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Tachibana Y, Otsuka K, Shiroo T, Asayama Y. Equilibrium phase images of the liver using a contrast-enhancement boost instead of the portal vein phase. World J Radiol 2025; 17:102462. [DOI: 10.4329/wjr.v17.i2.102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 01/22/2025] [Accepted: 02/14/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND Three-phase dynamic computed tomography imaging is particularly useful in the liver region. However, dynamic imaging with contrast media has the disadvantage of increased radiation exposure due to multiple imaging sessions. We hypothesized that the contrast enhancement boost (CE-boost) technique could be used to enhance the contrast in equilibrium phase (EP) images and produce enhancement similar to that of portal vein phase (PVP) images, and if this is possible, EP imaging could play the same role as PVP imaging. We also speculated that this might allow the conversion of three-phase dynamic imaging to biphasic dynamic imaging, reducing patients’ radiation exposure.
AIM To determine if the CE-boost of EP, CE-boost (EP) is useful compared to a conventional image.
METHODS We retrospectively analyzed the cases of 52 patients who were diagnosed with liver cancer between January 2016 and October 2022 at our institution. From these computed tomography images, CE-boost images were generated from the EP and plane images. We compared the PVP, EP, and CE-boost (EP) for blood vessels and hepatic parenchyma based on the contrast-to-noise ratio (CNR), signal-to-noise ratio, and figure-of-merit (FOM). Visual assessments were also performed for vessel visualization, lesion conspicuity, and image noise.
RESULTS The CE-boost (EP) images showed significant superiority compared to the PVP images in the CNR, signal-to-noise ratio, and FOM except regarding the hepatic parenchyma. No significant differences were detected in CNR or FOM comparisons within the hepatic parenchyma (P = 0.62, 0.67). The comparison of the EP and CE-boost (EP) images consistently favored CE-boost (EP). Regarding the visual assessment, the CE-boost (EP) images were significantly superior to the PVP images in lesion conspicuity, and the PVP in image noise. The CE-boost (EP) images were significantly better than the EP images in the vessel visualization of segmental branches of the portal vein and lesion conspicuity, and the EP in image noise.
CONCLUSION The image quality of CE-boost (EP) images was comparable or superior to that of conventional PVP and EP. CE-boost (EP) images might provide information comparable to the conventional PVP.
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Affiliation(s)
- Yuji Tachibana
- Department of Radiological Sciences, Faculty of Medicine, Fukuoka International University of Health and Welfare, Fukuoka 814-0001, Japan
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
| | - Kenichiro Otsuka
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
| | - Tomoaki Shiroo
- Department of Radiology, Division of Medical Technology, Oita University Hospital, Yufu 879-5593, Oita, Japan
| | - Yoshiki Asayama
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
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Guerrini S, Zanoni M, Sica C, Bagnacci G, Mancianti N, Galzerano G, Garosi G, Cacioppa LM, Cellina M, Zamboni GA, Minetti G, Floridi C, Mazzei MA. Dual-Energy CT as a Well-Established CT Modality to Reduce Contrast Media Amount: A Systematic Review from the Computed Tomography Subspecialty Section of the Italian Society of Radiology. J Clin Med 2024; 13:6345. [PMID: 39518485 PMCID: PMC11546204 DOI: 10.3390/jcm13216345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 10/13/2024] [Accepted: 10/18/2024] [Indexed: 11/16/2024] Open
Abstract
Background: Our study aims to provide an overview of existing evidence regarding the image quality of dual-energy CT (DECT) employing reduced contrast media (CM) volumes, in comparison to single-energy CT (SECT) with standard CM loads. The advantages, indications, and possible applications of DECT were investigated from the perspective of providing better patient care, minimizing CM volume and managing CM shortage. Methods: In this systematic review (PRISMA methodology), PubMed and WOS were searched from January 2010 to January 2023 by two independent reviewers. The scan and CM characteristics, radiation dose, and results of quantitative (contrast to noise ratio, CNR, and signal to noise ratio, SNR) and qualitative assessment of image quality were collected. Sixty non-duplicated records eligible for full-text screening were examined. Results: Finally, 22 articles (1818 patients) were included. The average CM reduction with DECT ranged between 43.4 ± 11%. Despite the wide variability in CT scan protocols, no differences were found in radiation doses between DECT and SECT. Conclusions: DECT scanners allow the employment of lower CM volumes with equal or better image quality evaluated by quantitative and qualitative analyses and similar dose radiation compared to SECT. Using image reconstructions at low monochromatic energy levels, DECT increases iodine conspicuity and attenuation contributing to CM containment measures.
