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Wu H, Wang J, Zhou M, Wang Y, Cui C, Zhou C, Chen X, Wang Z. Application of bolus tracking: The effect of ROI positions on the images quality of cervicocerebral CT angiography. Heliyon 2024; 10:e29260. [PMID: 38617933 PMCID: PMC11015132 DOI: 10.1016/j.heliyon.2024.e29260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
Background Cervicocerebral CT angiography (CTA) using the bolus tracking technique has been widely used for the assessment of cerebrovascular diseases. Regions of interest (ROI) can be placed in the descending aorta, ascending aorta, and the aortic arch. However, no study has compared the arteries and veins display when when the region of interest (ROI) is placed at different sites. In this study, we showed the impact of ROI positions on the image quality of cervicocerebral CTA. Methods Two hundred and seventy patients who underwent cervicocerebral CTA with bolus tracking technique were randomly divided into three groups based on the position of the ROI placement: ascending aorta (Group 1, n = 90), aortic arch (Group 2, n = 90), and descending aorta (Group 3, n = 90). The scanning parameters and contrast agent injection protocols were consistent across all groups. Three observers independently assessed the objective image quality, while two observers jointly assessed the subjective image quality using a grade scale: poor (grade 1), average (grade 2), good (grade 3), and excellent (grade 4). The differences in intravascular CT values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), AVCR (arterial venous contrast ratio), and subjective image quality scores were compared among the three groups. Results The CT values of the intracranial veins (superior sagittal sinus, ethmoid sinus and great cerebral vein) in group 1 were significantly lower than those in group 3 (p < 0.001). However, no significant differences were observed in CT values, SNR and CNR in the internal carotid artery and middle cerebral artery among the three groups. The proportion of images with grade 4 was significantly higher in group 1 than group 2 and 3 (41.1% vs 15.6% and 13.3%, p < 0.001). The proportion of images with grade 1 was significantly lower in group 1 than group 2 and 3 (1.1% vs 6.6% and 17.8%, p < 0.001). Conclusion The ROI positions for cervicocerebral CTA did not affect the arterial image quality, but venous structures imaging was affected when the ROI was placed in the ascending aorta.
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Affiliation(s)
- Huiming Wu
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Jianhua Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Maodong Zhou
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Yajie Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Can Cui
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Changsheng Zhou
- Department of Radiology, Jinling Hospital Nanjing University, 305 Zhongshan East road, Nanjing, 210029, China
| | - Xiao Chen
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Zhongqiu Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
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Watanabe S, Sakaguchi K, Murata D, Ishii K. Deep learning-based Hounsfield unit value measurement method for bolus tracking images in cerebral computed tomography angiography. Comput Biol Med 2021; 137:104824. [PMID: 34488029 DOI: 10.1016/j.compbiomed.2021.104824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 08/28/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patient movement during bolus tracking (BT) impairs the accuracy of Hounsfield unit (HU) measurements. This study assesses the accuracy of measuring HU values in the internal carotid artery (ICA) using an original deep learning (DL)-based method as compared with using the conventional region of interest (ROI) setting method. METHOD A total of 722 BT images of 127 patients who underwent cerebral computed tomography angiography were selected retrospectively and divided into groups for training data, validation data, and test data. To segment the ICA using our proposed method, DL was performed using a convolutional neural network. The HU values in the ICA were obtained using our DL-based method and the ROI setting method. The ROI setting was performed with and without correcting for patient body movement (corrected ROI and settled ROI). We compared the proposed DL-based method with settled ROI to evaluate HU value differences from the corrected ROI, based on whether or not patients experienced involuntary movement during BT image acquisition. RESULTS Differences in HU values from the corrected ROI in the settled ROI and the proposed method were 23.8 ± 12.7 HU and 9.0 ± 6.4 HU in patients with body movement and 1.1 ± 1.6 HU and 3.9 ± 4.7 HU in patients without body movement, respectively. There were significant differences in both comparisons (P < 0.01). CONCLUSION DL-based method can improve the accuracy of HU value measurements for ICA in BT images with patient involuntary movement.
