Reducing iodine contrast volume in CT angiography of the abdominal aorta using integrated tube potential selection and weight-based method without compromising image quality

Rogerio Vasconcelos, Terri J Vrtiska, Thomas A. Foley, Thanila A. Macedo, Juan C. Montoya Cardona, Eric E. Williamson, Cynthia H McCollough, Joel Garland Fletcher

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study is to determine whether image quality was maintained when a weight-based protocol incorporating tube potential selection was used to select lower iodine contrast volumes for aortic CT angiography (CTA). MATERIALS AND METHODS. Patients with potentially decreased renal function underwent CTA performed with the iodinated contrast volume determined using a table incorporating different tube potentials and patient weights. The image quality of CTA examinations performed with a reduced iodine volume (hereafter known as "low-iodine CTA examinations"), internal control CTA examinations (i.e., prior examinations), and size-matched control CTA examinations was evaluated in separate reading sessions conducted by three vascular radiologists who were blinded as to the contrast volume and tube potential used. Side-by-side unblinded comparison of the examinations was also performed. Aortic attenuation and the contrast-tonoise ratio were measured. Comparisons were performed using the Wilcoxon signed rank test. RESULTS. Fifty low-iodine CTA examinations, 36 internal control CTA examinations, and 50 size-matched control CTA examinations were performed. Contrast volumes were 63% lower when the protocol based on tube potential and patient weight was used (mean contrast volume, 49 mL for low-iodine CTA vs 133 mL for internal control CTA and 138 mL for sizematched control CTA). The mean volume CT dose index was 15.1 mGy for low-iodine CTA versus 18.8 mGy for internal control CTA (p < 0.001), and 15.3 mGy for low-iodine CTA versus 17.1 mGy for size-matched control CTA (p = 0.11). Of the image quality and diagnostic confidence evaluations for low-iodine CTA examinations, over 97% had acceptable image quality and diagnostic confidence for blinded (50/50) and unblinded (35/36) comparisons. Aortic attenuation was similar between groups (p = 0.13-0.71).

Original languageEnglish (US)
Pages (from-to)552-563
Number of pages12
JournalAmerican Journal of Roentgenology
Volume208
Issue number3
DOIs
StatePublished - Mar 1 2017

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Cone-Beam Computed Tomography
Abdominal Aorta
Iodine
Weights and Measures
Computed Tomography Angiography
Nonparametric Statistics

Keywords

  • CT angiography
  • Iodinated contrast
  • Nephrotoxicity
  • Tube potential

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Reducing iodine contrast volume in CT angiography of the abdominal aorta using integrated tube potential selection and weight-based method without compromising image quality. / Vasconcelos, Rogerio; Vrtiska, Terri J; Foley, Thomas A.; Macedo, Thanila A.; Montoya Cardona, Juan C.; Williamson, Eric E.; McCollough, Cynthia H; Fletcher, Joel Garland.

In: American Journal of Roentgenology, Vol. 208, No. 3, 01.03.2017, p. 552-563.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE. The purpose of this study is to determine whether image quality was maintained when a weight-based protocol incorporating tube potential selection was used to select lower iodine contrast volumes for aortic CT angiography (CTA). MATERIALS AND METHODS. Patients with potentially decreased renal function underwent CTA performed with the iodinated contrast volume determined using a table incorporating different tube potentials and patient weights. The image quality of CTA examinations performed with a reduced iodine volume (hereafter known as {"}low-iodine CTA examinations{"}), internal control CTA examinations (i.e., prior examinations), and size-matched control CTA examinations was evaluated in separate reading sessions conducted by three vascular radiologists who were blinded as to the contrast volume and tube potential used. Side-by-side unblinded comparison of the examinations was also performed. Aortic attenuation and the contrast-tonoise ratio were measured. Comparisons were performed using the Wilcoxon signed rank test. RESULTS. Fifty low-iodine CTA examinations, 36 internal control CTA examinations, and 50 size-matched control CTA examinations were performed. Contrast volumes were 63{\%} lower when the protocol based on tube potential and patient weight was used (mean contrast volume, 49 mL for low-iodine CTA vs 133 mL for internal control CTA and 138 mL for sizematched control CTA). The mean volume CT dose index was 15.1 mGy for low-iodine CTA versus 18.8 mGy for internal control CTA (p < 0.001), and 15.3 mGy for low-iodine CTA versus 17.1 mGy for size-matched control CTA (p = 0.11). Of the image quality and diagnostic confidence evaluations for low-iodine CTA examinations, over 97{\%} had acceptable image quality and diagnostic confidence for blinded (50/50) and unblinded (35/36) comparisons. Aortic attenuation was similar between groups (p = 0.13-0.71).",
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AU - Vrtiska, Terri J

AU - Foley, Thomas A.