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Affiliation(s)
- Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
| | - Matteo Zanoni
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
| | - Cristian Sica
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
| | - Giulio Bagnacci
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
| | - Nicoletta Mancianti
- Unit of Nephrology, Dialysis and Transplantation, Department of Emergency and Transplantation, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (N.M.); (G.G.)
| | - Giuseppe Galzerano
- Unit of Vascular Surgery, Department of Heart, Thorax and Vessels, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
| | - Guido Garosi
- Unit of Nephrology, Dialysis and Transplantation, Department of Emergency and Transplantation, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (N.M.); (G.G.)
| | - Laura Maria Cacioppa
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
| | - Michaela Cellina
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Principessa Clotilde 3, 20121 Milan, Italy
| | - Giulia A. Zamboni
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Institute of Radiology, Department of Diagnostics and Public Health, Policlinico GB Rossi, University of Verona, 37134 Verona, Italy
| | - Giuseppe Minetti
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Radiology Unit, Ospedale Santo Spirito, ASL AL Casale Monferrato, 15121 Alessandria, Italy
| | - Chiara Floridi
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
| | - Maria Antonietta Mazzei
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
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Hou J, Zhang Y, Yan J, Zhang T, Xia W, Zhu Y, Liu W. Clinical application of the contrast-enhancement boost technique in computed tomography angiography of the portal vein. Abdom Radiol (NY) 2023; 48:806-815. [PMID: 36471003 PMCID: PMC9902311 DOI: 10.1007/s00261-022-03754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this study was to explore the improved image quality of the portal vein using the contrast-enhancement boost (CE-boost) technique for the improved visibility of abdominal-enhanced computed tomography (CT) scans in clinical practice. METHODS This retrospective study included 50 patients in Group A who underwent routine abdominal-enhanced CT and 50 patients in Group B who underwent abdominal computed tomography angiography (CTA) with matched body mass index, age, and sex. Images in Group A were postprocessed with the CE-boost technique for further enhanced visibility of the portal vein. Both subjective and objective assessments of different branches of the portal vein in three types of images (i.e., Group A with CE-boost and without CE-boost, Group B) were statistically analyzed. RESULTS The subjective scores of two experienced radiologists showed good consistency (kappa value > 0.624, p < 0.001), and the score of Group A with CE-boost (mean, 4.64) was significantly higher than that of the others (p < 0.001). The liver parenchyma and most target veins in Group A with CE-boost showed the highest CT, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) values and the lowest standard deviation (SD), while the CNR of most portal veins in Group A without CE-boost had the lowest CNR (p < 0.001). There were no differences in the SNR of the portal vein in Group A without CE-Boost and Group B (p > 0.05). CONCLUSION CE-boost can significantly improve image quality in portal vein imaging without any additional scanning settings or changes in the clinical workflow.
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Affiliation(s)
- Juan Hou
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Yuan Zhang
- Imaging Center, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Jing Yan
- Canon Medical Systems (China), Co., Ltd., Room 1004-1006, City Point, NO 666 West Huaihai Rd, Changning District, 200052 Shanghai China
| | - Tieliang Zhang
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Wenwen Xia
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Yucai Zhu
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang China
| | - Wenya Liu
- Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, Xinjiang, China.
