PMID- 29412008 OWN - NLM STAT- MEDLINE DCOM- 20180606 LR - 20240403 IS - 1748-880X (Electronic) IS - 0007-1285 (Print) IS - 0007-1285 (Linking) VI - 91 IP - 1086 DP - 2018 Jun TI - Subtraction CT angiography in head and neck with low radiation and contrast dose dual-energy spectral CT using rapid kV-switching technique. PG - 20170631 LID - 10.1259/bjr.20170631 [doi] LID - 20170631 AB - OBJECTIVE: To investigate the application of low radiation and contrast dose spectral CT angiology using rapid kV-switching technique in the head and neck with subtraction method for bone removal. METHODS: This prospective study was approved by the local ethics committee. 64 cases for head and neck CT angiology were randomly divided into Groups A (n = 32) and B (n = 32). Group A underwent unenhanced CT with 100 kVp, 200 mA and contrast-enhanced CT with spectral CT mode with body mass index-dependent low dose protocols. Group B used conventional helical scanning with 120 kVp, auto mA for noise index of 12 HU (Hounsfield unit) for both the unenhanced and contrast-enhanced CT. Subtraction images were formed by subtracting the unenhanced images from enhanced images (with the 65 keV-enhanced spectral CT image in Group A). CT numbers and their standard deviations in aortic arch, carotid arteries, middle cerebral artery and air were measured in the subtraction images. The signal-to-noise ratio and contrast-to-noise ratio for the common and internal carotid arteries and middle cerebral artery were calculated. Image quality in terms of bone removal effect was evaluated by two experienced radiologists independently and blindly using a 4-point system. Radiation dose and total iodine load were recorded. Measurements were statistically compared between the two groups. RESULTS: The two groups had same demographic results. There was no difference in the CT number, signal-to-noise and contrast-to-noise ratio values for carotid arteries and middle cerebral artery in the subtraction images between the two groups (p > 0.05). However, the bone removal effect score [median (min-max)] in Group A [4 (3-4)] was rated better than in Group B [3 (2-4)] (p < 0.001), with excellent agreement between the two observers (kappa > 0.80). The radiation dose in Group A (average of 2.64 mSv) was 57% lower than the 6.18 mSv in Group B (p < 0.001). The total iodine intake in Group A was 13.5g, 36% lower than the 21g in Group B. CONCLUSION: Spectral CT imaging with rapid kV-switching in the subtraction angiography in head and neck provides better bone removal with significantly reduced radiation and contrast dose compared with conventional subtraction method. Advances in knowledge: This novel method provides better bone removal with significant radiation and contrast dose reduction compared with the conventional subtraction CT, and maybe used clinically to protect the thyroid gland and ocular lenses from unnecessary high radiation. FAU - Ma, Guangming AU - Ma G AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Yu, Yong AU - Yu Y AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Duan, Haifeng AU - Duan H AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Dou, Yuequn AU - Dou Y AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Jia, Yongjun AU - Jia Y AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Zhang, Xirong AU - Zhang X AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Yang, Chuangbo AU - Yang C AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Chen, Xiaoxia AU - Chen X AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Han, Dong AU - Han D AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. FAU - Guo, Changyi AU - Guo C AD - 2 Department of Diagnostic Radiology, The Second Affiliated Hospital of the Shannxi University of Traditional Chinese Medicine , Xianyang , China. FAU - He, Taiping AU - He T AD - 1 Department of Diagnostic Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine , Xianyang , China. LA - eng PT - Journal Article DEP - 20180307 PL - England TA - Br J Radiol JT - The British journal of radiology JID - 0373125 SB - IM MH - Aged MH - Angiography, Digital Subtraction/*methods MH - Aorta/diagnostic imaging MH - Carotid Arteries/diagnostic imaging MH - Cerebral Arteries/diagnostic imaging MH - Cerebrovascular Disorders/diagnostic imaging MH - Computed Tomography Angiography/*methods MH - Female MH - Head/*diagnostic imaging MH - Head and Neck Neoplasms/diagnostic imaging MH - Humans MH - Image Processing, Computer-Assisted MH - Intracranial Aneurysm/diagnostic imaging MH - Male MH - Middle Aged MH - Neck/*diagnostic imaging MH - Prospective Studies MH - Radiation Dosage PMC - PMC6223275 EDAT- 2018/02/08 06:00 MHDA- 2018/06/07 06:00 PMCR- 2019/06/01 CRDT- 2018/02/08 06:00 PHST- 2018/02/08 06:00 [pubmed] PHST- 2018/06/07 06:00 [medline] PHST- 2018/02/08 06:00 [entrez] PHST- 2019/06/01 00:00 [pmc-release] AID - 10.1259/bjr.20170631 [doi] PST - ppublish SO - Br J Radiol. 2018 Jun;91(1086):20170631. doi: 10.1259/bjr.20170631. Epub 2018 Mar 7.