Skip to main content
Top
Published in: Abdominal Radiology 11/2020

01-11-2020 | Computed Tomography | Hepatobiliary

Image quality in dual-source multiphasic dynamic computed tomography of the abdomen: evaluating the effects of a low tube voltage (70 kVp) in combination with contrast dose reduction

Authors: Keisuke Miyoshi, Hideko Onoda, Mashiro Tanabe, Sei Nakao, Mayumi Higashi, Etsushi Iida, Munemasa Okada, Matakazu Furukawa, Katsuyoshi Ito

Published in: Abdominal Radiology | Issue 11/2020

Login to get access

Abstract

Purpose

To compare the image quality of multiphasic (arterial, portal, and equilibrium phases) dynamic computed tomography (CT) of the abdomen obtained by a low tube voltage (70kVp) in combination with a half-dose iodine load using low-concentration contrast agent in high tube output dual-source CT with a standard tube voltage (120kVp) and full-dose iodine load using the same group of adult patients.

Methods

Fifty-five patients who underwent both low-tube-voltage (70kVp) abdominal CT with a half-dose iodine load and standard-tube-voltage (120kVp) CT with a full-dose iodine load were analyzed. The mean CT values and signal-to-noise ratio (SNR) of the liver, aorta and portal veins were quantitatively assessed. In addition, the contrast enhancement of the abdominal organs and overall image quality were qualitatively evaluated.

Results

The mean CT values and SNR of the liver parenchyma were significantly higher in 70-kVp protocol than in 120-kVp protocol in all 3 phases (p = 0.018 ~  < 0.001). Regarding the qualitative analysis, the overall image quality in the 70-kVp protocol was significantly better than in the 120-kVp protocol in all 3 phases (p < 0.001). In addition, the contrast enhancement scores of the liver parenchyma and hepatic vein in the equilibrium phase were also significantly higher in the 70-kVp protocol than in the 120-kVp protocol (p < 0.001).