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An J, Nam Y, Cho H, Chang J, Kim DK, Lee KS. Acute Pulmonary Embolism and Chronic Thromboembolic Pulmonary Hypertension: Clinical and Serial CT Pulmonary Angiographic Features. J Korean Med Sci 2022; 37:e76. [PMID: 35289137 PMCID: PMC8921210 DOI: 10.3346/jkms.2022.37.e76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/09/2022] [Indexed: 11/22/2022] Open
Abstract
In acute pulmonary embolism (PE), circulatory failure and systemic hypotension are important clinically for predicting poor prognosis. While pulmonary artery (PA) clot loads can be an indicator of the severity of current episode of PE or treatment effectiveness, they may not be used directly as an indicator of right ventricular (RV) failure or patient death. In other words, pulmonary vascular resistance or patient prognosis may not be determined only with mechanical obstruction of PAs and their branches by intravascular clot loads on computed tomography pulmonary angiography (CTPA), but determined also with vasoactive amines, reflex PA vasoconstriction, and systemic arterial hypoxemia occurring during acute PE. Large RV diameter with RV/left ventricle (LV) ratio > 1.0 and/or the presence of occlusive clot and pulmonary infarction on initial CTPA, and clinically determined high baseline PA pressure and RV dysfunction are independent predictors of oncoming chronic thromboembolic pulmonary hypertension (CTEPH). In this pictorial review, authors aimed to demonstrate clinical and serial CTPA features in patients with acute massive and submassive PE and to disclose acute CTPA and clinical features that are related to the prediction of oncoming CTEPH.
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Affiliation(s)
- Junho An
- Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yoojin Nam
- Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hyoun Cho
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeonga Chang
- Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Duk-Kyung Kim
- Division of Cardiology, Cardiac and Vascular Center, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung ChangWon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
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Sugawara H, Takayanagi T, Ishikawa T, Katada Y, Fukui R, Yamamoto Y, Suzuki S. New Fast kVp Switching Dual-Energy CT: Reduced Severity of Beam Hardening Artifacts and Improved Image Quality in Reduced-Iodine Virtual Monochromatic Imaging. Acad Radiol 2020; 27:1586-1593. [PMID: 31837969 DOI: 10.1016/j.acra.2019.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/23/2019] [Accepted: 11/24/2019] [Indexed: 12/23/2022]
Abstract
RATIONALE AND OBJECTIVES To compare degradation of the image quality due to beam hardening artifacts in reduced-iodine-dose virtual monochromatic imaging (VMI) between a new fast kVp switching dual-energy computed tomography (CT) scanner (Revolution CT) and the conventional dual-energy scanner (Discovery CT). MATERIALS AND METHODS First, a phantom study was performed to quantitatively evaluate beam hardening artifacts in images obtained by VMI reconstruction at different energy levels. In the second study, we performed a retrospective evaluation of the images of 28 patients who had undergone reduced-iodine (300 mg/kg) dual-energy scanning in both Revolution CT and Discovery CT. We evaluated each image quantitatively by measuring the contrast-to-noise ratio (CNR) and qualitatively by scoring the artifacts and image quality. We also calculated the modulation transfer function (MTF) and noise power spectrum (NPS) of the two scanners. RESULTS In the phantom study, VMI reconstruction of the CT images at 40-70 keV was associated with a significantly greater reduction in the severity of the artifacts in the Revolution CT images as compared to the Discovery CT images. In the retrospective study, there were no significant differences in the CT value of the aorta, noise, or CNR between the two scanners, but the scores for image quality were significantly higher in the Revolution CT images as compared to the Discovery CT images. The MTF of Revolution CT was higher than that of Discovery CT, reflecting the better spatial resolution. CONCLUSION In Revolution CT, beam hardening artifacts were reduced in reduced-iodine VMI at lower energy levels compared to Discovery CT, contributing to better image quality.
