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Impact of various iodine concentrations of iohexol and iodixanol contrast media on image reconstruction techniques in a vascular-specific contrast media phantom: quantitative and qualitative image quality assessment

  • CARDIAC RADIOLOGY
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Abstract

Purpose

The aim of our study is to investigate the impact of iodine quantification on image reconstruction when employing a vascular-specific contrast media phantom with varying iodine concentrations.

Materials and methods

A 30-cm phantom simulating arterial and venous blood vessel diameters was manufactured. Small (9 mm) and medium (12 mm) cylinders contained iodine concentrations from 10 to 100% while large (21 mm) cylinders were in quartiles from 25 to 100% diluted in blood equivalent medium. Each phantom was filled with either iohexol 350 mgI/mL (Group A) or iodixanol 320 mgI/mL (Group B) and then scanned separately. For each group, tube potential (80–140 kVp) and current (50–400 mAs) were changed and all image series were reconstructed with filtered back projection (FBP), hybrid-based iterative reconstruction (HBIR) and model-based iterative reconstruction (MBIR). Mean opacification was measured in all groups. All data were compared employing an independent t test and Pearson’s correlation. Visual grading characteristic (VGC) and Cohens’ kappa analyses were performed.

Results

At 80 kVp, mean opacification using HBIR was significantly higher in Group B (2165 ± 1108 HU) than in Group A (2040 ± 1036 HU) (p < 0.009). At 140 kVp, MBIR and HBIR were greater in Group A (1704 ± 1033 HU and 1685 ± 1023 HU) versus Group B (1567 ± 1036 HU and 1567 ± 1034 HU) (p < 0.022). CNR using FBP, HBIR and MBIR was higher in Group B (46 ± 42 HU, 70 ± 163 HU and 83 ± 74 HU, respectively) than in Group A (43 ± 39 HU, 174 ± 130 HU and 80 ± 65 HU, respectively) (p < 0.0001–0.035). Qualitative image analysis demonstrated no difference in Cohen’s kappa analysis. VGC was higher in Group A at all image reconstruction groups.

Conclusion

Iohexol outperforms iodixanol in observer performance when assessing image reconstruction techniques and iodine concentrations in a vascular-specific contrast media phantom.

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Abbreviations

CNR:

Contrast-to-noise ratio

CT:

Computed tomography

FBP:

Filtered back projection

HBIR:

Hybrid-based iterative reconstruction

HU:

Hounsfield unit

IMR:

Iterative model reconstruction

MBIR:

Model-based iterative reconstruction

ROI:

Region of interest

SD:

Standard deviation

VGC:

Visual grading characteristic

References

  1. Koonce JD, Vliegenthart R, Schoepf UJ, Schmidt B, Wahlquist AE, Nietert PJ, Bastarrika G, Flohr TG, Meinel FG (2014) Accuracy of dual-energy computed tomography for the measurement of iodine concentration using cardiac CT protocols: validation in a phantom model. Eur Radiol 24(2):512–518

    Article  Google Scholar 

  2. Saba L, Yuan C, Hatsukami TS, Balu N, Qiao Y, DeMarco JK, Saam T, Moody AR, Li D, Matouk CC, Johnson MH, Jäger HR, Mossa-Basha M, Kooi ME, Fan Z, Saloner D, Wintermark M, Mikulis DJ, Wasserman BA (2018) Carotid artery wall imaging: perspective and guidelines from the ASNR vessel wall imaging study group and expert consensus recommendations of the American Society of Neuroradiology. Am J Neuroradiol 39(2):E9–E31. https://doi.org/10.3174/ajnr.A5488

    Article  CAS  PubMed  Google Scholar 

  3. Rocha M, Delfyett WT, Agarwal V, Aghaebrahim A, Jadhav A, Jovin TG (2018) Diagnostic accuracy of emergency CT angiography for presumed tandem internal carotid artery occlusion before acute endovascular therapy. J Neurointerventional Surg 10(7):653–656

    Article  Google Scholar 

  4. Hua C-h, Shapira N, Merchant TE, Klahr P, Yagil Y (2018) Accuracy of electron density, effective atomic number, and iodine concentration determination with a dual-layer dual-energy computed tomography system. Med Phys 45(6):2486–2497. https://doi.org/10.1002/mp.12903

    Article  CAS  PubMed  Google Scholar 

  5. Duan X, Arbique G, Guild J, Xi Y, Anderson J (2018) Technical note: quantitative accuracy evaluation for spectral images from a detector-based spectral CT scanner using an iodine phantom. Med Phys 45(5):2048–2053. https://doi.org/10.1002/mp.12834

