Prospective comparison of reduced-iodine-dose virtual monochromatic imaging dataset from dual-energy CT angiography with standard-iodine-dose single-energy CT angiography for abdominal aortic aneurysm

Mukta D. Agrawal, George R. Oliveira, Sanjeeva P. Kalva, Daniella F. Pinho, Ronald S. Arellano, Dushyant V. Sahani

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective. The purpose of this study was to compare the image quality of reducediodine-dose single-source dual-energy CT angiography (CTA) with that of standard-iodinedose single-energy CTA in examinations of patients with abdominal aortic aneurysm and to assess the effect of the concentration of iodinated contrast medium on intravascular enhancement and image quality of reduced-iodine-dose CTA. SUBJECTS AND METHODS. In a prospective randomized clinical trial, 66 consecutively registered patients with abdominal aortic aneurysm who had previously undergone single-energy CTA (30-37 g I) underwent follow-up CTA at a reduced dose (21-27 g I) of iodinated contrast medium of either 270 mg I/mL (n = 33) or 320 mg I/mL (n = 33). Two readers independently evaluated virtual monochromatic imaging datasets (40-140 keV) and single-energy CTA images for image quality and noise and their preference for optimal energy virtual monochromatic imaging dataset. A value of p < 0.05 was considered statistically signifcant. RESULTS. All 66 dual-energy CTA examinations were rated diagnostic with mean image quality and image noise scores of 4.8 and 4.5 for reader 1 and 3.8 and 3.4 for reader 2 compared with single-energy CTA results of 4.5 and 4.2 for reader 1 and 4.5 and 4.1 for reader 2. Low-energy virtual monochromatic images (40-60 keV) from reduced-iodine-dose (28%) dual-energy CTA had signifcantly higher intravascular aortic attenuation (26-185%) and contrast-to-noise ratio (CNR) (20-25%) than standard-iodine-dose single-energy CTA images (p < 0.0001). No signifcant difference was found between patients who received 270 and those who received 320 mg I/mL with respect to intravascular aortic attenuation (p = 0.6331) or CNR (p = 0.9775). CONCLUSION. Low-energy virtual monochromatic imaging datasets from reduced-iodine (24 g I) single-source dual-energy CTA of the abdomen provide up to 185% higher attenuation and 25% higher CNR than standard-iodine-dose (33.3 g I) single-energy CTA while offering a wide range of energy settings irrespective of the concentration of IV contrast medium used.

Original languageEnglish (US)
Pages (from-to)W125-W132
JournalAmerican Journal of Roentgenology
Volume207
Issue number6
DOIs
StatePublished - Dec 1 2016

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Abdominal Aortic Aneurysm
Iodine
Noise
Contrast Media
Computed Tomography Angiography
Datasets
Image Enhancement
Abdomen
Randomized Controlled Trials

Keywords

  • Abdominal aortic aneurysm
  • CT angiography
  • Dual-energy CT
  • Low iodine dose
  • Virtual monochromatic imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Prospective comparison of reduced-iodine-dose virtual monochromatic imaging dataset from dual-energy CT angiography with standard-iodine-dose single-energy CT angiography for abdominal aortic aneurysm. / Agrawal, Mukta D.; Oliveira, George R.; Kalva, Sanjeeva P.; Pinho, Daniella F.; Arellano, Ronald S.; Sahani, Dushyant V.

In: American Journal of Roentgenology, Vol. 207, No. 6, 01.12.2016, p. W125-W132.

Research output: Contribution to journalArticle

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title = "Prospective comparison of reduced-iodine-dose virtual monochromatic imaging dataset from dual-energy CT angiography with standard-iodine-dose single-energy CT angiography for abdominal aortic aneurysm",
abstract = "Objective. The purpose of this study was to compare the image quality of reducediodine-dose single-source dual-energy CT angiography (CTA) with that of standard-iodinedose single-energy CTA in examinations of patients with abdominal aortic aneurysm and to assess the effect of the concentration of iodinated contrast medium on intravascular enhancement and image quality of reduced-iodine-dose CTA. SUBJECTS AND METHODS. In a prospective randomized clinical trial, 66 consecutively registered patients with abdominal aortic aneurysm who had previously undergone single-energy CTA (30-37 g I) underwent follow-up CTA at a reduced dose (21-27 g I) of iodinated contrast medium of either 270 mg I/mL (n = 33) or 320 mg I/mL (n = 33). Two readers independently evaluated virtual monochromatic imaging datasets (40-140 keV) and single-energy CTA images for image quality and noise and their preference for optimal energy virtual monochromatic imaging dataset. A value of p < 0.05 was considered statistically signifcant. RESULTS. All 66 dual-energy CTA examinations were rated diagnostic with mean image quality and image noise scores of 4.8 and 4.5 for reader 1 and 3.8 and 3.4 for reader 2 compared with single-energy CTA results of 4.5 and 4.2 for reader 1 and 4.5 and 4.1 for reader 2. Low-energy virtual monochromatic images (40-60 keV) from reduced-iodine-dose (28{\%}) dual-energy CTA had signifcantly higher intravascular aortic attenuation (26-185{\%}) and contrast-to-noise ratio (CNR) (20-25{\%}) than standard-iodine-dose single-energy CTA images (p < 0.0001). No signifcant difference was found between patients who received 270 and those who received 320 mg I/mL with respect to intravascular aortic attenuation (p = 0.6331) or CNR (p = 0.9775). CONCLUSION. Low-energy virtual monochromatic imaging datasets from reduced-iodine (24 g I) single-source dual-energy CTA of the abdomen provide up to 185{\%} higher attenuation and 25{\%} higher CNR than standard-iodine-dose (33.3 g I) single-energy CTA while offering a wide range of energy settings irrespective of the concentration of IV contrast medium used.",
keywords = "Abdominal aortic aneurysm, CT angiography, Dual-energy CT, Low iodine dose, Virtual monochromatic imaging",
author = "Agrawal, {Mukta D.} and Oliveira, {George R.} and Kalva, {Sanjeeva P.} and Pinho, {Daniella F.} and Arellano, {Ronald S.} and Sahani, {Dushyant V.}",
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T1 - Prospective comparison of reduced-iodine-dose virtual monochromatic imaging dataset from dual-energy CT angiography with standard-iodine-dose single-energy CT angiography for abdominal aortic aneurysm

