Sage Journals: Discover world-class research

Abstract

Background

The use of the smallest contrast dose is highly desirable in performing cardiac computed tomography (CT), especially for patients with cardiovascular diseases to prevent contrast-induced nephropathy.

Purpose

To evaluate the feasibility of 20% reduced contrast dose protocol in cardiac CT using 100 kVp and high-tube-current-time product setting.

Material and Methods

Fifty patients were scanned with our conventional 120 kVp protocol, and the other 50 patients underwent scans using a tube voltage of 100 kVp, a high-tube-current-time product, and a 20% reduced contrast dose. We evaluated estimated effective dose (ED), CT attenuation, image noise, and contrast-to-noise ratio (CNR) of the ascending aorta. We also evaluated CT attenuation of the coronary arteries. Two radiologists independently assessed image quality of coronary arteries.

Results

There was no significant difference in the ED between the 100 kVp and 120 kVp protocols (21.7 mSv ± 1.6 vs. 21.8 mSv ± 1.1, P = 0.65). There was no significant difference in the CNR of the ascending aorta between the 100 kVp and 120 kVp protocols (18.8 ± 3.5 vs. 18.7 ± 3.8, P = 0.98). Mean CT attenuation of the coronary arteries of the 100 kVp protocols was significantly higher than that of 120 kVp protocols (P < 0.05). There was no significant difference in the overall image quality of the coronary artery between the 100 kVp and 120 kVp protocols (3.7 ± 0.4 vs. 3.7 ± 0.5, P = 0.65).

Conclusion

For cardiac CT a voltage setting of 100 kVp and a high-tube-current-time product enable 20% reduction in the contrast dose without affecting the quality of coronary artery images compared with a 120 kVp and standard-contrast-dose CT protocol.

Keywords

Low contrast dose multidetector CT low kilo voltage contrast-induced nephropathy coronary CT angiography

Get full access to this article

View all access options for this article.

References

From

Bartholmai

Williams

. Mortality associated with nephropathy after radiographic contrast exposure. Mayo Clin Proc 2008; 83: 1095–1100.

McCullough

Wolyn

Rocher

. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997; 103: 368–375.

Gruberg

Mintz

Mehran

. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol 2000; 36: 1542–1548.

Utsunomiya

Yanaga

Awai

. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT. Acta Radiol 2011; 52: 581–586.

Bischoff

Hein

Meyer

. Impact of a reduced tube voltage on CT angiography and radiation dose: results of the PROTECTION I study. JACC Cardiovasc Imaging 2009; 2: 940–946.

Zhang

Yan

. 320-row CT coronary angiography: effect of 100-kV tube voltages on image quality, contrast volume, and radiation dose. Int J Cardiovasc Imaging 2011; 27: 1059–1068.

Huda

Ogden

. Optimizing abdominal CT dose and image quality with respect to x-ray tube voltage. Medical Imaging 2004; 5368: 499–507.

Bongartz G GS, Jurik AG, Leonardi M, et al. European Guidelines for Multislice Computed Tomography: Appendix C. Funded by the European Commission March 2004:Contract No. FIGM-CT2000-20078-CT-TIP.

Nakayama

Awai

Funama

. Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology 2005; 237: 945–951.

10.

Nakayama

Awai

Funama

. Lower tube voltage reduces contrast material and radiation doses on 16-MDCT aortography. Am J Roentgenol 2006; 187: W490–W497.

11.

Huda

Scalzetti

Levin

. Technique factors and image quality as functions of patient weight at abdominal CT. Radiology 2000; 217: 430–435.

12.

Ripsweden

Brismar

Holm

. Impact on image quality and radiation exposure in coronary CT angiography: 100 kVp versus 120 kVp. Acta Radiol 2010; 51: 903–909.

13.

Hausleiter

Meyer

Hadamitzky

. Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 2006; 113: 1305–1310.

14.

Nakaura

Awai

Maruyama

. Abdominal dynamic CT in patients with renal dysfunction: contrast agent dose reduction with low tube voltage and high tube current-time product settings at 256-detector row CT. Radiology 2011; 261: 467–476.

15.

Marin

Nelson

Samei

. Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection–initial clinical experience. Radiology 2009; 251: 771–779.

16.

Kalender

Wolf

Suess

. Dose reduction in CT by on-line tube current control: principles and validation on phantoms and cadavers. Eur Radiol 1999; 9: 323–328.

17.

Marin

Nelson

Schindera

. Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm–initial clinical experience. Radiology 2010; 254: 145–153.

18.

Guimaraes

Fletcher

Harmsen

. Appropriate patient selection at abdominal dual-energy CT using 80 kV: relationship between patient size, image noise, and image quality. Radiology 2010; 257: 732–742.

19.

Hausleiter

Martinoff

Hadamitzky

. Image quality and radiation exposure with a low tube voltage protocol for coronary CT angiography results of the PROTECTION II Trial. JACC Cardiovasc Imaging 2010; 3: 1113–1123.

20.

Bae

. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 2010; 256: 32–61.

21.

Hurwitz

Yoshizumi

Goodman

. Effective dose determination using an anthropomorphic phantom and metal oxide semiconductor field effect transistor technology for clinical adult body multidetector array computed tomography protocols. J Comput Assist Tomogr 2007; 31: 544–549.

Low-contrast-dose protocol in cardiac CT: 20% contrast dose reduction using 100 kVp and high-tube-current-time setting in 256-slice CT

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

Get full access to this article

References