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Low tube voltage and low contrast material volume cerebral CT angiography

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Abstract

Objectives

To evaluate the image quality, radiation dose and diagnostic accuracy of low kVp and low contrast material volume cerebral CT angiography (CTA) in intracranial aneurysm detection.

Methods

One hundred twenty patients were randomly divided into three groups (n = 40 for each): Group A, 70 ml iodinated contrast agent/120 kVp; group B, 30 ml/100 kVp; group C, 30 ml/80 kVp. The CT numbers, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the internal carotid artery (ICA) and middle cerebral artery (MCA). Subjective image quality was evaluated. For patients undergoing DSA, diagnostic accuracy of CTA was calculated with DSA as reference standard and compared.

Results

CT numbers of ICA and MCA were higher in groups B and C than in group A (P < 0.01). SNR and CNR in groups A and B were higher than in group C (both P < 0.05). There was no difference in subjective image quality among the three groups (P = 0.939). Diagnostic accuracy for aneurysm detection among these groups had no statistical difference (P = 1.00). Compared with group A, the radiation dose of groups B and C was decreased by 45 % and 74 %.

Conclusion

Cerebral CTA at 100 or 80 kVp using 30 ml contrast agent can obtain diagnostic image quality with a low radiation dose while maintaining the same diagnostic accuracy for aneurysm detection.

Key Points

Cerebral CTA is feasible using 100/80 kVp and 30 ml contrast agent.

This approach obtains diagnostic image quality with 45–74 % radiation dose reduction.

Diagnostic accuracy for intracranial aneurysm detection seems not to be compromised.

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Abbreviations

3D-DSA:

Three-dimensional digital subtraction angiography

CNR:

Contrast-to-noise ratio

CTA:

Computed tomography angiography

ICA:

Internal carotid artery

MCA:

Middle cerebral artery

SNR:

Signal-to-noise ratio

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Acknowledgments

The scientific guarantor of this publication is Guang Ming Lu. Dr. Schoepf is a consultant for and receives research support from Bayer, Bracco, GE and Siemens. All 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. This study was partially supported by the Programme 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, case–control study, performed at one institution.

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Correspondence to Long Jiang Zhang or Guang Ming Lu.

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Luo, S., Zhang, L.J., Meinel, F.G. et al. Low tube voltage and low contrast material volume cerebral CT angiography. Eur Radiol 24, 1677–1685 (2014). https://doi.org/10.1007/s00330-014-3184-z

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  • DOI: https://doi.org/10.1007/s00330-014-3184-z

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