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Low-tube-voltage (80 kVp) CT aortography using 320-row volume CT with adaptive iterative reconstruction: lower contrast medium and radiation dose

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate CT aortography at reduced tube voltage and contrast medium dose while maintaining image quality through iterative reconstruction (IR).

Methods

The Institutional Review Board approved a prospective study of 48 patients who underwent follow-up CT aortography. We performed intra-individual comparisons of arterial phase images using 120 kVp (standard tube voltage) and 80 kVp (low tube voltage). Low-tube-voltage imaging was performed on a 320-detector CT with IR following injection of 40 ml of contrast medium. We assessed aortic attenuation, aortic attenuation gradient, image noise, contrast-to-noise ratio (CNR), volume CT dose index (CTDIvol), and figure of merit (FOM) of image noise and CNR. Two readers assessed images for diagnostic quality, image noise, and artefacts.

Results

The low-tube-voltage protocol showed 23–31 % higher mean aortic attenuation and image noise (both P < 0.01) than the standard-tube-voltage protocol, but no significant difference in the CNR and aortic attenuation gradients. The low-tube-voltage protocol showed a 48 % reduction in CTDIvol and an 80 % increase in FOM of CNR. Subjective diagnostic quality was similar for both protocols, but low-tube-voltage images showed greater image noise (P = 0.01).

Conclusions

Application of IR to an 80-kVp CT aortography protocol allows radiation dose and contrast medium reduction without affecting image quality.

Key Points

• CT aortography at 80 kVp allows a significant reduction in radiation dose.

• Addition of iterative reconstruction reduces image noise and improves image quality.

• The injected contrast medium dose can be substantially reduced at 80 kVp.

• Aortic enhancement is uniform despite a reduced volume of contrast medium.

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Abbreviations

AIDR:

adaptive iterative dose reduction

CNR:

contrast-to-noise ratio

CTA:

computed tomography angiography

ED:

effective dose

EVAR:

endovascular aortic repair

FBP:

filtered-back projection

FOM:

figure of merit

IR:

iterative reconstruction

ROI:

region of interest

PACS:

picture-archiving and communication system

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Acknowledgments

This study was supported by a grant from the Chang Gung Medical Research Program (CMRPG1B0061). We acknowledge the assistance of the dedicated radiology staff at Chang Gung Memorial Hospital Linkou.

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Authors and Affiliations

  1. Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chien-Ming Chen, Sung-Yu Chu & Ming-Yi Hsu

  2. Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan

    Ying-Lan Liao

  3. Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Hui-Yu Tsai

  4. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan

    Hui-Yu Tsai

  5. Department of Medical Imaging & Radiological Sciences, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan, 333

    Hui-Yu Tsai

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  1. Chien-Ming Chen
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  2. Sung-Yu Chu
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  3. Ming-Yi Hsu
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Correspondence to Hui-Yu Tsai.

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Chen, CM., Chu, SY., Hsu, MY. et al. Low-tube-voltage (80 kVp) CT aortography using 320-row volume CT with adaptive iterative reconstruction: lower contrast medium and radiation dose. Eur Radiol 24, 460–468 (2014). https://doi.org/10.1007/s00330-013-3027-3

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  • DOI: https://doi.org/10.1007/s00330-013-3027-3

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