Conclusion

A low tube voltage (70kVp) in combination with a half-dose iodine load using a low-concentration contrast agent and an iterative reconstruction algorithm in high tube output dual-source CT may improve the contrast enhancement and image quality in multiphasic dynamic CT of the abdomen in patients under 71 kg of body weight.
Literature
1.
go back to reference McDonald JS, McDonald RJ, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Risk of intravenous contrast material-mediated acute kidney injury: a propensity score-matched study stratified by baseline-estimated glomerular filtration rate. Radiology. 2014;271(1):65-73.CrossRef McDonald JS, McDonald RJ, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Risk of intravenous contrast material-mediated acute kidney injury: a propensity score-matched study stratified by baseline-estimated glomerular filtration rate. Radiology. 2014;271(1):65-73.CrossRef
2.
go back to reference Launay-Vacher V, Oudard S, Janus N, et al. Prevalence of Renal Insufficiency in cancer patients and implications for anticancer drug management: the renal insufficiency and anticancer medications (IRMA) study. Cancer. 2007;110(6):1376-84.CrossRef Launay-Vacher V, Oudard S, Janus N, et al. Prevalence of Renal Insufficiency in cancer patients and implications for anticancer drug management: the renal insufficiency and anticancer medications (IRMA) study. Cancer. 2007;110(6):1376-84.CrossRef
3.
go back to reference Garcia-Compean D, Jaquez-Quintana JO, Maldonado-Garza H. Hepatogenous diabetes. Current views of an ancient problem. Annals of Hepatology. 2009;8(1):13–20. Garcia-Compean D, Jaquez-Quintana JO, Maldonado-Garza H. Hepatogenous diabetes. Current views of an ancient problem. Annals of Hepatology. 2009;8(1):13–20.
4.
go back to reference Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. European radiology. 2011;21(12):2527-41.CrossRef Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. European radiology. 2011;21(12):2527-41.CrossRef
5.
go back to reference Cicin I, Erdogan B, Gulsen E, et al. Incidence of contrast-induced nephropathy in hospitalised patients with cancer. European radiology. 2014;24(1):184-90.CrossRef Cicin I, Erdogan B, Gulsen E, et al. Incidence of contrast-induced nephropathy in hospitalised patients with cancer. European radiology. 2014;24(1):184-90.CrossRef
6.
go back to reference Hunsaker AR, Oliva IB, Cai T, et al. Contrast opacification using a reduced volume of iodinated contrast material and low peak kilovoltage in pulmonary CT angiography: Objective and subjective evaluation. AJR American journal of roentgenology. 2010;195(2):W118-24.CrossRef Hunsaker AR, Oliva IB, Cai T, et al. Contrast opacification using a reduced volume of iodinated contrast material and low peak kilovoltage in pulmonary CT angiography: Objective and subjective evaluation. AJR American journal of roentgenology. 2010;195(2):W118-24.CrossRef
7.
go back to reference Huda W. Dose and image quality in CT. Pediatric radiology. 2002;32(10):709–13; discussion 51–4. Huda W. Dose and image quality in CT. Pediatric radiology. 2002;32(10):709–13; discussion 51–4.
8.
go back to reference Thor D, Brismar TB, Fischer MA. Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study. Medical physics. 2015;42(9):5100-9.CrossRef Thor D, Brismar TB, Fischer MA. Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study. Medical physics. 2015;42(9):5100-9.CrossRef
9.
go back to reference Schindera ST, Nelson RC, Mukundan S, Jr., et al. Hypervascular liver tumors: low tube voltage, high tube current multi-detector row CT for enhanced detection--phantom study. Radiology. 2008;246(1):125-32.CrossRef Schindera ST, Nelson RC, Mukundan S, Jr., et al. Hypervascular liver tumors: low tube voltage, high tube current multi-detector row CT for enhanced detection--phantom study. Radiology. 2008;246(1):125-32.CrossRef
10.
go back to reference Noda Y, Kanematsu M, Goshima S, et al. Reducing iodine load in hepatic CT for patients with chronic liver disease with a combination of low-tube-voltage and adaptive statistical iterative reconstruction. European journal of radiology. 2015;84(1):11-8.CrossRef Noda Y, Kanematsu M, Goshima S, et al. Reducing iodine load in hepatic CT for patients with chronic liver disease with a combination of low-tube-voltage and adaptive statistical iterative reconstruction. European journal of radiology. 2015;84(1):11-8.CrossRef
11.
go back to reference Botsikas D, Barnaure I, Terraz S, Becker CD, Kalovidouri A, Montet X. Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction. World journal of radiology. 2016;8(7):693-9.CrossRef Botsikas D, Barnaure I, Terraz S, Becker CD, Kalovidouri A, Montet X. Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction. World journal of radiology. 2016;8(7):693-9.CrossRef
12.
go back to reference Araki K, Yoshizako T, Yoshida R, Tada K, Kitagaki H. Low-voltage (80-kVp) abdominopelvic computed tomography allows 60% contrast dose reduction in patients at risk of contrast-induced nephropathy. Clinical imaging. 2018;51:352-5.CrossRef Araki K, Yoshizako T, Yoshida R, Tada K, Kitagaki H. Low-voltage (80-kVp) abdominopelvic computed tomography allows 60% contrast dose reduction in patients at risk of contrast-induced nephropathy. Clinical imaging. 2018;51:352-5.CrossRef
13.
go back to reference Onoda H, Ueno H, Hashimoto M, Kuwahara H, Sobajima M, Kinugawa K. Clinical Advantages of Using Low Tube Voltage in Third-Generation 192-Slice Dual-Source Computed Tomographic Angiography Before Transcatheter Aortic Valve Implantation. International heart journal. 2019;60(5):1091-7.CrossRef Onoda H, Ueno H, Hashimoto M, Kuwahara H, Sobajima M, Kinugawa K. Clinical Advantages of Using Low Tube Voltage in Third-Generation 192-Slice Dual-Source Computed Tomographic Angiography Before Transcatheter Aortic Valve Implantation. International heart journal. 2019;60(5):1091-7.CrossRef
14.
go back to reference Svensson A, Thor D, Fischer MA, Brismar T. Dual source abdominal computed tomography: the effect of reduced X-ray tube voltage and intravenous contrast media dosage in patients with reduced renal function. Acta radiologica (Stockholm, Sweden : 1987). 2019;60(3):293–300. Svensson A, Thor D, Fischer MA, Brismar T. Dual source abdominal computed tomography: the effect of reduced X-ray tube voltage and intravenous contrast media dosage in patients with reduced renal function. Acta radiologica (Stockholm, Sweden : 1987). 2019;60(3):293–300.