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Affiliation(s)
- Shota Watanabe
- Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine, Kindai University Hospital, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan; Radiology Center, Kindai University Hospital, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan.
| | - Kenta Sakaguchi
- Radiology Center, Kindai University Hospital, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan.
| | - Daisuke Murata
- Radiology Center, Kindai University Hospital, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan.
| | - Kazunari Ishii
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan.
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Forbrig R, Geyer LL, Stahl R, Thorsteinsdottir J, Schichor C, Kreth FW, Patzig M, Herzberg M, Liebig T, Dorn F, Trumm CG. Radiation dose and image quality in intraoperative CT (iCT) angiography of the brain with stereotactic head frames. Eur Radiol 2019; 29:2859-2867. [PMID: 30635759 DOI: 10.1007/s00330-018-5930-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/06/2018] [Accepted: 11/28/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Intraoperative CT (iCT) angiography of the brain with stereotactic frames is an integral part of navigated neurosurgery. Validated data regarding radiation dose and image quality in these special examinations are not available. We therefore investigated two iCT protocols in this IRB-approved study. METHODS Retrospective analysis of patients, who received a cerebral stereotactic iCT angiography on a 128 slice CT scanner between February 2016 and December 2017. In group A, automated tube current modulation (ATCM; reference value 410 mAs) and automated tube voltage selection (reference value 120 kV) were enabled, and only examinations with a selected voltage of 120 kV were included. In group B, fixed parameters were applied (300 mAs, 120 kV). Radiation dose was measured by assessing the volumetric CT dose index (CTDIvol), dose length product (DLP) and effective dose (ED). Signal-to-noise ratio (SNR) and image noise were assessed for objective image quality, visibility of arteries and grey-white differentiation for subjective image quality. RESULTS Two hundred patients (n = 100 in each group) were included. In group A, median selected tube current was 643 mAs (group B, 300 mAs; p < 0.001). Median values of CTDIvol, DLP and ED were 91.54 mGy, 1561 mGy cm and 2.97 mSv in group A, and 43.15 mGy, 769 mGy cm and 1.46 mSv in group B (p < 0.001). Image quality did not significantly differ between groups (p > 0.05). CONCLUSIONS ATCM yielded disproportionally high radiation dose due to substantial tube current increase at the frame level, while image quality did not improve. Thus, ATCM should preferentially be disabled. KEY POINTS • Automated tube current modulation (ATCM) yields disproportionally high radiation dose in intraoperative CT angiography of the brain with stereotactic head frames. • ATCM does not improve overall image quality in these special examinations. • ATCM is not yet optimised for CT angiography of the brain with major extracorporeal foreign materials within the scan range.
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Affiliation(s)
- Robert Forbrig
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | - Lucas L Geyer
- Center of Radiology and Neuroradiology, Klinikum Ingolstadt, Ingolstadt, Germany
| | - Robert Stahl
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | | | - Christian Schichor
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | | | - Maximilian Patzig
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Moriz Herzberg
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Thomas Liebig
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Franziska Dorn
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Christoph G Trumm
- Institute for Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Städtisches Klinikum München Harlaching, Munich, Germany
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Optimal injection method for long-range computed tomography angiography. Radiol Phys Technol 2017; 10:301-310. [DOI: 10.1007/s12194-017-0402-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 01/28/2023]
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Shirasaka T, Hiwatashi A, Yamashita K, Kondo M, Hamasaki H, Shimomiya Y, Nakamura Y, Funama Y, Honda H. Optimal scan timing for artery-vein separation at whole-brain CT angiography using a 320-row MDCT volume scanner. Br J Radiol 2016; 90:20160634. [PMID: 27995807 DOI: 10.1259/bjr.20160634] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE A 320-row multidetector CT (MDCT) is expected for a good artery-vein separation in terms of temporal resolution. However, a shortened scan duration may lead to insufficient vascular enhancement. We assessed the optimal scan timing for the artery-vein separation at whole-brain CT angiography (CTA) when bolus tracking was used at 320-row MDCT. METHODS We analyzed 60 patients, who underwent whole-brain four-dimensional CTA. Difference in CT attenuation between the internal carotid artery (ICA) and the superior sagittal sinus (Datt) was calculated in each phase. Using a visual evaluation score for the depiction of arteries and veins, we calculated the difference between the mean score for the intracranial arteries and the mean score for the veins (Dscore). We assessed the time at which the maximum Datt and Dscore were simultaneously observed. RESULTS The maximum Datt was observed at 6.0 s and 8.0 s in the arterial-dominant phase and at 16.0 s and 18.0 s in the venous-dominant phase after the contrast media arrival time at the ICA (Taa). The maximum Dscore was observed at 6.0 s and 8.0 s in the arterial-dominant phase and at 16.0 s in the venous-dominant phase after the Taa. There were no statistically significant differences in Datt (p = 0.375) or Dscore (p = 0.139) between these scan timings. CONCLUSION The optimal scan timing for artery-vein separation at whole-brain CTA was 6.0 s or 8.0 s for the arteries and 16.0 s for the veins after the Taa. Advances in knowledge: Optimal scan timing allowed us to visualize intracranial arteries or veins with minimal superimposition.
