Reduced Iodine Load at CT Pulmonary Angiography with Dual-Energy Monochromatic Imaging: Comparison with Standard CT Pulmonary Angiography—A Prospective Randomized Trial
To compare quantitative and subjective image quality and radiation dose between standard computed tomographic (CT) pulmonary angiography (CTPA) and CTPA with a dual-energy technique with reduced iodine load. This prospective study was approved by the institutional review board and each participant p...
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| Veröffentlicht in: | Radiology 2012, Vol.262 (1), p.290-297 |
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| creator | REN YUAN SHUMAN, William P EARLS, James P HAGUE, Cameron J MUMTAZ, Hina A SCOTT-MONCRIEFF, Andrew ELLIS, Jennifer D MAYO, John R LEIPSIC, Jonathon A |
| description | To compare quantitative and subjective image quality and radiation dose between standard computed tomographic (CT) pulmonary angiography (CTPA) and CTPA with a dual-energy technique with reduced iodine load.
This prospective study was approved by the institutional review board and each participant provided informed consent. Ninety-four patients (59% male; mean age ± standard deviation, 62 years ± 15) were randomized to one of two protocols: standard CTPA (100-120 kVp) with standard contrast medium injection (n = 46) and dual-energy CTPA (image reconstruction at 50 keV) with the same injection volume as in the standard protocol but composed of contrast medium and saline in a 1:1 fashion, resulting in 50% reduction in iodine load (n = 48). Signal intensity and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A five-point scale was used to subjectively evaluate vascular enhancement and image noise. The proportion of diagnostic (score, ≥ 3) studies and the interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale were compared between the two groups.
Compared with standard CTPA, dual-energy CTPA demonstrated higher signal intensity in all pulmonary arteries (all P < .01), inferior noise only in segmental arteries (P < .05), higher SNR and CNR (both P < .05), and compatible effective dose (P > .05). The five-point score was higher in the standard CTPA protocol (P < .05). The interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale was similar (P > .05) between the two groups.
Dual-energy CTPA with image reconstruction at 50 keV allows a significant reduction in iodine load while improving intravascular signal intensity, maintaining SNR and with comparable radiation dose. |
| doi_str_mv | 10.1148/radiol.11110648 |
| format | Article |
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This prospective study was approved by the institutional review board and each participant provided informed consent. Ninety-four patients (59% male; mean age ± standard deviation, 62 years ± 15) were randomized to one of two protocols: standard CTPA (100-120 kVp) with standard contrast medium injection (n = 46) and dual-energy CTPA (image reconstruction at 50 keV) with the same injection volume as in the standard protocol but composed of contrast medium and saline in a 1:1 fashion, resulting in 50% reduction in iodine load (n = 48). Signal intensity and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A five-point scale was used to subjectively evaluate vascular enhancement and image noise. The proportion of diagnostic (score, ≥ 3) studies and the interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale were compared between the two groups.
Compared with standard CTPA, dual-energy CTPA demonstrated higher signal intensity in all pulmonary arteries (all P < .01), inferior noise only in segmental arteries (P < .05), higher SNR and CNR (both P < .05), and compatible effective dose (P > .05). The five-point score was higher in the standard CTPA protocol (P < .05). The interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale was similar (P > .05) between the two groups.
Dual-energy CTPA with image reconstruction at 50 keV allows a significant reduction in iodine load while improving intravascular signal intensity, maintaining SNR and with comparable radiation dose.</description><identifier>ISSN: 0033-8419</identifier><identifier>EISSN: 1527-1315</identifier><identifier>DOI: 10.1148/radiol.11110648</identifier><identifier>PMID: 22084206</identifier><identifier>CODEN: RADLAX</identifier><language>eng</language><publisher>Oak Brook, IL: Radiological Society of North America</publisher><subject>Angiography - methods ; Biological and medical sciences ; Cardiovascular system ; Chi-Square Distribution ; Contrast Media - administration & dosage ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Pulmonary Embolism - diagnostic imaging ; Radiation Dosage ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Signal-To-Noise Ratio ; Statistics, Nonparametric ; Tomography, X-Ray Computed - methods ; Triiodobenzoic Acids - administration & dosage</subject><ispartof>Radiology, 2012, Vol.262 (1), p.290-297</ispartof><rights>2015 INIST-CNRS</rights><rights>RSNA, 2011.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-8624519161966dc7ef6393e533bdd327832924cffed31078b444978966672ae33</citedby><cites>FETCH-LOGICAL-c359t-8624519161966dc7ef6393e533bdd327832924cffed31078b444978966672ae33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25476265$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22084206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>REN YUAN</creatorcontrib><creatorcontrib>SHUMAN, William P</creatorcontrib><creatorcontrib>EARLS, James P</creatorcontrib><creatorcontrib>HAGUE, Cameron J</creatorcontrib><creatorcontrib>MUMTAZ, Hina A</creatorcontrib><creatorcontrib>SCOTT-MONCRIEFF, Andrew</creatorcontrib><creatorcontrib>ELLIS, Jennifer D</creatorcontrib><creatorcontrib>MAYO, John R</creatorcontrib><creatorcontrib>LEIPSIC, Jonathon A</creatorcontrib><title>Reduced Iodine Load at CT Pulmonary Angiography with Dual-Energy Monochromatic Imaging: Comparison with Standard CT Pulmonary Angiography—A Prospective Randomized Trial</title><title>Radiology</title><addtitle>Radiology</addtitle><description>To compare quantitative and subjective image quality and radiation dose between standard computed tomographic (CT) pulmonary angiography (CTPA) and CTPA with a dual-energy technique with reduced iodine load.
