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Yoshiura T, Masuda T, Tahara M, Kobayashi Y, Kikuhara Y, Ishibashi T, Nonaka H, Oku T, Sato T, Funama Y. Cardiac computed tomography angiography with and without bolus tracking methods in infants with congenital heart disease. Radiat Prot Dosimetry 2024; 200:251-258. [PMID: 38088430 DOI: 10.1093/rpd/ncad295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 10/12/2023] [Accepted: 11/15/2023] [Indexed: 03/05/2024]
Abstract
The study investigated radiation dose, vascular computed tomography (CT) enhancement and image quality of cardiac computed tomography angiography (CCTA) with and without bolus tracking (BT) methods in infants with congenital heart disease (CHD). The volume CT dose index (CTDIvol) and dose length product (DLP) were recorded for all CT scans, and the effective dose was obtained using a conversion factors. The CT number for the ascending aorta (AO) and pulmonary artery (PA), image noise of muscle tissue and contrast-to-noise ratio (CNR) were measured and calculated. The median values in the groups with and without BT were 2.20 mGy versus 0.44 mGy for CTDIvol, 8.10 mGy·cm versus 6.20 mGy·cm for DLP, and 0.66 mSv versus 0.51 mSv for effective dose (p < 0.001). There were no statistical differences in vascular CT enhancement, image noise, and CNR. CCTA without BT methods can reduce the radiation dose while maintaining vascular CT enhancement and image quality compared to CCTA with BT methods.
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Affiliation(s)
- Takayuki Yoshiura
- Graduate School of Health Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto, 862-0976, Japan
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki-City, Okayama, 701-0193, Japan
| | - Masahiro Tahara
- Hiroshima Central Street Children's Clinic, 7-1 Mikawa-cho, Hiroshima, 730-0029, Japan
| | - Yukie Kobayashi
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Yukari Kikuhara
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Toru Ishibashi
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Haruki Nonaka
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Takayuki Oku
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Tomoyasu Sato
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto, 862-0976, Japan
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Yoshiura T, Masuda T, Kobayashi Y, Kikuhara Y, Ishibashi T, Nonaka H, Oku T, Sato T, Funama Y. Iodine contrast volume reduction in preoperative transcatheter aortic valve implantation computed tomography: Comparison with 64- and 256-multidetector row computed tomography. Radiography (Lond) 2024; 30:408-415. [PMID: 38176131 DOI: 10.1016/j.radi.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/24/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION This study aimed to compare the vascular enhancement and radiation dose in preoperative transcatheter aortic valve implantation (TAVI) computed tomography (CT) with a reduced contrast medium (CM) using volume scans in 256-multidetector row CT (MDCT) with a standard CM using 64-MDCT. METHODS This study included 78 patients with preoperative TAVI CT with either 64- or 256-MDCT. The CM was injected at 1.5 mL/kg in the 64-MDCT group and 1.0 mL/kg in the 256-MDCT group. We compared vascular enhancement of the aortic root and access routes, image quality (IQ) scores, and radiation dose in both groups. RESULTS Despite the reduced CM (by 33 %) in the 256-MDCT group, the mean vascular enhancement of the right and left subclavian arteries was significantly higher than that in the 64-MDCT group [284 and 267 Hounsfield units (HU) vs. 376 and 359 HU; p < 0.05]; however, no significant differences in the mean vascular enhancement in the ascending aorta, abdominal aorta at the celiac level, and bilateral common femoral arteries were observed between the two groups (p > 0.05 for all). The median IQ scores at the aortic root were higher in the 256-MDCT group than in the 64-MDCT group (3 vs. 4; p < 0.05), and those at the femoral access routes were comparable (4 vs. 4; p = 0.33). The mean effective dose was significantly reduced by 30 % in the 256-MDCT group (23.6 vs. 16.3 mSv; p < 0.05). CONCLUSION In preoperative TAVI CT, volume scans using 256-MDCT provide comparable or better vascular enhancement and IQ with a 30 % reduction in CM and radiation dose than those using 64-MDCT. IMPLICATIONS FOR PRACTICE Volume scan using 256-MDCT for preoperative TAVI CT may reduce CM and radiation dose in TAVI patients with renal dysfunction.
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Affiliation(s)
- T Yoshiura
- Graduate School of Health Sciences, Kumamoto University, Kuhonji 4-24-1, Chuo-ku, Kumamoto, 860-0976, Japan; Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Okayama, 701-0193, Japan.
| | - Y Kobayashi
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - Y Kikuhara
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Ishibashi
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - H Nonaka
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Oku
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Sato
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - Y Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan.
