PMID- 30237063
OWN - NLM
STAT- MEDLINE
DCOM- 20190923
LR  - 20190923
IS  - 1365-229X (Electronic)
IS  - 0009-9260 (Linking)
VI  - 73
IP  - 12
DP  - 2018 Dec
TI  - Dual-layer detector CT of chest, abdomen, and pelvis with a one-third iodine 
      dose: image quality, radiation dose, and optimal monoenergetic settings.
PG  - 1058.e21-1058.e29
LID - S0009-9260(18)30512-9 [pii]
LID - 10.1016/j.crad.2018.08.010 [doi]
AB  - AIM: To compare the image quality and radiation dose of reduced iodine dose 
      dual-layer detector (DL) computed tomography (CT) with those of a conventional 
      120 kVp protocol for chest-abdomen-pelvis CT (CAP-CT). MATERIALS AND METHODS: 
      Forty patients with renal dysfunction (estimated glomerular filtrating ratio <45 
      ml/min/1.73 m(2)) underwent reduced iodine dose CAP-CT (120 kVp, 200 mg 
      iodine/kg) on DLCT. Virtual monochromatic images (VMI) at 40-70 keV (5 keV 
      interval) were reconstructed retrospectively. Forty matched patients who 
      underwent conventional CAP-CT (120 kVp, 600 mg iodine/kg, iterative 
      reconstruction) were included as controls. The size-specific dose estimate 
      (SSDE), image noise, CT attenuation, and contrast-to-noise ratio (CNR) were 
      compared between the protocols. Two radiologists rated image contrast, image 
      noise, streak artefact, and diagnostic confidence on a five-point scale. RESULTS: 
      The SSDE of the DLCT group was approximately 20% lower than that of the 120 kVp 
      group (15.4+/-1.9 versus 19.4+/-2.3 mGy, p<0.01). DLCT-VMI provided almost constant 
      image noise throughout the range of energies (differences of </=13%), with the 
      noise being equivalent or lower than 120 kVp in the abdomen. CT attenuation and 
      CNR gradually increased as the energy decreased, with values comparable to 120 
      kVp being attained at around 45-50 keV. Although streak artefact was accentuated 
      at 40-50 keV (p<0.01), the highest scores for diagnostic confidence were assigned 
      at 40 and 45 keV, both of which were equivalent to 120 kVp (p=1.0). CONCLUSION: 
      For CAP-CT with a one-third iodine dose, DLCT-VMI at 40-45 keV allows for a 20% 
      reduction in radiation dose, while preserving image quality comparable to that of 
      conventional 120 kVp protocol.
CI  - Copyright (c) 2018 The Royal College of Radiologists. Published by Elsevier Ltd. 
      All rights reserved.
FAU - Nagayama, Y
AU  - Nagayama Y
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan. Electronic address: 
      y.nagayama1980@gmail.com.
FAU - Nakaura, T
AU  - Nakaura T
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Oda, S
AU  - Oda S
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Taguchi, N
AU  - Taguchi N
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Utsunomiya, D
AU  - Utsunomiya D
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Funama, Y
AU  - Funama Y
AD  - Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 
      4-24-1 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan.
FAU - Kidoh, M
AU  - Kidoh M
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Namimoto, T
AU  - Namimoto T
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Sakabe, D
AU  - Sakabe D
AD  - Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, 
      Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Hatemura, M
AU  - Hatemura M
AD  - Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, 
      Chuo-ku, Kumamoto 860-8556, Japan.
FAU - Yamashita, Y
AU  - Yamashita Y
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180917
PL  - England
TA  - Clin Radiol
JT  - Clinical radiology
JID - 1306016
RN  - 0 (Iodine Radioisotopes)
SB  - IM
MH  - Abdomen/*diagnostic imaging/radiation effects
MH  - Aged
MH  - Female
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Iodine Radioisotopes
MH  - Male
MH  - Middle Aged
MH  - Pelvis/*diagnostic imaging/radiation effects
MH  - Radiation Dosage
MH  - Radiographic Image Enhancement
MH  - *Radiographic Image Interpretation, Computer-Assisted
MH  - *Radiography, Dual-Energy Scanned Projection
MH  - Renal Insufficiency, Chronic/*diagnostic imaging/pathology
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Signal-To-Noise Ratio
MH  - Thorax/*diagnostic imaging/radiation effects
EDAT- 2018/09/22 06:00
MHDA- 2019/09/24 06:00
CRDT- 2018/09/22 06:00
PHST- 2018/02/14 00:00 [received]
PHST- 2018/08/24 00:00 [accepted]
PHST- 2018/09/22 06:00 [pubmed]
PHST- 2019/09/24 06:00 [medline]
PHST- 2018/09/22 06:00 [entrez]
AID - S0009-9260(18)30512-9 [pii]
AID - 10.1016/j.crad.2018.08.010 [doi]
PST - ppublish
SO  - Clin Radiol. 2018 Dec;73(12):1058.e21-1058.e29. doi: 10.1016/j.crad.2018.08.010. 
      Epub 2018 Sep 17.