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Affiliation(s)
- Takashi Shirasaka
- 1 Department of Medical Technology, Division of Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Akio Hiwatashi
- 2 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yamashita
- 2 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Kondo
- 1 Department of Medical Technology, Division of Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroshi Hamasaki
- 1 Department of Medical Technology, Division of Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Yamato Shimomiya
- 1 Department of Medical Technology, Division of Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Yasuhiko Nakamura
- 1 Department of Medical Technology, Division of Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshinori Funama
- 3 Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Honda
- 2 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Effect of Right-Sided Versus Left-Sided Contrast Injection on Intra-arterial Opacification Characteristics of Head and Neck Computed Tomography Angiograms and Interactions With Patient Sex, Weight, and Cardiac Output. J Comput Assist Tomogr 2015; 39:752-9. [PMID: 26295189 DOI: 10.1097/rct.0000000000000273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to support the standard clinical assumption that preferential right-sided injection (RSI) over left-sided injection (LSI) results in improved head and neck computed tomography angiograms and to determine which patients most benefit from RSIs. METHODS Head and neck computed tomography angiograms of 453 RSIs and 419 LSIs were included. Interactions between injection side, age, weight, body mass index, and left ventricular ejection fraction with mean vessel Hounsfield units (HU) were compared. Statistical analysis was performed using 2-tailed Student t tests, Mann-Whitney U tests, and simple linear (SL) and multiple linear regressions. RESULTS Right-sided injection yielded higher HU for patients older than 40 years (eg, RSI of the right common carotid artery [RCCA] vs LSI of the RCCA; P < 0.01). Body mass index (eg, RCCA; r = -0.31, P < 0.01 [SL]) and weight (eg, RCCA; r = -0.39, P < 0.01 [SL]) were negatively correlated with HU. Female had higher HU (mean ± SE, +39.7 ± 7.6 HU; P < 0.01 [multiple linear]). Left ventricular ejection fraction had no interactions with injection side or HU. CONCLUSIONS The findings support preferential RSI in patients older than 40 years with higher body mass index and weight, particularly male.
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Carmalt JL, Montgomery J. INTRAARTERIAL INJECTION OF IODINATED CONTRAST MEDIUM FOR CONTRAST ENHANCED COMPUTED TOMOGRAPHY OF THE EQUINE HEAD. Vet Radiol Ultrasound 2015; 56:384-90. [DOI: 10.1111/vru.12252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 01/14/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- James L. Carmalt
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon SKS7N5B4 Canada
| | - James Montgomery
- Department of Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon SKS7N5B4 Canada
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Evaluation of high-pitch dual-source CT angiography for evaluation of coronary and carotid-cerebrovascular arteries. Eur J Radiol 2015; 84:398-406. [DOI: 10.1016/j.ejrad.2014.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 10/07/2014] [Accepted: 11/11/2014] [Indexed: 11/18/2022]
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