CT pulmonary angiography in patients with acute or chronic renal insufficiency: Evaluation of a low dose contrast material protocol
Adverse effects of intravenous contrast media (CM) in patients with renal risk factors and acute kidney injury are still controversially discussed. The aim of this study was to investigate whether dual-energy (DE) pulmonary CT angiography (CTPA) in combination with a noise optimized virtual monoener...
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| description | Adverse effects of intravenous contrast media (CM) in patients with renal risk factors and acute kidney injury are still controversially discussed. The aim of this study was to investigate whether dual-energy (DE) pulmonary CT angiography (CTPA) in combination with a noise optimized virtual monoenergetic imaging algorithm allows for a reduction of CM. This IRB-approved study comprised 150 patients with suspected pulmonary embolism (78 male; mean age 65 ± 17years). 50 patients with acute/chronic renal failure were examined on a 3
rd
generation dual-source CT with an optimized DE CTPA protocol and a low CM injection protocol (5.4 g iodine). 100 further patients were either examined with a standard CTPA protocol or a standard DE CTPA (32 g iodine). For the DE CTPA virtual monoenergetic spectral datasets (40–100 keV) were reconstructed. Main pulmonary arteries at 50 keV and peripheral pulmonary arteries at 40 keV datasets provided the highest contrast-to-noise-ratio (CNR) for both the standard DE CTPA and the optimized protocol, with significantly higher CNR values for the standard DE CTPA protocol (p |
| doi_str_mv | 10.1038/s41598-018-20254-y |
| format | Article |
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rd
generation dual-source CT with an optimized DE CTPA protocol and a low CM injection protocol (5.4 g iodine). 100 further patients were either examined with a standard CTPA protocol or a standard DE CTPA (32 g iodine). For the DE CTPA virtual monoenergetic spectral datasets (40–100 keV) were reconstructed. Main pulmonary arteries at 50 keV and peripheral pulmonary arteries at 40 keV datasets provided the highest contrast-to-noise-ratio (CNR) for both the standard DE CTPA and the optimized protocol, with significantly higher CNR values for the standard DE CTPA protocol (p < 0.05). No pulmonary embolism was missed on the optimized CM protocol. DE CTPA utilizing image reconstruction at 40/50 keV allowed for a reduction of 84% in iodine load while maintaining CNR, which is especially important in patients with acute/chronic renal failure.</description><subject>692/308/409</subject><subject>692/700/1421/1846/2771</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography - methods</subject><subject>Computed Tomography Angiography - standards</subject><subject>Contrast media</subject><subject>Contrast Media - administration & dosage</subject><subject>Embolism</subject><subject>Embolisms</subject><subject>Female</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Image processing</subject><subject>Intravenous administration</subject><subject>Iodine</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Pulmonary arteries</subject><subject>Pulmonary artery</subject><subject>Pulmonary Artery - diagnostic imaging</subject><subject>Renal failure</subject><subject>Renal insufficiency</subject><subject>Renal Insufficiency - diagnostic imaging</subject><subject>Risk factors</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kcFrHCEUxofS0IQk_0APReill2n1qbNjD4WypE0gkEt6FsfRXcOMTtVJmHP-8brZNGwLEUHh_b7P9_yq6j3Bnwmm7ZfECBdtjUlbAwbO6uVNdQKY8RoowNuD-3F1ntIdLouDYES8q45B0LbhFE6qx_UtmuZhDF7FBSm_cWET1bRdkPNoUtkZnxN6cHmLlJ6zQSEivY3BO42i8WooXJqtdbqQevmKLu7VMBdd8ChYpNAQHlAfkkE6-BxVymhU2URXlFMMOegwnFVHVg3JnD-fp9WvHxe368v6-ubn1fr7da3ZiuW6a0wPvBekFY1oBe0aWuaxjcWso5QTBdByoRpCTIctU12BADdacAMEbE9Pq29732nuRtNrs2tokFN0YxleBuXkvxXvtnIT7iVfCWCUFoNPzwYx_J5NynJ0SZthUN6EOUkiBKUt0IYU9ON_6F2YY_mvJwrKblY7Q9hTOoaUorEvzRAsdzHLfcyyxCyfYpZLEX04HONF8jfUAtA9kErJb0w8ePt12z8L-7XN</recordid><startdate>20180131</startdate><enddate>20180131</enddate><creator>Meyer, Mathias</creator><creator>Haubenreisser, Holger</creator><creator>Schabel, Christoph</creator><creator>Leidecker, Christianne</creator><creator>Schmidt, Bernhard</creator><creator>Schoenberg, Stefan O.