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Guerrini S, Zanoni M, Sica C, Bagnacci G, Mancianti N, Galzerano G, Garosi G, Cacioppa LM, Cellina M, Zamboni GA, Minetti G, Floridi C, Mazzei MA. Dual-Energy CT as a Well-Established CT Modality to Reduce Contrast Media Amount: A Systematic Review from the Computed Tomography Subspecialty Section of the Italian Society of Radiology. J Clin Med 2024; 13:6345. [PMID: 39518485 PMCID: PMC11546204 DOI: 10.3390/jcm13216345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 10/13/2024] [Accepted: 10/18/2024] [Indexed: 11/16/2024] Open
Abstract
Background: Our study aims to provide an overview of existing evidence regarding the image quality of dual-energy CT (DECT) employing reduced contrast media (CM) volumes, in comparison to single-energy CT (SECT) with standard CM loads. The advantages, indications, and possible applications of DECT were investigated from the perspective of providing better patient care, minimizing CM volume and managing CM shortage. Methods: In this systematic review (PRISMA methodology), PubMed and WOS were searched from January 2010 to January 2023 by two independent reviewers. The scan and CM characteristics, radiation dose, and results of quantitative (contrast to noise ratio, CNR, and signal to noise ratio, SNR) and qualitative assessment of image quality were collected. Sixty non-duplicated records eligible for full-text screening were examined. Results: Finally, 22 articles (1818 patients) were included. The average CM reduction with DECT ranged between 43.4 ± 11%. Despite the wide variability in CT scan protocols, no differences were found in radiation doses between DECT and SECT. Conclusions: DECT scanners allow the employment of lower CM volumes with equal or better image quality evaluated by quantitative and qualitative analyses and similar dose radiation compared to SECT. Using image reconstructions at low monochromatic energy levels, DECT increases iodine conspicuity and attenuation contributing to CM containment measures.
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Affiliation(s)
- Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
| | - Matteo Zanoni
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
| | - Cristian Sica
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
| | - Giulio Bagnacci
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
| | - Nicoletta Mancianti
- Unit of Nephrology, Dialysis and Transplantation, Department of Emergency and Transplantation, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (N.M.); (G.G.)
| | - Giuseppe Galzerano
- Unit of Vascular Surgery, Department of Heart, Thorax and Vessels, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
| | - Guido Garosi
- Unit of Nephrology, Dialysis and Transplantation, Department of Emergency and Transplantation, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (N.M.); (G.G.)
| | - Laura Maria Cacioppa
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
| | - Michaela Cellina
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Principessa Clotilde 3, 20121 Milan, Italy
| | - Giulia A. Zamboni
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Institute of Radiology, Department of Diagnostics and Public Health, Policlinico GB Rossi, University of Verona, 37134 Verona, Italy
| | - Giuseppe Minetti
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Radiology Unit, Ospedale Santo Spirito, ASL AL Casale Monferrato, 15121 Alessandria, Italy
| | - Chiara Floridi
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy
| | - Maria Antonietta Mazzei
- Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy; (G.B.); (M.C.); (G.A.Z.); (G.M.); (C.F.); (M.A.M.)
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (M.Z.); (C.S.)
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Galtung KF, Lauritzen PM, Rud E. Reply to Fabio Zattoni, Fabrizio Dal Moro, Iliana Bednarova, and Giacomo Novara's Letter to the Editor re: Kristina F. Galtung, Peter M. Lauritzen, Gunnar Sandbæk, et al. Is a Single Nephrographic Phase Computed Tomography Sufficient for Detecting Urothelial Carcinoma in Patients with Visible Haematuria? A Prospective Paired Noninferiority Comparison. Eur Urol Open Sci 2023;55:1-10. EUR UROL SUPPL 2024; 61:54-55. [PMID: 38357532 PMCID: PMC10864753 DOI: 10.1016/j.euros.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Affiliation(s)
| | - Peter M. Lauritzen
- Department of Radiology, Oslo University Hospital, Oslo, Norway
- Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Erik Rud
- Department of Radiology, Oslo University Hospital, Oslo, Norway
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Zattoni F, Dal Moro F, Bednarova I, Novara G. Re: Kristina F. Galtung, Peter M. Lauritzen, Gunnar Sandbæk, et al. Is a Single Nephrographic Phase Computed Tomography Sufficient for Detecting Urothelial Carcinoma in Patients with Visible Haematuria? A Prospective Paired Noninferiority Comparison. Eur Urol Open Sci 2023;55:1-10. EUR UROL SUPPL 2024; 61:52-53. [PMID: 38357531 PMCID: PMC10864751 DOI: 10.1016/j.euros.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 02/16/2024] Open
Affiliation(s)
- Fabio Zattoni
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Fabrizio Dal Moro
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Iliana Bednarova
- Radiology Unit, Veneto Institute of Oncology IRCCS, Padua, Italy
| | - Giacomo Novara
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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