AU - Agrawal, Mukta D.

AU - Oliveira, George R.

AU - Kalva, Sanjeeva P.

AU - Pinho, Daniella F.

AU - Arellano, Ronald S.

AU - Sahani, Dushyant V.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Objective. The purpose of this study was to compare the image quality of reducediodine-dose single-source dual-energy CT angiography (CTA) with that of standard-iodinedose single-energy CTA in examinations of patients with abdominal aortic aneurysm and to assess the effect of the concentration of iodinated contrast medium on intravascular enhancement and image quality of reduced-iodine-dose CTA. SUBJECTS AND METHODS. In a prospective randomized clinical trial, 66 consecutively registered patients with abdominal aortic aneurysm who had previously undergone single-energy CTA (30-37 g I) underwent follow-up CTA at a reduced dose (21-27 g I) of iodinated contrast medium of either 270 mg I/mL (n = 33) or 320 mg I/mL (n = 33). Two readers independently evaluated virtual monochromatic imaging datasets (40-140 keV) and single-energy CTA images for image quality and noise and their preference for optimal energy virtual monochromatic imaging dataset. A value of p < 0.05 was considered statistically signifcant. RESULTS. All 66 dual-energy CTA examinations were rated diagnostic with mean image quality and image noise scores of 4.8 and 4.5 for reader 1 and 3.8 and 3.4 for reader 2 compared with single-energy CTA results of 4.5 and 4.2 for reader 1 and 4.5 and 4.1 for reader 2. Low-energy virtual monochromatic images (40-60 keV) from reduced-iodine-dose (28%) dual-energy CTA had signifcantly higher intravascular aortic attenuation (26-185%) and contrast-to-noise ratio (CNR) (20-25%) than standard-iodine-dose single-energy CTA images (p < 0.0001). No signifcant difference was found between patients who received 270 and those who received 320 mg I/mL with respect to intravascular aortic attenuation (p = 0.6331) or CNR (p = 0.9775). CONCLUSION. Low-energy virtual monochromatic imaging datasets from reduced-iodine (24 g I) single-source dual-energy CTA of the abdomen provide up to 185% higher attenuation and 25% higher CNR than standard-iodine-dose (33.3 g I) single-energy CTA while offering a wide range of energy settings irrespective of the concentration of IV contrast medium used.

AB - Objective. The purpose of this study was to compare the image quality of reducediodine-dose single-source dual-energy CT angiography (CTA) with that of standard-iodinedose single-energy CTA in examinations of patients with abdominal aortic aneurysm and to assess the effect of the concentration of iodinated contrast medium on intravascular enhancement and image quality of reduced-iodine-dose CTA. SUBJECTS AND METHODS. In a prospective randomized clinical trial, 66 consecutively registered patients with abdominal aortic aneurysm who had previously undergone single-energy CTA (30-37 g I) underwent follow-up CTA at a reduced dose (21-27 g I) of iodinated contrast medium of either 270 mg I/mL (n = 33) or 320 mg I/mL (n = 33). Two readers independently evaluated virtual monochromatic imaging datasets (40-140 keV) and single-energy CTA images for image quality and noise and their preference for optimal energy virtual monochromatic imaging dataset. A value of p < 0.05 was considered statistically signifcant. RESULTS. All 66 dual-energy CTA examinations were rated diagnostic with mean image quality and image noise scores of 4.8 and 4.5 for reader 1 and 3.8 and 3.4 for reader 2 compared with single-energy CTA results of 4.5 and 4.2 for reader 1 and 4.5 and 4.1 for reader 2. Low-energy virtual monochromatic images (40-60 keV) from reduced-iodine-dose (28%) dual-energy CTA had signifcantly higher intravascular aortic attenuation (26-185%) and contrast-to-noise ratio (CNR) (20-25%) than standard-iodine-dose single-energy CTA images (p < 0.0001). No signifcant difference was found between patients who received 270 and those who received 320 mg I/mL with respect to intravascular aortic attenuation (p = 0.6331) or CNR (p = 0.9775). CONCLUSION. Low-energy virtual monochromatic imaging datasets from reduced-iodine (24 g I) single-source dual-energy CTA of the abdomen provide up to 185% higher attenuation and 25% higher CNR than standard-iodine-dose (33.3 g I) single-energy CTA while offering a wide range of energy settings irrespective of the concentration of IV contrast medium used.

KW - Abdominal aortic aneurysm

KW - CT angiography

KW - Dual-energy CT

KW - Low iodine dose

KW - Virtual monochromatic imaging

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