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Han D, Chen X, Lei Y, Ma C, Zhou J, Xiao Y, Yu Y. Iodine load reduction in dual-energy spectral CT portal venography with low energy images combined with adaptive statistical iterative reconstruction. Br J Radiol 2019; 92:20180414. [PMID: 30894009 PMCID: PMC6724639 DOI: 10.1259/bjr.20180414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To study the application of using low energy images combined with adaptive statistical iterative reconstruction (ASiR) in dual-energy spectral CT portal venography (CTPV) to reduce iodine load. METHODS 41 patients for CTPV were prospectively and randomly divided into two groups. Group A ( n = 21) used conventional 120 kVp scanning protocol with contrast dose at 0.6 gI/kg while group B ( n = 20) used dual-energy spectral imaging with reduced contrast dose at 0.3 gI/kg. The 120 kVp images in Group A and 50 keV images in Group B were reconstructed with 40% ASiR. The contrast-to-noise ratio of portal vein was calculated. The image quality and the numbers of intrahepatic portal vein branches were evaluated by two experienced radiologists using a 5-point scoring system. RESULTS Group B reduced iodine load by 52% compared to Group A (17.21 ± 3.30 gI vs 35.80 ± 6.18 gI, p < 0.001). All images in both groups were acceptable for diagnosis. CT values and standard deviations in portal veins of Group B were higher than Group A (all p < 0.05); There were no statistical differences in contrast-to-noise ratio, image quality score and the number of observed portal vein branches between the two groups (all p > 0.05), and the two observers had excellent agreement in image quality assessment (all κ > 0.75). CONCLUSION The use of 50 keV images in dual-energy spectral CTPV with ASiR reduces total iodine load by 52% while maintaining good image quality. ADVANCES IN KNOWLEDGE Spectral CT images combined with ASiR can be used in low contrast dose CTPV portal venography to maintain image quality and reduce contrast dose.
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Affiliation(s)
- Dong Han
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xiaoxia Chen
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yuxin Lei
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Chunling Ma
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Jieli Zhou
- Department of Ultrasound, Xijing Hospital, Xi'an, Shaanxi, China
| | - Yingcong Xiao
- Department of Ultrasound, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yong Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
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Sugawara H, Suzuki S, Katada Y, Ishikawa T, Fukui R, Yamamoto Y, Abe O. Comparison of full-iodine conventional CT and half-iodine virtual monochromatic imaging: advantages and disadvantages. Eur Radiol 2018; 29:1400-1407. [PMID: 30209591 DOI: 10.1007/s00330-018-5724-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/05/2018] [Accepted: 08/16/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE To compare image quality of abdominal arteries between full-iodine-dose conventional CT and half-iodine-dose virtual monochromatic imaging (VMI). MATERIALS AND METHODS We retrospectively evaluated images of 21 patients (10 men, 11 women; mean age, 73.9 years) who underwent both full-iodine (600 mg/kg) conventional CT and half-iodine (300 mg/kg) VMI. For each patient, we measured and compared CT attenuation and the contrast-to-noise ratio (CNR) of the aorta, celiac artery, and superior mesenteric artery (SMA). We also compared CT dose index (CTDI). Two board-certified diagnostic radiologists evaluated visualisation of the main trunks and branches of the celiac artery and SMA in maximum-intensity-projection images. We evaluated spatial resolution of the two scans using an acrylic phantom. RESULTS The two scans demonstrated no significant difference in CT attenuation of the aorta, celiac artery, and SMA, but CNRs of the aorta and celiac artery were significantly higher in VMI (p = 0.011 and 0.030, respectively). CTDI was significantly higher in VMI (p = 0.024). There was no significant difference in visualisation of the main trunk of the celiac artery and SMA, but visualisation of the gastroduodenal artery, pancreatic arcade, branch of the SMA, marginal arteries, and vasa recta was significantly better in the conventional scan (p < 0.001). The calculated modular transfer function (MTF) suggested decreased spatial resolution of the half-iodine VMI. CONCLUSION Large-vessel depiction and CNRs were comparable between full-iodine conventional CT and half-iodine VMI images, but VMI did not permit clear visualisation of small arteries and required a larger radiation dose. KEY POINTS ・Reducing the dose of iodine contrast medium is essential for chronic kidney disease patients to prevent contrast-induced nephropathy. ・In virtual monochromatic images at low keV, contrast of relatively large vessels is maintained even with reduced iodine load, but visibility of small vessels is impaired with decreased spatial resolution. ・We should be aware about the advantages and disadvantages associated with virtual monochromatic imaging with reduced iodine dose.
