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
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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.
Keywords
Cerebral arteries Carotid arteries Computed tomography angiography Monoenergetic imaging Low-concentration contrast mediumAbbreviations
- 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
Notes
Compliance with ethical standards
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.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent
Written informed consent was waived by the Institutional Review Board.
Ethical approval
Institutional Review Board approval was obtained.
Methodology
• prospective
• case-control study
• performed at one institution
Supplementary material
References
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