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Radiation dose and image quality of 70 kVp cerebral CT angiography with optimized sinogram-affirmed iterative reconstruction: comparison with 120 kVp cerebral CT angiography

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Abstract

Objectives

To evaluate radiation dose, image quality, and optimal level of sinogram-affirmed iterative reconstruction (SAFIRE) of cerebral CT angiography (CTA) at 70 kVp.

Methods

One hundred patients were prospectively classified into two groups: Group A (n = 50), 70 kVp cerebral CTA with 5 levels of SAFIRE reconstruction (S1-S5); and Group B (n = 50), 120 kVp with filtered back projection (FBP) reconstruction. CT attenuation values, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the internal carotid artery (ICA) and middle cerebral artery (MCA) were measured. Subjective image quality was evaluated. Effective dose (ED) was estimated.

Results

CT attenuation and noise of the ICA and MCA in Group A were higher than those of Group B (all P < 0.001) while the SNRICA, SNRMCA, CNRICA, and CNRMCA of Group A at S4-5 were comparable to (P > 0.05) or higher than in Group B (P < 0.05). There was no difference in overall image quality between Group A S3-5 and Group B (P > 0.05). ED was 0.2 ± 0.0 mSv for Group A with 85 % ED reduction in comparison to Group B (1.3 ± 0.2 mSv).

Conclusion

Cerebral CTA at 70 kVp is feasible, allowing for substantial radiation dose reduction. SAFIRE S4 level is recommended for obtaining optimal image quality.

Key points

• 70 kVp cerebral CTA is feasible and provides diagnostic image quality.

• 70 kVp cerebral CTA resulted in 85 % effective dose reduction.

• S4 level of SAFIRE is recommended for 70 kVp cerebral CTA.

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References

  1. Zhang LJ, Wu SY, Niu JB et al (2010) Dual-energy CT angiography in the evaluation of intracranial aneurysms: image quality, radiation dose, and comparison with 3D rotational digital subtraction angiography. AJR Am J Roentgenol 194:23–30

    Article  PubMed  Google Scholar 

  2. Jayaraman MV, Mayo-Smith WW, Tung GA et al (2004) Detection of intracranial aneurysms: multi-detector row CT angiography compared with DSA. Radiology 230:510–518

    Article  PubMed  Google Scholar 

  3. Donmez H, Serifov E, Kahriman G, Mavili E, Durak AC, Menkü A (2011) Comparison of 16-row multislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms. Eur J Radiol 80:455–461

    Article  PubMed  Google Scholar 

  4. McCollough CH, Primak AN, Braun N, Kofler J, Yu L, Christner J (2009) Strategies for reducing radiation dose in CT. Radiol Clin North Am 47:27–40

    Article  PubMed Central  PubMed  Google Scholar 

  5. Zhang WL, Li M, Zhang B et al (2013) CT angiography of the head-and-neck vessels acquired with low tube voltage, low iodine, and iterative image reconstruction: Clinical evaluation of radiation dose and image quality. PLoS One 8:e81486

    Article  PubMed Central  PubMed  Google Scholar 

  6. Sun G, Ding J, Lu Y et al (2012) Comparison of standard- and low-tube voltage 320-detector row volume CT angiography in detection of intracranial aneurysms with digital subtraction angiography as gold standard. Acad Radiol 19:281–288

    Article  PubMed  Google Scholar 

  7. Huda W, Lieberman KA, Chang J, Roskopf ML (2004) Patient size and x-ray technique factors in head computed tomography examinations. I. Radiation doses. Med Phys 31:588–594

    Article  PubMed  Google Scholar 

  8. Luo S, Zhang LJ, Meinel FG et al (2014) Low tube voltage and low contrast material volume cerebral CT angiography. Eur Radiol 24:1677–1685

    Article  PubMed  Google Scholar 

  9. Qi L, Zhao Y, Zhou CS et al (2014) Image quality and radiation dose of lower extremity CT angiography at 70 kVp on an integrated circuit detector dual-source computed tomography. Acta Radiol

  10. Qi L, Meinel FG, Zhou CS et al (2014) Image quality and radiation dose of lower extremity CT angiography using 70 kVp, high pitch acquisition and sinogram-affirmed iterative reconstruction. PLoS One 9:e99112

    Article  PubMed Central  PubMed  Google Scholar 

  11. Zhang LJ, Qi L, Wang J et al (2014) Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience. Eur Radiol 24:1537–1546

    Article  PubMed  Google Scholar 

  12. Li ZL, Li H, Zhang K et al (2014) Improvement of image quality and radiation dose of CT perfusion of the brain by means of low-tube voltage (70 KV). Eur Radiol 24:1906–1913

    Article  PubMed  Google Scholar 

  13. Korn A, Bender B, Fenchel M et al (2013) Sinogram affirmed iterative reconstruction in head CT: Improvement of objective and subjective image quality with concomitant radiation dose reduction. Eur J Radiol 82:1431–1435

    Article  CAS  PubMed  Google Scholar 

  14. Wu TH, Hung SC, Sun JY et al (2013) How far can the radiation dose be lowered in head CT with iterative reconstruction? Analysis of imaging quality and diagnostic accuracy. Eur Radiol 23:2612–2621