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Affiliation(s)
- Haruto Sugawara
- Department of Radiology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.,Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shigeru Suzuki
- Department of Radiology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.
| | - Yoshiaki Katada
- Department of Radiology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Takuya Ishikawa
- Department of Radiology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Rika Fukui
- Department of Radiology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Yuzo Yamamoto
- Department of Radiology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Dual-Energy Spectral Computed Tomography With Adaptive Statistical Iterative Reconstruction for Improving Image Quality of Portal Venography. J Comput Assist Tomogr 2018; 42:954-958. [PMID: 30119062 DOI: 10.1097/rct.0000000000000785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate whether spectral computed tomography (CT) plus adaptive statistical iterative reconstruction (ASIR) could improve imaging quality of computed tomography portal venography (CTPV). METHODS Sixty-four patients underwent CTPV, with CT number of portal vein (PV) less than 150 HU in portal phase, were divided into 2 groups A (n = 31), using standard 120-kVp protocol. group B (n = 33), using spectral CT protocol. Standard 120-kVp images were reconstructed with 40% ASIR, and monochromatic images at 60 keV were reconstructed with the following 4 ASIR percentages: 0%, 20%, 40%, and 60%. The CT number, image noise, and contrast-to-noise ratio in main PV were measured. The maximum intensity projection and volume-rendering images were used for subjective evaluation. These 2 kinds of results were statistically analyzed. RESULTS The contrast-to-noise ratio and subjective scoring of PV increased gradually from 120-kVp images to 60% weight ASIR (3.44 ± 0.95, 4.58 ± 1. 59, 5.26 ± 1.85, 6.18 ± 2.18, and 7.39 ± 2.65 and 4.35 ± 1.17, 6.21 ± 1.29, 6.48 ± 1.35, 6.85 ± 1.28, and 7.00 ± 1.19). There were statistically different for the 5 groups (P < 0.001). The CT number of the PV in the 60-kiloelectron volt spectral images had higher than the 120-kVp images (P < 0.001). The noise of 120 kVp was significantly higher than those of 60% ASIR and significantly lower than those of 0% ASIR (both P < 0.001), and there were no significant differences between 120-kVp, 20% ASIR, and 40% ASIR (P = 0.107 and 1.000, respectively). The diagnostic acceptability was highest at 40% ASIR. CONCLUSIONS Forty-percent ASIR addition to the 60-kiloelectron volt monochromatic image could improve image quality of CTPV comparing with conventional 120-kVp images.
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Yin XP, Gao BL, Li CY, Zhou H, Zhao L, Zheng YT, Zhao YX. Optimal Monochromatic Imaging of Spectral Computed Tomography Potentially Improves the Quality of Hepatic Vascular Imaging. Korean J Radiol 2018; 19:578-584. [PMID: 29962864 PMCID: PMC6005939 DOI: 10.3348/kjr.2018.19.4.578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 02/01/2018] [Indexed: 12/26/2022] Open
Abstract
Objective To investigate the efficiency of spectral computed tomography (CT) optimal monochromatic images in improving imaging quality of liver vessels. Materials and Methods The imaging data of 35 patients with abdominal CT angiography were retrospectively analyzed. Hepatic arteries, portal veins, and hepatic veins were reconstructed with mixed energy (quality check, QC), 70 keV and optimal monochromatic mode. Comparative parameters were analyzed including CT value, image noise (IN), contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and subjective qualitative analysis. Results The optimal monochromatic value for assessment of the common hepatic artery, portal vein, and hepatic vein ranged between 49 keV and 53 keV, with a mean of 51 keV. There were statistically significant differences (p < 0.001) among the optimal monochromatic, 70 keV and QC images with regards to the hepatic vascular CT value, IN, CNR, SNR, and subjective qualitative score. CNR of the common hepatic artery in the optimal monochromatic, 70 keV and QC groups was 24.6 ± 10.9, 18.1 ± 8.3, and 11.6 ± 4.6, respectively (p < 0.001) with subjective scores of 4.7 ± 0.2, 4.0 ± 0.3, and 3.6 ± 0.4, respectively (p < 0.001). CNR of the hepatic portal vein was 6.9 ± 2.7, 4.3 ± 1.9, and 3.0 ± 2.1, respectively (p < 0.001) with subjective scores of 4.5 ± 0.3, 3.9 ± 0.4, and 3.3 ± 0.3, respectively (p < 0.001). CNR of the hepatic vein was 5.7 ± 2.3, 4.2 ± 1.9, and 2.7 ± 1.4, respectively with subjective scores of 4.3 ± 0.3, 3.8 ± 0.4, and 3.2 ± 0.3, respectively (p < 0.001). Conclusion Optimal monochromatic images can lead to improvement in the imaging parameters and optimization of the image quality of the common hepatic artery, hepatic portal vein and hepatic vein compared with conventional mixed kV and with 70 keV datasets.