    Article  PubMed  Google Scholar 

  6. Higaki T, Tatsugami F, Fujioka C, Sakane H, Nakamura Y, Baba Y, Iida M, Awai K (2017) Visualization of simulated small vessels on computed tomography using a model-based iterative reconstruction technique. Data Brief 13:437–443

    Article  Google Scholar 

  7. Kim H, Goo JM, Kang CK, Chae KJ, Park CM (2018) Comparison of iodine density measurement among dual-energy computed tomography scanners from 3 vendors. Investig Radiol 53(6):321–327

    Article  CAS  Google Scholar 

  8. Jacobsen MC, Schellingerhout D, Wood CA, Tamm EP, Godoy MC, Sun J, Cody DD (2017) Intermanufacturer comparison of dual-energy CT iodine quantification and monochromatic attenuation: a phantom study. Radiology 287(1):224–234

    Article  Google Scholar 

  9. Deák Z, Grimm JM, Treitl M, Geyer LL, Linsenmaier U, Körner M, Reiser MF, Wirth S (2013) Filtered back projection, adaptive statistical iterative reconstruction, and a model-based iterative reconstruction in abdominal CT: an experimental clinical study. Radiology 266(1):197–206

    Article  Google Scholar 

  10. Niesten J, van der Schaaf I, Vos P, Willemink M, Velthuis B (2015) Improving head and neck CTA with hybrid and model-based iterative reconstruction techniques. Clin Radiol 70(11):1252–1259

    Article  CAS  Google Scholar 

  11. Christianson O, Chen JJ, Yang Z, Saiprasad G, Dima A, Filliben JJ, Peskin A, Trimble C, Siegel EL, Samei E (2015) An improved index of image quality for task-based performance of CT iterative reconstruction across three commercial implementations. Radiology 275(3):725–734

    Article  Google Scholar 

  12. Bath M, Mansson LG (2007) Visual grading characteristics (VGC) analysis: a non-parametric rank-invariant statistical method for image quality evaluation. Br J Radiol 80(951):169–176. https://doi.org/10.1259/bjr/35012658

    Article  CAS  PubMed  Google Scholar 

  13. Imai K, Ikeda M, Satoh Y, Fujii K, Kawaura C, Nishimoto T, Mori M (2018) Contrast enhancement efficacy of iodinated contrast media: effect of molecular structure on contrast enhancement. Eur J Radiol Open 5:183–188

    Article  Google Scholar 

  14. Pannu HK, Thompson RE, Phelps J, Magee CA, Fishman EK (2005) Optimal contrast agents for vascular imaging on computed tomography: iodixanol versus Iohexol 1. Acad Radiol 12(5):576–584

    Article  Google Scholar 

  15. Marin D, Nelson RC, Guerrisi A, Barnhart H, Schindera ST, Passariello R, Catalano C (2011) 64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement. Eur Radiol 21(9):1938–1947

    Article  Google Scholar 

  16. Saade C, El-Merhi F, El-Achkar B, Kerek R, Vogl TJ, Maroun GG, Jamjoom L, Al-Mohiy H, Naffaa L (2016) 256 Slice multi-detector computed tomography thoracic aorta computed tomography angiography: improved luminal opacification using a patient-specific contrast protocol and caudocranial scan acquisition. J Comput Assist Tomogr 40(6):964–970. https://doi.org/10.1097/RCT.0000000000000456

    Article  PubMed  Google Scholar 

  17. Saade C, Mohamad M, Kerek R, Hamieh N, Alsheikh Deeb I, El-Achkar B, Tamim H, Abdul Razzak F, Haddad M, Abi-Ghanem AS, El-Merhi F (2017) Augmented quadruple-phase contrast media administration and triphasic scan protocol increases image quality at reduced radiation dose during computed tomography urography. J Comput Assist Tomogr. https://doi.org/10.1097/RCT.0000000000000674

    Article  Google Scholar 

  18. Saade C, Bourne R, Wilkinson M, Evanoff M, Brennan PC (2013) Caudocranial scan direction and patient-specific injection protocols optimize ECG-gated and non-gated thoracic CTA. J Comput Assist Tomogr 37(5):725–731. https://doi.org/10.1097/RCT.0b013e31829e02b9

    Article  PubMed  Google Scholar 

  19. Saade C, El-Merhi F, Mayat A, Brennan PC, Yousem D (2015) Comparison of standard and quadruple-phase contrast material injection for artifacts, image quality, and radiation dose in the evaluation of head and neck cancer metastases. Radiology 279(2):571–577

