Significance of enhanced cerebral gray-white matter contrast at 80 kVp compared to conventional 120 kVp CT scan in the evaluation of acute stroke.
We aimed to determine whether 80 kVp conventional nonenhanced head CT scans have better gray-white matter contrast than standard 120 kVp scans performed on the same patients. Thirty head CT scans acquired at 80 kVp (CT dose index [CTDI]vol 46) were compared to prior studies in the same patients performed at 120 kVp (CTDIvol 59). Signal (Hounsfield units [HU]), noise (sd HU), and contrast-to-noise ratio per dose (CNRD) were assessed in multiple cerebral gray and white matter regions of interest. A noise correction factor was used to compensate for scanning at different CTDIvol values. Average gray matter signal at 80 kVp and 120 kVP was 33.9 ± 3.5 HU and 29 ± 4.6 HU, respectively (p<0.0001); the averages for white matter were 22.5 ± 3.1 HU and 21.6 ± 4.6 HU, respectively (p=0.11). Corrected noise was 3 ± 0.6 and 2.7 ± 0.6, respectively, for gray matter (p=0.0001), and 2.8 ± 0.6 and 2.6 ± 0.5, respectively, for white matter (p=0.00001). The gray-white matter CNRD was 4.0 ± 1.2 at 80 kVp and 2.8 ± 1 at 120 kVp (p<0.00001). Cerebral gray-white matter CNRD is increased by 40% at 80 kVp compared to conventional 120 kVp CT scans. These findings justify further clinical evaluation in the acute stroke setting.
Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
Eliel
E
Ben-David
Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel; Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Jose E
JE
Cohen
Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
S
S
Nahum Goldberg
Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jacob
J
Sosna
Philips Healthcare, Haifa, Israel.
Reuven
R
Levinson
Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
Isaac S
IS
Leichter
Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel. Electronic address: gomori@cc.huji.ac.il.
John M
JM
Gomori
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006257:Head / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D066127:White Matter / Q000000981:diagnostic imaging*
Acute ischemic stroke; Computed tomography; Low dose; Low kVp