This prospective study was approved by the institutional review board and each participant provided informed consent. Ninety-four patients (59% male; mean age ± standard deviation, 62 years ± 15) were randomized to one of two protocols: standard CTPA (100-120 kVp) with standard contrast medium injection (n = 46) and dual-energy CTPA (image reconstruction at 50 keV) with the same injection volume as in the standard protocol but composed of contrast medium and saline in a 1:1 fashion, resulting in 50% reduction in iodine load (n = 48). Signal intensity and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A five-point scale was used to subjectively evaluate vascular enhancement and image noise. The proportion of diagnostic (score, ≥ 3) studies and the interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale were compared between the two groups.
Compared with standard CTPA, dual-energy CTPA demonstrated higher signal intensity in all pulmonary arteries (all P < .01), inferior noise only in segmental arteries (P < .05), higher SNR and CNR (both P < .05), and compatible effective dose (P > .05). The five-point score was higher in the standard CTPA protocol (P < .05). The interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale was similar (P > .05) between the two groups.
Dual-energy CTPA with image reconstruction at 50 keV allows a significant reduction in iodine load while improving intravascular signal intensity, maintaining SNR and with comparable radiation dose.</description><subject>Angiography - methods</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Chi-Square Distribution</subject><subject>Contrast Media - administration & dosage</subject><subject>Female</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Pulmonary Embolism - diagnostic imaging</subject><subject>Radiation Dosage</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Signal-To-Noise Ratio</subject><subject>Statistics, Nonparametric</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Triiodobenzoic Acids - administration & dosage</subject><issn>0033-8419</issn><issn>1527-1315</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90buOEzEUBmALgdiwUNMhNwiaYX0bX-iisECkIFZLqEeO7ZkYzdiz9gwoVDwET8Fj8SQYJQsVVHbx_Uf2-QF4jNELjJm8SNr62Jc7xogzeQcscE1EhSmu74IFQpRWkmF1Bh7k_AkhzGop7oMzQpBkBPEF-HHt7GychetofXBwE7WFeoKrLbya-yEGnQ5wGTofu6TH_QF-8dMevpp1X10Gl7oDfBdDNPsUBz15A9eD7nzoXsJVHEadfI7hGPkw6WB1sv-c_PPb9yW8SjGPzkz-s4PXJRAH_7U8bpu87h-Ce63us3t0Os_Bx9eX29XbavP-zXq13FSG1mqqJCesxgpzrDi3RriWU0VdTenOWkqEpEQRZtrWWYqRkDvGmBKyYC6IdpSeg2fHuWOKN7PLUzP4bFzf6-DinBuFCWdIKFLk8_9KjJCUlCLEC704UlN-mJNrmzH5oaygoOZ3lc2xyua2ypJ4cho-7wZn__jb7gp4egI6G923SQfj819XM8EJr-kvuEOpyQ</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>REN YUAN</creator><creator>SHUMAN, William P</creator><creator>EARLS, James P</creator><creator>HAGUE, Cameron J</creator><creator>MUMTAZ, Hina A</creator><creator>SCOTT-MONCRIEFF, Andrew</creator><creator>ELLIS, Jennifer D</creator><creator>MAYO, John R</creator><creator>LEIPSIC, Jonathon A</creator><general>Radiological Society of North America</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7ST</scope><scope>C1K</scope><scope>SOI</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Reduced Iodine Load at CT Pulmonary Angiography with Dual-Energy Monochromatic Imaging: Comparison with Standard CT Pulmonary Angiography—A Prospective Randomized Trial</title><author>REN YUAN ; SHUMAN, William P ; EARLS, James P ; HAGUE, Cameron J ; MUMTAZ, Hina A ; SCOTT-MONCRIEFF, Andrew ; ELLIS, Jennifer D ; MAYO, John R ; LEIPSIC, Jonathon A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-8624519161966dc7ef6393e533bdd327832924cffed31078b444978966672ae33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Angiography - methods</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Chi-Square Distribution</topic><topic>Contrast Media - administration & dosage</topic><topic>Female</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Pulmonary Embolism - diagnostic imaging</topic><topic>Radiation Dosage</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Signal-To-Noise