Reduced-iodine-dose dual-energy coronary CT angiography: qualitative and quantitative comparison between virtual monochromatic and polychromatic CT images.

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License: CC BY 4.0
Serval ID
serval:BIB_2873409D551F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Reduced-iodine-dose dual-energy coronary CT angiography: qualitative and quantitative comparison between virtual monochromatic and polychromatic CT images.
Journal
European radiology
Author(s)
Rotzinger D.C., Si-Mohamed S.A., Yerly J., Boccalini S., Becce F., Boussel L., Meuli R.A., Qanadli S.D., Douek P.C.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
To quantitatively evaluate the impact of virtual monochromatic images (VMI) on reduced-iodine-dose dual-energy coronary computed tomography angiography (CCTA) in terms of coronary lumen segmentation in vitro, and secondly to assess the image quality in vivo, compared with conventional CT obtained with regular iodine dose.
A phantom simulating regular and reduced iodine injection was used to determine the accuracy and precision of lumen area segmentation for various VMI energy levels. We retrospectively included 203 patients from December 2017 to August 2018 (mean age, 51.7 ± 16.8 years) who underwent CCTA using either standard (group A, n = 103) or reduced (group B, n = 100) iodine doses. Conventional images (group A) were qualitatively and quantitatively compared with 55-keV VMI (group B). We recorded the location of venous catheters.
In vitro, VMI outperformed conventional CT, with a segmentation accuracy of 0.998 vs. 1.684 mm <sup>2</sup> , respectively (p < 0.001), and a precision of 0.982 vs. 1.229 mm <sup>2</sup> , respectively (p < 0.001), in simulated overweight adult subjects. In vivo, the rate of diagnostic CCTA in groups A and B was 88.4% (n = 91/103) vs. 89% (n = 89/100), respectively, and noninferiority of protocol B was inferred. Contrast-to-noise ratios (CNR) of lumen versus fat and muscle were higher in group B (p < 0.001) and comparable for lumen versus calcium (p = 0.423). Venous catheters were more often placed on the forearm or hand in group B (p < 0.001).
In vitro, low-keV VMI improve vessel area segmentation. In vivo, low-keV VMI allows for a 40% iodine dose and injection rate reduction while maintaining diagnostic image quality and improves the CNR between lumen versus fat and muscle.
• Dual-energy coronary CT angiography is becoming increasingly available and might help improve patient management. • Compared with regular-iodine-dose coronary CT angiography, reduced-iodine-dose dual-energy CT with low-keV monochromatic image reconstructions performed better in phantom-based vessel cross-sectional segmentation and proved to be noninferior in vivo. • Patients receiving reduced-iodine-dose dual-energy coronary CT angiography often had the venous catheter placed on the forearm or wrist without compromising image quality.
Keywords
Computed tomography angiography, Coronary vessels, Dimensional measurement accuracy, Iodine, Phantoms, imaging
Pubmed
Web of science
Open Access
Yes
Create date
23/03/2021 9:12
Last modification date
27/03/2021 7:32
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