</creator><creator>Henzler, Thomas</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180131</creationdate><title>CT pulmonary angiography in patients with acute or chronic renal insufficiency: Evaluation of a low dose contrast material protocol</title><author>Meyer, Mathias ; Haubenreisser, Holger ; Schabel, Christoph ; Leidecker, Christianne ; Schmidt, Bernhard ; Schoenberg, Stefan O. ; Henzler, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-b6ed25d918969893b63294f6f04b3351a22859a611eb0f4ab989206c95e212fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>692/308/409</topic><topic>692/700/1421/1846/2771</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Computed tomography</topic><topic>Computed Tomography Angiography - methods</topic><topic>Computed Tomography Angiography - standards</topic><topic>Contrast media</topic><topic>Contrast Media - administration & dosage</topic><topic>Embolism</topic><topic>Embolisms</topic><topic>Female</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Image processing</topic><topic>Intravenous administration</topic><topic>Iodine</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Pulmonary arteries</topic><topic>Pulmonary artery</topic><topic>Pulmonary Artery - diagnostic imaging</topic><topic>Renal failure</topic><topic>Renal insufficiency</topic><topic>Renal Insufficiency - diagnostic imaging</topic><topic>Risk factors</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meyer, Mathias</creatorcontrib><creatorcontrib>Haubenreisser, Holger</creatorcontrib><creatorcontrib>Schabel, Christoph</creatorcontrib><creatorcontrib>Leidecker, Christianne</creatorcontrib><creatorcontrib>Schmidt, Bernhard</creatorcontrib><creatorcontrib>Schoenberg, Stefan O.</creatorcontrib><creatorcontrib>Henzler, Thomas</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meyer, Mathias</au><au>Haubenreisser, Holger</au><au>Schabel, Christoph</au><au>Leidecker, Christianne</au><au>Schmidt, Bernhard</au><au>Schoenberg, Stefan O.</au><au>Henzler, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CT pulmonary angiography in patients with acute or chronic renal insufficiency: Evaluation of a low dose contrast material protocol</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2018-01-31</date><risdate>2018</risdate><volume>8</volume><issue>1</issue><spage>1995</spage><epage>9</epage><pages>1995-9</pages><artnum>1995</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Adverse effects of intravenous contrast media (CM) in patients with renal risk factors and acute kidney injury are still controversially discussed. The aim of this study was to investigate whether dual-energy (DE) pulmonary CT angiography (CTPA) in combination with a noise optimized virtual monoenergetic imaging algorithm allows for a reduction of CM. This IRB-approved study comprised 150 patients with suspected pulmonary embolism (78 male; mean age 65 ± 17years). 50 patients with acute/chronic renal failure were examined on a 3
rd
generation dual-source CT with an optimized DE CTPA protocol and a low CM injection protocol (5.4 g iodine). 100 further patients were either examined with a standard CTPA protocol or a standard DE CTPA (32 g iodine). For the DE CTPA virtual monoenergetic spectral datasets (40–100 keV) were reconstructed. Main pulmonary arteries at 50 keV and peripheral pulmonary arteries at 40 keV datasets provided the highest contrast-to-noise-ratio (CNR) for both the standard DE CTPA and the optimized protocol, with significantly higher CNR values for the standard DE CTPA protocol (p < 0.05). No pulmonary embolism was missed on the optimized CM protocol. DE CTPA utilizing image reconstruction at 40/50 keV allowed for a reduction of 84% in iodine load while maintaining CNR, which is especially important in patients with acute/chronic renal failure.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>29386532</pmid><doi>10.1038/s41598-018-20254-y</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 692/308/409 692/700/1421/1846/2771 Adult Aged Aged, 80 and over Angiography Computed tomography Computed Tomography Angiography - methods Computed Tomography Angiography - standards Contrast media Contrast Media - administration & dosage Embolism Embolisms Female Humanities and Social Sciences Humans Image processing Intravenous administration Iodine Kidneys Male Medical imaging Middle Aged multidisciplinary Pulmonary arteries Pulmonary artery Pulmonary Artery - diagnostic imaging Renal failure Renal insufficiency Renal Insufficiency - diagnostic imaging Risk factors Science Science (multidisciplinary) |
| title | CT pulmonary angiography in patients with acute or chronic renal insufficiency: Evaluation of a low dose contrast material protocol |
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