    Article  PubMed  Google Scholar 

  15. Yin WH, Lu B, Li N et al (2013) Iterative reconstruction to preserve image quality and diagnostic accuracy at reduced radiation dose in coronary CT angiography. JACC Cardiovasc Imaging 6:1239–1249

    Article  PubMed  Google Scholar 

  16. Winklehner A, Karlo C, Puippe G et al (2011) Raw data-based iterative reconstruction in body CTA: evaluation of radiation dose saving potential. Eur Radiol 21:2521–2526

    Article  PubMed  Google Scholar 

  17. Cho ES, Chung TS, Oh DK et al (2012) Cerebral computed tomography angiography using a low tube voltage (80 kVp) and a moderate concentration of iodine contrast material: a quantitative and qualitative comparison with conventional computed tomography angiography. Invest Radiol 47:142–147

    Article  PubMed  Google Scholar 

  18. Furtado AD, Adraktas DD, Brasic N et al (2010) The triple rule-out for acute ischemic stroke: imaging the brain, carotid arteries, aorta, and heart. AJNR Am J Neuroradiol 31:1290–1296

    Article  CAS  PubMed  Google Scholar 

  19. Rapalino O, Kamalian S, Kamalian S et al (2012) Cranial CT with adaptive statistical iterative reconstruction: Improved image quality with concomitant radiation dose reduction. AJNR Am J Neuroradiol 33:609–615

    Article  CAS  PubMed  Google Scholar 

  20. Haubenreisser H, Fink C, Nance JW Jr et al (2014) Feasibility of slice width reduction for spiral cranial computed tomography using iterative image reconstruction. Eur J Radiol 83:964–969

    Article  PubMed  Google Scholar 

  21. Renker M, Nance JW Jr, Schoepf UJ et al (2011) Evaluation of heavily calcified vessels with coronary CT angiography: comparison of iterative and filtered back projection image reconstruction. Radiology 260:390–399

    Article  PubMed  Google Scholar 

  22. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  23. Hara AK, Paden RG, Silva AC, Kujak JL, Lawder HJ, Pavlicek W (2009) Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study. AJR Am J Roentgenol 193:764–771

    Article  PubMed  Google Scholar 

  24. Prakash P, Kalra MK, Kambadakone AK et al (2010) Reducing abdominal CT radiation dose with adaptive statistical iterative reconstruction technique. Invest Radiol 45:202–210

    Article  PubMed  Google Scholar 

  25. Prakash P, Kalra MK, Ackman JB et al (2010) Diffuse lung disease: CT of the chest with adaptive statistical iterative reconstruction technique. Radiology 256:261–269

    Article  PubMed  Google Scholar 

  26. Moscariello A, Takx RA, Schoepf UJ et al (2011) Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique—comparison with traditional filtered back projection. Eur Radiol 21:2130–2138

    Article  PubMed  Google Scholar 

  27. Prakash P, Kalra MK, Digumarthy SR et al (2010) Radiation dose reduction with chest computed tomography using adaptive statistical iterative reconstruction technique: initial experience. J Comput Assist Tomogr 34:40–45

    Article  PubMed  Google Scholar 

  28. Singh S, Kalra MK, Hsieh J et al (2010) Abdominal CT: comparison of adaptive statistical iIterative and filtered back projection reconstruction techniques. Radiology 257:373–383

    Article  PubMed  Google Scholar 

  29. Silva AC, Lawder HJ, Hara A, Kujak J, Pavlicek W (2010) Innovations in CT dose reduction strategy: application of the adaptive statistical iterative reconstruction algorithm. AJR Am J Roentgenol 194:191–199

    Article  PubMed  Google Scholar 

  30. Wang G, Snyder DL, O'Sullivan JA, Vannier MW (1996) Iterative deblurring for CT metal artifact reduction. IEEE Trans Med Imaging 15:657–664

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The scientific guarantor of this publication is Guang Ming Lu. The authors of this manuscript declare relationships with the following companies: UJS is a consultant for and receives research support from Bayer, Bracco, GE, Medrad, and Siemens. The other authors have no conflicts of interest to declare.

This study has received funding by the Program for New Century Excellent Talents in University (NCET-12-0260 to L.J.Z.). 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. No study subjects or cohorts have been previously reported. Methodology: Prospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China

    Guo Zhong Chen, Long Jiang Zhang, U. Joseph Schoepf, Chang Sheng Zhou, Li Qi, Song Luo & Guang Ming Lu

  2. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29401, USA

    U. Joseph Schoepf, Julian L. Wichmann & Cole M. Milliken

  3. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Julian L. Wichmann

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  1. Guo Zhong Chen
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  2. Long Jiang Zhang
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  4. Julian L. Wichmann
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  6. Chang Sheng Zhou
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  7. Li Qi
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  8. Song Luo
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  9. Guang Ming Lu
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Correspondence to Long Jiang Zhang or Guang Ming Lu.

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Chen, G.Z., Zhang, L.J., Schoepf, U.J. et al. Radiation dose and image quality of 70 kVp cerebral CT angiography with optimized sinogram-affirmed iterative reconstruction: comparison with 120 kVp cerebral CT angiography. Eur Radiol 25, 1453–1463 (2015). https://doi.org/10.1007/s00330-014-3533-y

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  • DOI: https://doi.org/10.1007/s00330-014-3533-y

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