80-kVp) abdominopelvic computed tomography allows 60% contrast dose reduction in patients at risk of contrast-induced nephropathy. Clinical imaging. 2018;51:352-5.

    Article  Google Scholar 

  13. Onoda H, Ueno H, Hashimoto M, Kuwahara H, Sobajima M, Kinugawa K. Clinical Advantages of Using Low Tube Voltage in Third-Generation 192-Slice Dual-Source Computed Tomographic Angiography Before Transcatheter Aortic Valve Implantation. International heart journal. 2019;60(5):1091-7.

    Article  CAS  Google Scholar 

  14. Svensson A, Thor D, Fischer MA, Brismar T. Dual source abdominal computed tomography: the effect of reduced X-ray tube voltage and intravenous contrast media dosage in patients with reduced renal function. Acta radiologica (Stockholm, Sweden : 1987). 2019;60(3):293–300.

  15. Peer A, Averbukh Z, Berman S, Modai D, Averbukh M, Weissgarten J. Contrast media augmented apoptosis of cultured renal mesangial, tubular, epithelial, endothelial, and hepatic cells. Invest Radiol. 2003;38(3):177-82.

    CAS  PubMed  Google Scholar 

  16. Romano G, Briguori C, Quintavalle C, et al. Contrast agents and renal cell apoptosis. Eur Heart J. 2008;29(20):2569-76.

    Article  CAS  Google Scholar 

  17. Persson PB, Tepel M. Contrast medium-induced nephropathy: the pathophysiology. Kidney Int Suppl. 2006(100):S8-10.

    Article  CAS  Google Scholar 

  18. Rudnick MR, Leonberg-Yoo AK, Litt HI, Cohen RM, Hilton S, Reese PP. The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk? Am J Kidney Dis. 2020;75(1):105–13.

  19. Luk L, Steinman J, Newhouse JH. Intravenous Contrast-Induced Nephropathy-The Rise and Fall of a Threatening Idea. Adv Chronic Kidney Dis. 2017;24(3):169-75.

    Article  Google Scholar 

  20. McDonald RJ, McDonald JS, Newhouse JH, Davenport MS. Controversies in Contrast Material-induced Acute Kidney Injury: Closing in on the Truth? Radiology. 2015;277(3):627-32.

    Article  Google Scholar 

  21. Onishi H, Murakami T, Kim T, et al. Abdominal multi-detector row CT: effectiveness of determining contrast medium dose on basis of body surface area. European journal of radiology. 2011;80(3):643-7.

    Article  Google Scholar 

  22. Kalra MK, Woisetschlager M, Dahlstrom N, et al. Radiation dose reduction with Sinogram Affirmed Iterative Reconstruction technique for abdominal computed tomography. J Comput Assist Tomogr. 2012;36(3):339-46.

    Article  Google Scholar 

  23. Joemai RM, Geleijns J, Veldkamp WJ. Development and validation of a low dose simulator for computed tomography. European radiology. 2010;20(4):958-66.

    Article  CAS  Google Scholar 

  24. Higashigaito K, Schmid T, Puippe G, et al. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols. Radiology. 2016;280(3):960-8.

    Article  Google Scholar 

  25. Schoenhagen P, Hausleiter J, Achenbach S, Desai MY, Tuzcu EM. Computed tomography in the evaluation for transcatheter aortic valve implantation (TAVI). Cardiovasc Diagn Ther. 2011;1(1):44-56.

    PubMed  PubMed Central  Google Scholar 

  26. Sharma SK, Kini A. Effect of nonionic radiocontrast agents on the occurrence of contrast-induced nephropathy in patients with mild-moderate chronic renal insufficiency: pooled analysis of the randomized trials. Catheter Cardiovasc Interv. 2005;65(3):386-93.

    Article  Google Scholar 

  27. Marin D, Nelson RC, Schindera ST, et al. Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm--initial clinical experience. Radiology. 2010;254(1):145-53.

    Article  Google Scholar 

  28. Yonekura Y. Diagnostic reference levels based on latest surveys in Japan. Report from Japan network for research and information on medical exposure (J-RIME). 2015:1–11.

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan

    Keisuke Miyoshi, Hideko Onoda, Mashiro Tanabe, Sei Nakao, Mayumi Higashi, Etsushi Iida, Munemasa Okada, Matakazu Furukawa & Katsuyoshi Ito

Authors
  1. Keisuke Miyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hideko Onoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mashiro Tanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sei Nakao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mayumi Higashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Etsushi Iida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Munemasa Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Matakazu Furukawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Katsuyoshi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katsuyoshi Ito.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyoshi, K., Onoda, H., Tanabe, M. et al. Image quality in dual-source multiphasic dynamic computed tomography of the abdomen: evaluating the effects of a low tube voltage (70 kVp) in combination with contrast dose reduction. Abdom Radiol 45, 3755–3762 (2020). https://doi.org/10.1007/s00261-020-02565-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-020-02565-9

Keywords

Search

Navigation