Madeleine Kok1,2, Casper Mihl1,2, Anna Seehofnerová1, Jakub Turek1, Gregor Jost3, Hubertus Pietsch3, Ulrike Haberland4, Joachim E Wildberger1,2, Marco Das2. 1. 1 Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands. 2. 2 CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands. 3. 3 Bayer HealthCare, Contrast Media Research, Berlin, Germany. 4. 4 Siemens AG, Healthcare Sector, Forchheim, Germany.
Abstract
OBJECTIVE: The purpose of this study was to systematically investigate radiation dose reduction using automated tube voltage selection during CT angiography (CTA) and to evaluate the impact of contrast medium (CM) injection protocols on dose reduction. MATERIALS AND METHODS: A circulation phantom containing the thoracic and abdominal vasculature was used. Four different concentrations of CM (iopromide 300 and 370 mg I/mL and iomeprol 350 and 400 mg I/mL) were administered while maintaining an identical iodine delivery rate (1.8 g I/s) and total iodine load (20.0 g). Three different scanning protocols for CTA of the thoracoabdominal aorta were used: protocol A, no dose modulation; protocol B, automated tube current modulation (CARE Dose4D); and protocol C, automated tube voltage selection (CARE kV). The dose-length product was recorded to calculate the effective dose. Attenuation values (in Hounsfield units), image noise levels, and signal-to-noise ratios (SNRs) in six predefined intravascular sites (three thoracic and three abdominal) were measured by two readers. All values were analyzed using the Kruskal-Wallis test and two-way ANOVA. RESULTS: There was a significant reduction in the effective dose (in millisieverts) for protocols B (mean ± SD, 2.03 ± 0.1 mSv) and C (1.00 ± 0.0 mSv) compared with protocol A (4.34 ± 0.0 mSv). The dose was reduced by 53% for protocol B and by 77% for protocol C. No significant differences were found in the effective dose among the different CM injection protocols within the scanning protocols; all p values were > 0.05. The attenuation values and SNRs were comparable among all the different CM injection protocols; all p values were > 0.05. CONCLUSION: A large radiation dose reduction (77%) can be achieved using automated tube voltage selection independent of the CM injection protocol.
OBJECTIVE: The purpose of this study was to systematically investigate radiation dose reduction using automated tube voltage selection during CT angiography (CTA) and to evaluate the impact of contrast medium (CM) injection protocols on dose reduction. MATERIALS AND METHODS: A circulation phantom containing the thoracic and abdominal vasculature was used. Four different concentrations of CM (iopromide 300 and 370 mg I/mL and iomeprol 350 and 400 mg I/mL) were administered while maintaining an identical iodine delivery rate (1.8 g I/s) and total iodine load (20.0 g). Three different scanning protocols for CTA of the thoracoabdominal aorta were used: protocol A, no dose modulation; protocol B, automated tube current modulation (CARE Dose4D); and protocol C, automated tube voltage selection (CARE kV). The dose-length product was recorded to calculate the effective dose. Attenuation values (in Hounsfield units), image noise levels, and signal-to-noise ratios (SNRs) in six predefined intravascular sites (three thoracic and three abdominal) were measured by two readers. All values were analyzed using the Kruskal-Wallis test and two-way ANOVA. RESULTS: There was a significant reduction in the effective dose (in millisieverts) for protocols B (mean ± SD, 2.03 ± 0.1 mSv) and C (1.00 ± 0.0 mSv) compared with protocol A (4.34 ± 0.0 mSv). The dose was reduced by 53% for protocol B and by 77% for protocol C. No significant differences were found in the effective dose among the different CM injection protocols within the scanning protocols; all p values were > 0.05. The attenuation values and SNRs were comparable among all the different CM injection protocols; all p values were > 0.05. CONCLUSION: A large radiation dose reduction (77%) can be achieved using automated tube voltage selection independent of the CM injection protocol.
Authors: Toon Van Cauteren; Gert Van Gompel; Kaoru Tanaka; Douwe E Verdries; Dries Belsack; Koenraad H Nieboer; Inneke Willekens; Paul Evans; Sven Macholl; Guy Verfaillie; Steven Droogmans; Johan de Mey; Nico Buls Journal: Biomed Res Int Date: 2017-05-23 Impact factor: 3.411
Authors: Marian S Solbak; Mette K Henning; Andrew England; Anne C Martinsen; Trond M Aaløkken; Safora Johansen Journal: Eur Radiol Exp Date: 2020-09-11
Authors: Nienke G Eijsvoogel; Babs M F Hendriks; Jef L Willigers; Bibi Martens; Luc F Carati; Barbora Horehledova; Bastiaan L J H Kietselaer; Harry J G M Crijns; Joachim E Wildberger; Marco Das Journal: PLoS One Date: 2018-09-26 Impact factor: 3.240
Authors: N G Eijsvoogel; B M F Hendriks; P Nelemans; C Mihl; J Willigers; B Martens; J E Wildberger; M Das Journal: Contrast Media Mol Imaging Date: 2020-01-17 Impact factor: 3.161