    Article  Google Scholar 

  20. Saade C, Deeb IA, Mohamad M, Al-Mohiy H, El-Merhi F (2016) Contrast medium administration and image acquisition parameters in renal CT angiography: what radiologists need to know. Diagn Interv Radiol 22(2):116–124. https://doi.org/10.5152/dir.2015.15219

    Article  PubMed  PubMed Central  Google Scholar 

  21. Saade C, Mayat A, El-Merhi F (2016) Exponentially decelerated contrast media injection rate combined with a novel patient-specific contrast formula reduces contrast volume administration and radiation dose during computed tomography pulmonary angiography. J Comput Assist Tomogr 40(3):370–374. https://doi.org/10.1097/RCT.0000000000000371

    Article  PubMed  Google Scholar 

  22. Saade C, Al-Fout G, Mayat A, Brennan P, Hui F, Maroun G, Kikano R, Naffaa L (2017) Increased image quality and reduced radiation dose and contrast media volume: a holistic approach to intracranial CTA. Clin Radiol 72(9):797.e11–797.e16

    Article  CAS  Google Scholar 

  23. Saade C (2012) A low contrast regimen improves attenuation profile of head and neck vasculature using 64 slice multi detector computed tomography (MDCT). In: 2012. European Congress of Radiology 2012

  24. Saade C, Bourne R, El-Merhi F, Somanathan A, Chakraborty D, Brennan P (2013) An optimised patient-specific approach to administration of contrast agent for CT pulmonary angiography. Eur Radiol 23(11):3205–3212

    Article  Google Scholar 

  25. Zein-El-Dine S, Bou Akl I, Mohamad M, Chmaisse A, Chahwan S, Asmar K, El-Merhi F, Saade C (2018) Split-bolus contrast injection protocol enhances the visualization of the thoracic vasculature and reduced radiation dose during chest CT. Br J Radiol 91(1092):20180509. https://doi.org/10.1259/bjr.20180509

    Article  PubMed  PubMed Central  Google Scholar 

  26. Saade C, El-Merhi F, El-Ashkar B, Mohamad M, Haydar A, Abchee A (2017) Synchronisation between contrast media administration and caudocranial scan direction increases visualisation of altered coronary artery blood flow in patients presenting with dual left anterior descending coronary artery. BJR| Case Reports 20150500

  27. Saade C, Bourne R, Wilkinson M, Brennan P (2011) Contrast medium administration and parameters affecting bolus geometry in multidetector computed tomography angiography: an overview. J Med Imaging Radiat Sci 42(3):113–117

    Article  Google Scholar 

  28. Pelgrim GJ, van Hamersvelt RW, Willemink MJ, Schmidt BT, Flohr T, Schilham A, Milles J, Oudkerk M, Leiner T, Vliegenthart R (2017) Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT. Eur Radiol 27(9):3904–3912

    Article  Google Scholar 

  29. Serra R, Settimio UF, Butrico L, Falasconi C, De Caridi G, Massara M, Grande R, De Franciscis S (2017) Reporting standards for normal blood vessels diameters: a systematic review. Chirurgia-Italy 30(1):6–13

    Google Scholar 

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Funding

The University Research Board of the American University of Beirut funded this study (Award Number: 103608–Project Number: 24622). The funding source was not involved in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O. Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon

    Charbel Saade & Lina Karout

  2. Department of Epidemiology and Population Health Sciences, Faculty of Health Sciences, American University of Beirut Medical Center, P.O. Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon

    Khalil El Asmar

  3. Diagnostic Radiology Department, American University of Beirut Medical Center, P.O. Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon

    Lena Naffaa, Fadi El Merhi, Rida Salman & Alain S. Abi-Ghanem

Authors
  1. Charbel Saade
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  4. Lena Naffaa
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  7. Alain S. Abi-Ghanem
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Dr. Alai S. Abi-Ghanem, Prof Charbel Saade and Dr. Lina Karout. The first draft of the manuscript was written by Dr. Charbel Saade and Dr. Alain S. Abi-Ghanem and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alain S. Abi-Ghanem.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

No informed consent was obtained since this is a phantom study.

Human and animal rights statement

This study is a phantom study with no animal and human involvement. The manuscript does not contain clinical studies or patient data.

Statement of data access and integrity

Authors declare that they had full access to all of the data in this study and the authors take complete responsibility for the integrity of the data and the accuracy of the data analysis.

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Saade, C., Karout, L., El Asmar, K. et al. Impact of various iodine concentrations of iohexol and iodixanol contrast media on image reconstruction techniques in a vascular-specific contrast media phantom: quantitative and qualitative image quality assessment. Radiol med 126, 221–230 (2021). https://doi.org/10.1007/s11547-020-01253-4

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  • DOI: https://doi.org/10.1007/s11547-020-01253-4

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