title: Lower tube voltage reduces contrast material and radiation doses on 16-MDCT aortography.
abstract: OBJECTIVE
  The purpose of our study was to compare aortic CT angiography performed at a low tube voltage and reduced dose of contrast material with standard-voltage, standard-contrast-dose CT angiography.
  
  
  METHODS
  We evaluated 74 patients for aortic disease on MDCT angiography (collimation, 16 x 1.5 mm; beam pitch, 0.9). In 36 patients, we used the standard tube voltage (120 kVp) and a contrast dose of 100 mL (300 mg I/mL) (protocol 1), and in the remaining 38 patients we applied a reduced tube voltage (90 kVp) and a contrast dose of 40 mL (300 mg I/mL) (protocol 2). The patients' weights, CT attenuation of the aorta, visualization of the celiac axis and renal artery, and graininess and streak artifacts on transverse CT scans were evaluated and recorded for each data set. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also measured. For statistical analysis, we used the two-tailed Student's t test and logistic regression; agreement between measurements recorded independently by two blinded reviewers was assessed using Cohen kappa statistics.
  
  
  RESULTS
  In both protocols a negative correlation was seen between patient weight and CT attenuation. In three protocol 1 patients weighing more than 70 kg, CT attenuation was less than 200 H. No difference was seen between the two protocols with respect to mean attenuation of the aorta (p = 0.13) or visualization of the celiac axis and renal artery (p = 0.35 and 0.60, respectively). Although the SNR and CNR were significantly higher in protocol 1 than in protocol 2, qualitative evaluation of graininess and streak artifacts showed no statistically significant difference (p = 0.15 and 0.48, respectively). Interobserver agreement for quality assessments was within an acceptable range (kappa = 0.42-0.80).
  
  
  CONCLUSIONS
  Low-contrast and low-voltage scans are appropriate for lighter patients (< 70 kg in body weight) with aortic disease. Moreover, this method is particularly valuable for follow-up studies of heavier patients (> 70 kg) with renal dysfunction.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. yoshiharu156@lily.ocn.ne.jp
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Funama
authors.forename: Duo
authors.initials: D
authors.lastname: Liu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakaura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Tamura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging; D001027:Aortography; D001161:Arteriosclerosis / Q000000981:diagnostic imaging; D001835:Body Weight; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media