Application of dual-layer spectral CT low-contrast agent protocol in follow-up examinations of pediatric abdominal tumors
10.3760/cma.j.cn112149-20241230-00774
- VernacularTitle:双层探测器光谱CT低对比剂剂量扫描方案在儿童腹部肿瘤复查中的应用价值
- Author:
Xiaoshan LIU
1
;
Lutong ZHANG
1
;
Zhaorui SUN
1
;
Yong HUANG
1
;
Qianyu LIU
1
;
Qiang TANG
1
;
Yingxuan WANG
1
;
Yuqin JIN
1
Author Information
1. 山东省肿瘤防治研究院（山东省肿瘤医院）影像科 山东第一医科大学（山东省医学科学院），济南 250117
- Publication Type:Journal Article
- Keywords:
Tomography, X-ray computed;
Child;
Abdominal neoplasms;
Low contrast medium dose
- From:
Chinese Journal of Radiology
2025;59(9):1011-1016
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of dual-layer spectral CT virtual monoenergetic images (VMI) in contrast-enhanced abdominal CT scans with reduced contrast medium volume in pediatric tumor patients.Methods:The study is a self-matched case-control study. From January to October 2024, pediatric patients admitted to Shandong Cancer Hospital with abdominal tumors who underwent low contrast dose spectral CT contrast-enhanced scans during follow-up were prospectively included. A total of 47 patients aged (6.2±2.2) years (4-14 years) were enrolled. Usual contrast dose enhanced CT served as the conventional-dose group, while the follow-up low-dose spectral CT scans employed a protocol with half the contrast agent dose (low-dose group). Images were reconstructed as conventional CT images and VMI at 45, 55, and 65 keV. Using muscle as the reference background, differences in CT values and contrast-to-noise ratio (CNR) in the aorta, kidneys, liver, and spleen were compared between the low-dose group and conventional-dose group. Multi-group comparisons were performed using the Friedman test. Post-hoc pairwise comparisons were conducted with Bonferroni correction for P-values. Results:CT values and CNRs for all measured regions progressively increased with decreasing keV levels in spectral CT VMI. Significant overall differences were found in CT values and CNRs for the aorta, kidneys, liver, and spleen among the low-dose group (all VMIs) and the conventional-dose group (all P<0.001). At 65 keV VMI in the low-dose group, both CT values and CNRs (except for the liver CNR) were significantly lower than those in the conventional-dose group (all adjusted P<0.05). At 55 keV VMI in the low-dose group, CT values and CNRs for all regions did not show statistically significant differences compared to the conventional-dose group (all adjusted P>0.05). At 45 keV VMI in the low-dose group, CT values for all structures and CNR for the spleen were significantly higher than those in the conventional-dose group (all adjusted P<0.05). However, no statistically significant difference was found in CNRs for the aorta, kidneys, and liver (adjusted P=1.000, 0.313, and 0.503, respectively). Conclusion:When the contrast dose is halved, spectral CT 45 keV VMI enhances CT attenuation values and CNR in the abdomen of pediatric tumor patients, while 55 keV VMI provides image quality comparable to that of conventional-dose CT.
