title: High-pitch, low-voltage and low-iodine-concentration CT angiography of aorta: assessment of image quality and radiation dose with iterative reconstruction.
abstract: OBJECTIVE
  To assess the image quality of aorta obtained by dual-source computed tomography angiography (DSCTA), performed with high pitch, low tube voltage, and low iodine concentration contrast medium (CM) with images reconstructed using iterative reconstruction (IR).
  
  
  METHODS
  One hundred patients randomly allocated to receive one of two types of CM underwent DSCTA with the electrocardiogram-triggered Flash protocol. In the low-iodine group, 50 patients received CM containing 270 mg I/mL and were scanned at low tube voltage (100 kVp). In the high-iodine CM group, 50 patients received CM containing 370 mg I/mL and were scanned at the tube voltage (120 kVp). The filtered back projection (FBP) algorithm was used for reconstruction in both groups. In addition, the IR algorithm was used in the low-iodine group. Image quality of the aorta was analyzed subjectively by a 3-point grading scale and objectively by measuring the CT attenuation in terms of the signal- and contrast-to-noise ratios (SNR and CNR, respectively). Radiation and CM doses were compared.
  
  
  RESULTS
  The CT attenuation, subjective image quality assessment, SNR, and CNR of various aortic regions of interest did not differ significantly between two groups. In the low-iodine group, images reconstructed by FBP and IR demonstrated significant differences in image noise, SNR, and CNR (p<0.05). The low-iodine group resulted in 34.3% less radiation (4.4 ± 0.5 mSv) than the high-iodine group (6.7 ± 0.6 mSv), and 27.3% less iodine weight (20.36 ± 2.65 g) than the high-iodine group (28 ± 1.98 g). Observers exhibited excellent agreement on the aortic image quality scores (κ = 0.904).
  
  
  CONCLUSIONS
  CT images of aorta could be obtained within 2 s by using a DSCT Flash protocol with low tube voltage, IR, and low-iodine-concentration CM. Appropriate contrast enhancement was achieved while maintaining good image quality and decreasing the radiation and iodine doses.
authors: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China; Department of Radiology, Hospital Affiliated to Hainan Medical College, Haikou, City of Hainan Province, China.
authors: Yanguang
authors: Y
authors: Shen
authors: Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, Perth, Australia.
authors: Zhonghua
authors: Z
authors: Sun
authors: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Lei
authors: L
authors: Xu
authors: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Yu
authors: Y
authors: Li
authors: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Nan
authors: N
authors: Zhang
authors: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Zixu
authors: Z
authors: Yan
authors: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Zhanming
authors: Z
authors: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001011:Aorta; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007455:Iodine / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007455:Iodine
references: Radiology. 2000 Jun;215(3):670-6
references: 10831682
references: Radiology. 2001 Aug;220(2):519-23
references: 11477263
references: Radiology. 2001 Oct;221(1):146-58
references: 11568333
references: J Comput Assist Tomogr. 2004 Jul-Aug;28 Suppl 1:S7-11
references: 15258487
references: Br J Surg. 2005 Aug;92(8):960-7
references: 16034841
references: Radiology. 2005 Aug;236(2):661-5
references: 16040923
references: Acta Radiol. 2005 Dec;46(8):830-42
references: 16392608
references: J Vasc Interv Radiol. 2006 May;17(5):759-64
references: 16687740
references: AJR Am J Roentgenol. 2006 Nov;187(5):W490-7
references: 17056879
references: Radiology. 2007 Jun;243(3):622-8
references: 17446526
references: Phys Med Biol. 2008 May 7;53(9):2439-56
references: 18421124
references: Br J Surg. 2008 Jun;95(6):699-702
references: 18446782
references: Radiology. 2009 Apr;251(1):175-84
references: 19332852
references: Interact Cardiovasc Thorac Surg. 2009 Jul;9(1):119-23
references: 19339275
references: AJR Am J Roentgenol. 2009 Jul;193(1):227-33
references: 19542418
references: AJR Am J Roentgenol. 2009 Sep;193(3):764-71
references: 19696291
references: Invest Radiol. 2010 Apr;45(4):202-10
references: 20177389
references: Eur Radiol. 2010 Aug;20(8):1917-25
references: 20306079
references: AJR Am J Roentgenol. 2010 Apr;194(4):938-44
references: 20308495
references: J Med Assoc Thai. 2010 Jan;93 Suppl 1:S29-34
references: 20364554
references: Radiol Clin North Am. 2010 Mar;48(2):237-47, vii
references: 20609872
references: Radiology. 2010 Aug;256(2):450-9
references: 20656835
references: Eur Radiol. 2011 Jan;21(1):205-12
references: 20677006
references: Acta Radiol. 2010 Nov;51(9):982-9
references: 20849317
references: Eur Radiol. 2012 Jan;22(1):138-43
references: 21688003
references: Eur Radiol. 2011 Dec;21(12):2521-6
references: 21822785
references: Eur J Radiol. 2012 Oct;81(10):2592-6
references: 22226854
references: Comput Med Imaging Graph. 2012 Jun;36(4):294-303
references: 22257909
references: Clin Radiol. 2012 Aug;67(8):802-14
references: 22341185
references: AJR Am J Roentgenol. 2012 Apr;198(4):931-8
references: 22451563
references: Eur J Radiol. 2012 Nov;81(11):3141-5
references: 22578834
references: Eur Radiol. 2012 Nov;22(11):2432-40
references: 22661055
references: AJR Am J Roentgenol. 2012 Sep;199(3):588-94
references: 22915398
references: J Endovasc Ther. 2012 Oct;19(5):656-60
references: 23046332
references: AJR Am J Roentgenol. 2012 Dec;199(6):1402-9
references: 23169737
references: PLoS One. 2013 Sep 13;8(9):e73093
references: 24058460
references: J Cardiothorac Surg. 2013 Dec 12;8:228
references: 24330784
references: Eur J Radiol. 2014 Feb;83(2):e92-9
references: 24332352
references: PLoS One. 2013 Dec 05;8(12):e81486
references: 24339936
references: Biomed Eng Online. 2014 Feb 12;13:15
references: 24521481
references: AJR Am J Roentgenol. 2014 Mar;202(3):648-55
references: 24555604
references: J Vasc Interv Radiol. 2014 Aug;25(8):1172-1180.e1
references: 24837981
references: Acta Radiol. 2015 Jun;56(6):659-65
references: 24919466
references: Radiol Med. 2014 Dec;119(12):934-941
references: 24985136