Ratio</topic><topic>Statistics, Nonparametric</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Triiodobenzoic Acids - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>REN YUAN</creatorcontrib><creatorcontrib>SHUMAN, William P</creatorcontrib><creatorcontrib>EARLS, James P</creatorcontrib><creatorcontrib>HAGUE, Cameron J</creatorcontrib><creatorcontrib>MUMTAZ, Hina A</creatorcontrib><creatorcontrib>SCOTT-MONCRIEFF, Andrew</creatorcontrib><creatorcontrib>ELLIS, Jennifer D</creatorcontrib><creatorcontrib>MAYO, John R</creatorcontrib><creatorcontrib>LEIPSIC, Jonathon A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Environment Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Environment Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>REN YUAN</au><au>SHUMAN, William P</au><au>EARLS, James P</au><au>HAGUE, Cameron J</au><au>MUMTAZ, Hina A</au><au>SCOTT-MONCRIEFF, Andrew</au><au>ELLIS, Jennifer D</au><au>MAYO, John R</au><au>LEIPSIC, Jonathon A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reduced Iodine Load at CT Pulmonary Angiography with Dual-Energy Monochromatic Imaging: Comparison with Standard CT Pulmonary Angiography—A Prospective Randomized Trial</atitle><jtitle>Radiology</jtitle><addtitle>Radiology</addtitle><date>2012</date><risdate>2012</risdate><volume>262</volume><issue>1</issue><spage>290</spage><epage>297</epage><pages>290-297</pages><issn>0033-8419</issn><eissn>1527-1315</eissn><coden>RADLAX</coden><abstract>To compare quantitative and subjective image quality and radiation dose between standard computed tomographic (CT) pulmonary angiography (CTPA) and CTPA with a dual-energy technique with reduced iodine load.
This prospective study was approved by the institutional review board and each participant provided informed consent. Ninety-four patients (59% male; mean age ± standard deviation, 62 years ± 15) were randomized to one of two protocols: standard CTPA (100-120 kVp) with standard contrast medium injection (n = 46) and dual-energy CTPA (image reconstruction at 50 keV) with the same injection volume as in the standard protocol but composed of contrast medium and saline in a 1:1 fashion, resulting in 50% reduction in iodine load (n = 48). Signal intensity and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A five-point scale was used to subjectively evaluate vascular enhancement and image noise. The proportion of diagnostic (score, ≥ 3) studies and the interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale were compared between the two groups.
Compared with standard CTPA, dual-energy CTPA demonstrated higher signal intensity in all pulmonary arteries (all P < .01), inferior noise only in segmental arteries (P < .05), higher SNR and CNR (both P < .05), and compatible effective dose (P > .05). The five-point score was higher in the standard CTPA protocol (P < .05). The interreader agreement regarding the dichotomized diagnostic versus nondiagnostic scale was similar (P > .05) between the two groups.
Dual-energy CTPA with image reconstruction at 50 keV allows a significant reduction in iodine load while improving intravascular signal intensity, maintaining SNR and with comparable radiation dose.</abstract><cop>Oak Brook, IL</cop><pub>Radiological Society of North America</pub><pmid>22084206</pmid><doi>10.1148/radiol.11110648</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Angiography - methods Biological and medical sciences Cardiovascular system Chi-Square Distribution Contrast Media - administration & dosage Female Humans Image Interpretation, Computer-Assisted Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Prospective Studies Pulmonary Embolism - diagnostic imaging Radiation Dosage Radiodiagnosis. Nmr imagery. Nmr spectrometry Signal-To-Noise Ratio Statistics, Nonparametric Tomography, X-Ray Computed - methods Triiodobenzoic Acids - administration & dosage |
| title | Reduced Iodine Load at CT Pulmonary Angiography with Dual-Energy Monochromatic Imaging: Comparison with Standard CT Pulmonary Angiography—A Prospective Randomized Trial |
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