AU - Macedo, Thanila A.

AU - Montoya Cardona, Juan C.

AU - Williamson, Eric E.

AU - McCollough, Cynthia H

AU - Fletcher, Joel Garland

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N2 - OBJECTIVE. The purpose of this study is to determine whether image quality was maintained when a weight-based protocol incorporating tube potential selection was used to select lower iodine contrast volumes for aortic CT angiography (CTA). MATERIALS AND METHODS. Patients with potentially decreased renal function underwent CTA performed with the iodinated contrast volume determined using a table incorporating different tube potentials and patient weights. The image quality of CTA examinations performed with a reduced iodine volume (hereafter known as "low-iodine CTA examinations"), internal control CTA examinations (i.e., prior examinations), and size-matched control CTA examinations was evaluated in separate reading sessions conducted by three vascular radiologists who were blinded as to the contrast volume and tube potential used. Side-by-side unblinded comparison of the examinations was also performed. Aortic attenuation and the contrast-tonoise ratio were measured. Comparisons were performed using the Wilcoxon signed rank test. RESULTS. Fifty low-iodine CTA examinations, 36 internal control CTA examinations, and 50 size-matched control CTA examinations were performed. Contrast volumes were 63% lower when the protocol based on tube potential and patient weight was used (mean contrast volume, 49 mL for low-iodine CTA vs 133 mL for internal control CTA and 138 mL for sizematched control CTA). The mean volume CT dose index was 15.1 mGy for low-iodine CTA versus 18.8 mGy for internal control CTA (p < 0.001), and 15.3 mGy for low-iodine CTA versus 17.1 mGy for size-matched control CTA (p = 0.11). Of the image quality and diagnostic confidence evaluations for low-iodine CTA examinations, over 97% had acceptable image quality and diagnostic confidence for blinded (50/50) and unblinded (35/36) comparisons. Aortic attenuation was similar between groups (p = 0.13-0.71).

AB - OBJECTIVE. The purpose of this study is to determine whether image quality was maintained when a weight-based protocol incorporating tube potential selection was used to select lower iodine contrast volumes for aortic CT angiography (CTA). MATERIALS AND METHODS. Patients with potentially decreased renal function underwent CTA performed with the iodinated contrast volume determined using a table incorporating different tube potentials and patient weights. The image quality of CTA examinations performed with a reduced iodine volume (hereafter known as "low-iodine CTA examinations"), internal control CTA examinations (i.e., prior examinations), and size-matched control CTA examinations was evaluated in separate reading sessions conducted by three vascular radiologists who were blinded as to the contrast volume and tube potential used. Side-by-side unblinded comparison of the examinations was also performed. Aortic attenuation and the contrast-tonoise ratio were measured. Comparisons were performed using the Wilcoxon signed rank test. RESULTS. Fifty low-iodine CTA examinations, 36 internal control CTA examinations, and 50 size-matched control CTA examinations were performed. Contrast volumes were 63% lower when the protocol based on tube potential and patient weight was used (mean contrast volume, 49 mL for low-iodine CTA vs 133 mL for internal control CTA and 138 mL for sizematched control CTA). The mean volume CT dose index was 15.1 mGy for low-iodine CTA versus 18.8 mGy for internal control CTA (p < 0.001), and 15.3 mGy for low-iodine CTA versus 17.1 mGy for size-matched control CTA (p = 0.11). Of the image quality and diagnostic confidence evaluations for low-iodine CTA examinations, over 97% had acceptable image quality and diagnostic confidence for blinded (50/50) and unblinded (35/36) comparisons. Aortic attenuation was similar between groups (p = 0.13-0.71).

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KW - Nephrotoxicity

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