15.
go back to reference Peer A, Averbukh Z, Berman S, Modai D, Averbukh M, Weissgarten J. Contrast media augmented apoptosis of cultured renal mesangial, tubular, epithelial, endothelial, and hepatic cells. Invest Radiol. 2003;38(3):177-82.PubMed Peer A, Averbukh Z, Berman S, Modai D, Averbukh M, Weissgarten J. Contrast media augmented apoptosis of cultured renal mesangial, tubular, epithelial, endothelial, and hepatic cells. Invest Radiol. 2003;38(3):177-82.PubMed
16.
go back to reference Romano G, Briguori C, Quintavalle C, et al. Contrast agents and renal cell apoptosis. Eur Heart J. 2008;29(20):2569-76.CrossRef Romano G, Briguori C, Quintavalle C, et al. Contrast agents and renal cell apoptosis. Eur Heart J. 2008;29(20):2569-76.CrossRef
17.
go back to reference Persson PB, Tepel M. Contrast medium-induced nephropathy: the pathophysiology. Kidney Int Suppl. 2006(100):S8-10.CrossRef Persson PB, Tepel M. Contrast medium-induced nephropathy: the pathophysiology. Kidney Int Suppl. 2006(100):S8-10.CrossRef
18.
go back to reference Rudnick MR, Leonberg-Yoo AK, Litt HI, Cohen RM, Hilton S, Reese PP. The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk? Am J Kidney Dis. 2020;75(1):105–13. Rudnick MR, Leonberg-Yoo AK, Litt HI, Cohen RM, Hilton S, Reese PP. The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk? Am J Kidney Dis. 2020;75(1):105–13.
19.
go back to reference Luk L, Steinman J, Newhouse JH. Intravenous Contrast-Induced Nephropathy-The Rise and Fall of a Threatening Idea. Adv Chronic Kidney Dis. 2017;24(3):169-75.CrossRef Luk L, Steinman J, Newhouse JH. Intravenous Contrast-Induced Nephropathy-The Rise and Fall of a Threatening Idea. Adv Chronic Kidney Dis. 2017;24(3):169-75.CrossRef
20.
go back to reference McDonald RJ, McDonald JS, Newhouse JH, Davenport MS. Controversies in Contrast Material-induced Acute Kidney Injury: Closing in on the Truth? Radiology. 2015;277(3):627-32.CrossRef McDonald RJ, McDonald JS, Newhouse JH, Davenport MS. Controversies in Contrast Material-induced Acute Kidney Injury: Closing in on the Truth? Radiology. 2015;277(3):627-32.CrossRef
21.
go back to reference Onishi H, Murakami T, Kim T, et al. Abdominal multi-detector row CT: effectiveness of determining contrast medium dose on basis of body surface area. European journal of radiology. 2011;80(3):643-7.CrossRef Onishi H, Murakami T, Kim T, et al. Abdominal multi-detector row CT: effectiveness of determining contrast medium dose on basis of body surface area. European journal of radiology. 2011;80(3):643-7.CrossRef
22.
go back to reference Kalra MK, Woisetschlager M, Dahlstrom N, et al. Radiation dose reduction with Sinogram Affirmed Iterative Reconstruction technique for abdominal computed tomography. J Comput Assist Tomogr. 2012;36(3):339-46.CrossRef Kalra MK, Woisetschlager M, Dahlstrom N, et al. Radiation dose reduction with Sinogram Affirmed Iterative Reconstruction technique for abdominal computed tomography. J Comput Assist Tomogr. 2012;36(3):339-46.CrossRef
23.
go back to reference Joemai RM, Geleijns J, Veldkamp WJ. Development and validation of a low dose simulator for computed tomography. European radiology. 2010;20(4):958-66.CrossRef Joemai RM, Geleijns J, Veldkamp WJ. Development and validation of a low dose simulator for computed tomography. European radiology. 2010;20(4):958-66.CrossRef
24.
go back to reference Higashigaito K, Schmid T, Puippe G, et al. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols. Radiology. 2016;280(3):960-8.CrossRef Higashigaito K, Schmid T, Puippe G, et al. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols. Radiology. 2016;280(3):960-8.CrossRef
25.
go back to reference Schoenhagen P, Hausleiter J, Achenbach S, Desai MY, Tuzcu EM. Computed tomography in the evaluation for transcatheter aortic valve implantation (TAVI). Cardiovasc Diagn Ther. 2011;1(1):44-56.PubMedPubMedCentral Schoenhagen P, Hausleiter J, Achenbach S, Desai MY, Tuzcu EM. Computed tomography in the evaluation for transcatheter aortic valve implantation (TAVI). Cardiovasc Diagn Ther. 2011;1(1):44-56.PubMedPubMedCentral
26.
go back to reference Sharma SK, Kini A. Effect of nonionic radiocontrast agents on the occurrence of contrast-induced nephropathy in patients with mild-moderate chronic renal insufficiency: pooled analysis of the randomized trials. Catheter Cardiovasc Interv. 2005;65(3):386-93.CrossRef Sharma SK, Kini A. Effect of nonionic radiocontrast agents on the occurrence of contrast-induced nephropathy in patients with mild-moderate chronic renal insufficiency: pooled analysis of the randomized trials. Catheter Cardiovasc Interv. 2005;65(3):386-93.CrossRef
27.
go back to reference Marin D, Nelson RC, Schindera ST, et al. Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm--initial clinical experience. Radiology. 2010;254(1):145-53.CrossRef Marin D, Nelson RC, Schindera ST, et al. Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm--initial clinical experience. Radiology. 2010;254(1):145-53.CrossRef
28.
go back to reference Yonekura Y. Diagnostic reference levels based on latest surveys in Japan. Report from Japan network for research and information on medical exposure (J-RIME). 2015:1–11. Yonekura Y. Diagnostic reference levels based on latest surveys in Japan. Report from Japan network for research and information on medical exposure (J-RIME). 2015:1–11.
Metadata
Title
Image quality in dual-source multiphasic dynamic computed tomography of the abdomen: evaluating the effects of a low tube voltage (70 kVp) in combination with contrast dose reduction
Authors
Keisuke Miyoshi
Hideko Onoda
Mashiro Tanabe
Sei Nakao
Mayumi Higashi
Etsushi Iida
Munemasa Okada
Matakazu Furukawa
Katsuyoshi Ito
Publication date
01-11-2020
Publisher
Springer US
Published in
Abdominal Radiology / Issue 11/2020
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02565-9

Other articles of this Issue 11/2020

Abdominal Radiology 11/2020 Go to the issue