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CT angiography of the neck: value of contrast medium dose reduction with low tube voltage and high tube current in a 64-detector row CT.

Clinical radiology (2014-02-08)
W Xia, J-T Wu, X-R Yin, Z-J Wang, H-T Wu
ABSTRACT

To evaluate the feasibility of a low-dose contrast medium protocol for 64-detector row computed tomography angiography (CTA) of the neck using a low-tube-voltage/high-tube-current setting. A phantom study was performed using 64-detector row spiral CT at multiple tube voltage and current settings. Iodine contrast medium attenuation curves were acquired by processing and used to select the best contrast medium-to-noise ratio (CNR). A prospective clinical study was then performed on 84 patients requiring neck CTA. Patients were randomly divided into two groups of 42. Group A was examined using the conventional imaging protocol (120 kV, 400 mAs) and group B was examined at 80 kV and 600 mAs along with a 50% reduction in contrast medium dose. The CT dose index-volume (CTDI(vol)), background noise (BN), and CNR were measured and statistically analysed. Various image quality criteria were evaluated by two senior radiologists using a qualitative five-point scale. Comparing group B with A, CTDIvol decreased by 54% (B: 27.48 mGy, A: 59.11 mGy), however, the CNR increased by 50%. The mean attenuation, which was caused by venous streak artefacts, was significantly lower in group B than A. Qualitative image analysis found that all criteria were significantly better for group B than A. At 64-detector row spiral CT, the low-tube-voltage/high-tube-current with low-dose contrast medium protocol was superior to the conventional protocol regarding radiation dose, venous streak artefacts, and image quality, and is feasible for CTA of the neck.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Iodine, ≥99.99% trace metals basis
Sigma-Aldrich
Iodine, anhydrous, beads, −10 mesh, 99.999% trace metals basis
Sigma-Aldrich
Iodine, 99.999% trace metals basis
Sigma-Aldrich
Iodine, Vetec, reagent grade, 99%
Sigma-Aldrich
Iodine, ReagentPlus®, 99.7% trace metals basis, beads, 1-3 mm
Sigma-Aldrich
Iodine, puriss., ≥99.5% (RT), particles (round)
Sigma-Aldrich
Iodine, flakes, ReagentPlus®, ≥99%
Sigma-Aldrich
Iodine, ACS reagent, ≥99.8%, solid
Sigma-Aldrich
Iodine, puriss., meets analytical specification of Ph. Eur., BP, USP, 99.8-100.5%
Supelco
Iodine, ReagentPlus®, ≥99.8% (titration)