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Affiliation(s)
- Xiao-Ping Yin
- Department of CT and MRI, Affiliated Hospital of Hebei University, Baoding 071002, China
| | - Bu-Lang Gao
- Department of Medical Research, Shijiazhuang First Hospital, Shijiazhuang 050011, China
| | - Cai-Ying Li
- The Second Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Huan Zhou
- Department of CT and MRI, Affiliated Hospital of Hebei University, Baoding 071002, China
| | - Liang Zhao
- Department of CT and MRI, Affiliated Hospital of Hebei University, Baoding 071002, China
| | - Ya-Ting Zheng
- Department of CT and MRI, Affiliated Hospital of Hebei University, Baoding 071002, China
| | - Yong-Xia Zhao
- Department of CT and MRI, Affiliated Hospital of Hebei University, Baoding 071002, China
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Son BG, Kim MJ, Park MH, Kim K, Kim J, Kim SY, Lee KJ, Choi SH, Kim AY, Park SH. Two Small Intravenous Catheters for High-Rate Contrast Medium Injection for Computed Tomography in Patients Lacking Superficial Veins to Accommodate a Large Catheter. Korean J Radiol 2018; 19:489-497. [PMID: 29713227 PMCID: PMC5904476 DOI: 10.3348/kjr.2018.19.3.489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/30/2017] [Indexed: 01/29/2023] Open
Abstract
Objective To prospectively investigate the feasibility of using 2 small intravenous catheters for high-rate computed tomography (CT) contrast injection in patients lacking superficial veins capable of accommodating ≤ 20-gauge catheters. Materials and Methods Sixty-eight consecutive eligible adults referred for dynamic liver CT were enrolled; 58 had previously undergone liver CT, including 8 that experienced extravasation. Two 22- or 24-gauge catheters were placed in all patients after 2–5 venipunctures, and 2 mL/kg of contrast agent (370 mg I/mL) was split-administered through both catheters to achieve total flow rate of 4 mL/s. Patients' experience and examination success rate, defined as uneventful scans completed at 4 mL/s or at < 4 mL/s achieving standard image quality in all phases, were analyzed. Quantitative hepatic signal-to-noise and hepatic vascular contrast-to-noise ratios (CNRs) were compared with 30 control examinations scanned at 4 mL/s using an 18-gauge catheter. Results One case each of extravasation and severe injection pain caused the examination to be aborted. Success rate was 88.2% (60/68; 54 patients scanned at 4 mL/s, 6 at 3.5–3.9 mL/s). Fifty-five of 58 patients (94.8%) that had past CT regarded the venipuncture as more tolerable than (n = 36) or similar to (n = 19) past experiences; 45 of 58 patients (77.6%) found contrast injection less painful than (n = 35) or similar to (n = 10) past experiences. When compared with control examinations, signal-to-noise ratio was similar in all phases (p ≥ 0.502), but the hepatic arterial CNR in arterial phase was slightly inferior (p ≤ 0.047). Conclusion Using 2 small intravenous catheters can effectively achieve high-rate CT contrast injection in patients lacking adequate superficial veins.
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Affiliation(s)
- Bum Gu Son
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Min Jung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Myeung Hwa Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Kyoungsook Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jiyu Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Se-Young Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Kyung Jin Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ah Young Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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Measurement of Vascular Diameter in Computed Tomography Angiography With Reduced Iodine Load. J Comput Assist Tomogr 2018; 42:919-924. [DOI: 10.1097/rct.0000000000000769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Dual-energy CT workflow: multi-institutional consensus on standardization of abdominopelvic MDCT protocols. Abdom Radiol (NY) 2017; 42:676-687. [PMID: 27888303 DOI: 10.1007/s00261-016-0966-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions. RESULTS 5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00). CONCLUSIONS DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.
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