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Using 80 kVp on a 320-row scanner for hepatic multiphasic CT reduces the contrast dose by 50 % in patients at risk for contrast-induced nephropathy

  • Contrast Media
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Abstract

Objectives

We evaluated the effects of a low contrast material (CM) dose protocol using 80-kVp on the image quality of hepatic multiphasic CT scans acquired on a 320-row CT scanner.

Methods

We scanned 30 patients with renal insufficiency (eGFR < 45 mL/min/1.73 m2) using 80-kVp and a CM dose of 300mgI/kg. Another 30 patients without renal insufficiency (eGFR > 60 mL/min/1.73 m2) were scanned with the conventional 120-kVp protocol and the standard CM dose of 600mgI/kg. Quantitative image quality parameters, i.e. CT attenuation, image noise, and the contrast-to-noise ratio (CNR) were compared and the visual image quality was scored on a four-point scale. The volume CT dose index (CTDIvol) and the size-specific dose estimate (SSDE) recorded with the 80- and the 120-kVp protocols were also compared.

Results

Image noise and contrast enhancement were equivalent for the two protocols. There was no significant difference in the CNR of all anatomic sites and in the visual scores for overall image quality. The CTDIvol and SSDE were approximately 25–30 % lower under the 80-kVp protocol.

Conclusion

Hepatic multiphase CT using 80-kVp on a 320-row CT scanner allowed for a decrease in the CM dose and a reduction in the radiation dose without image quality degradation in patients with renal insufficiency.

Key Points

• The 80-kVp CT protocol enabled reduction of contrast dose by 50 %

• The 80-kVp CT protocol reduced the radiation dose by 25–33 %

• There was no degradation in the image quality of the 80-kVp protocol

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Acknowledgments

The scientific guarantor of this publication is Prof. Yasuyuki Yamashita, Kumamoto University. 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. The authors state that this work has not received any funding.

No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Study subjects or cohorts have not been previously reported. Methodology: prospective, randomized controlled study, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuou-ku, Kumamoto, 860-8556, Japan

    Narumi Taguchi, Seitaro Oda, Daisuke Utsunomiya, Takeshi Nakaura, Masanori Imuta, Sadahiro Yamamura, Hideaki Yuki, Masafumi Kidoh, Kenichiro Hirata, Tomohiro Namimoto & Yasuyuki Yamashita

  2. Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan

    Yoshinori Funama

  3. Department of Central Radiology, Kumamoto University Hospital, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan

    Masahiro Hatemura & Noriyuki Kai

Authors
  1. Narumi Taguchi
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  2. Seitaro Oda
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  13. Noriyuki Kai
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  14. Yasuyuki Yamashita
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Corresponding author

Correspondence to Seitaro Oda.

APPENDIX

APPENDIX

Phantom study

This graph shows the CT number in test tubes filled with water and varying concentrations of iodinated solution (3, 6, 7.5, 10, 12, 15, 20, and 30 mgI/mL). Scanning was at 80 kVp on 4 different CT systems: (A) Aquilion ONE ViSION Edition, Toshiba Medical Systems, Otawara, Japan; (B) Light Speed VCT, GE Healthcare, Milwaukee, WI, USA; (C) Brilliance 64, Philips Healthcare, Cleveland, OH, USA; and (D) SOMATOM Definition AS+, Siemens Healthcare, Forchheim, Germany.

There was a significant linear correlation between the mean CT number and the increase in the iodine concentration for all four CT systems (R2 = 0.99, p < 0.001). The 320-row CT scanner (Aquilion ONE ViSION Edition, Toshiba Medical Systems) used in this study yielded the highest CT numbers among the four scanners.

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Taguchi, N., Oda, S., Utsunomiya, D. et al. Using 80 kVp on a 320-row scanner for hepatic multiphasic CT reduces the contrast dose by 50 % in patients at risk for contrast-induced nephropathy. Eur Radiol 27, 812–820 (2017). https://doi.org/10.1007/s00330-016-4435-y

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