Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography.
10.3348/kjr.2018.19.6.1119
- Author:
Sang Youn KIM
1
;
Jeong Yeon CHO
;
Joongyub LEE
;
Sung Il HWANG
;
Min Hoan MOON
;
Eun Ju LEE
;
Seong Sook HONG
;
Chan Kyo KIM
;
Kyeong Ah KIM
;
Sung Bin PARK
;
Deuk Jae SUNG
;
Yongsoo KIM
;
You Me KIM
;
Sung Il JUNG
;
Sung Eun RHA
;
Dong Won KIM
;
Hyun LEE
;
Youngsup SHIM
;
Inpyeong HWANG
;
Sungmin WOO
;
Hyuck Jae CHOI
Author Information
1. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea. radjycho@snu.ac.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Computed tomography;
Low dose;
Urography;
Contrast media;
Double dose reduction
- MeSH:
Commerce;
Contrast Media*;
Humans;
Iodine;
Noise;
Prospective Studies;
Radiation Exposure;
Signal-To-Noise Ratio;
Urinary Tract;
Urography*
- From:Korean Journal of Radiology
2018;19(6):1119-1129
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. MATERIALS AND METHODS: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. RESULTS: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose (5.73 ± 4.04 vs. 8.43 ± 4.38 mSv) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ≥ 3), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. CONCLUSION: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.