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Yoshiura T, Masuda T, Sato T, Kikuhara Y, Kobayashi Y, Ishibashi T, Oku T, Yoshida M, Funama Y. [Coronary Artery Visualization by Using the 64-row MDCT in Pediatric Patients]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:856-863. [PMID: 35858799 DOI: 10.6009/jjrt.2022-1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE We retrospectively evaluated the visualization of pediatric coronary computed tomography angiography (CCTA) images by using the 64-detector row CT scanner between the electrocardiogram-gated helical scan and non-electrocardiogram-gated helical scan. METHODS From January 2015 to March 2019, 100 children who underwent CT angiography examination were retrospectively enrolled. Group A consisted of 50 patients with electrocardiogram-gated helical scan. Group B consisted of 50 patients with non-electrocardiogram-gated helical scan. All patients were scanned using a 64-detector row CT scanner (LightSpeed VCT), and helical scans were acquired. The CT scanning parameters were 0.4-s rotation, 0.625-mm slice thickness, 0.24 (group A) helical pitch (beam pitch), 1.375 (group B) helical pitch (beam pitch), 80 kVp, and 50-300 mA (noise index 40). A retrospective method was used for electrocardiogram gated. To compare the radiation dose, CT volume dose index (CTDIvol) and dose length product (DLP) displayed on the console were recorded. The visualization scores of the coronary artery images were compared between each group. RESULTS In group A, CTDIvol and DLP values were 6.74 (1.05-11.97) mGy and 79.87 (15.90-146.65) mGy·cm, respectively. In group B, CTDIvol and DLP values were 0.51 (0.39-0.95) mGy and 8.15 (6.30-17.50) mGy·cm, respectively. There were significant differences in CTDIvol and DLP values between both groups (p<0.05). The visualization rates for the proximal and distal coronary arteries were 88% and 54% for the right coronary artery, 84% and 58% for the left anterior descending artery, and 66% and 30% for the left circumflex branch in group A, respectively. The visualization rates for the proximal and distal coronary arteries were 52% and 0% for the right coronary artery, 56% and 0% for the left anterior descending artery, and 32% and 0% for the left circumflex branch in group B. CONCLUSION In 64-row multidetector computed tomography (MDCT), the visualization rates for the proximal and distal coronary arteries were significantly higher in the electrocardiogram-gated scan, but the exposure dose was several times higher in the pediatric CCTA. For accurate diagnosis in pediatric coronary arteries, electrocardiogram-gated helical scan should be performed.
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Affiliation(s)
- Takayuki Yoshiura
- Department of Medical Technology, Tsuchiya General Hospital
- Graduate School of Health Sciences, Kumamoto University
| | - Takanori Masuda
- Department of Medical Technology, Tsuchiya General Hospital (Current address: Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare)
| | - Tomoyasu Sato
- Department of Medical Technology, Tsuchiya General Hospital
| | | | | | | | - Takayuki Oku
- Department of Medical Technology, Tsuchiya General Hospital
| | - Masato Yoshida
- Department of Medical Technology, Tsuchiya General Hospital
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University
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Yoshida M, Matsumoto Y, Masuda T, Kikuhara Y, Kobayashi Y, Yoshiura T, Sato T. [Comparison of Contrast Enhancement between Bolus-tracking and Test-bolus Methods on Coronary CT Angiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:579-585. [PMID: 32565515 DOI: 10.6009/jjrt.2020_jsrt_76.6.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare the contrast enhancement between bolus-tracking (BT) and test-bolus (TB) methods in coronary computed tomography angiography (CCTA). METHOD We enrolled 300 patients who underwent CCTA by BT (245 mg I/kg main bolus) or TB (77.4 mg I/kg test bolus with 245 mg I/kg main bolus) methods. In group BT (n=150), scanning was started automatically 5-second after contrast enhancement exceeded a predefined threshold of 150 Hounsfield units (HU). In group TB (n=150), TB peak attenuation plus 2-second was used as a delay. We recorded the CT number in the ascending aorta and determined whether the CT number was equivalent in two groups. For the equivalence test, we adopted 70 HU as the equivalence margin. The standard deviation (SD) in the CT number and the rate of patients with an acceptable CT number were compared. We also compared total iodine dose and total dose length product (DLP). RESULT The CT number of the ascending aorta was 437.6±68.9 HU in group BT and 438.9±69.7 HU in group TB; the 95% confidence interval for the difference between the groups was from -11.6 to 20.2 HU and within the range of the equivalence margins. The SD of the CT number and the rate of patients with acceptable CT number did not differ significantly between the two groups (p=0.857 and p=0.614, respectively). Total iodine dose in group TB was significantly higher than in group BT (p<0.001), and total DLP was not statistically significant (p=0.197). CONCLUSION The contrast enhancement between BT and TB methods in CCTA was equivalent, and the distribution was not significantly different between the two groups.
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Affiliation(s)
- Masato Yoshida
- Department of Radiological Technology, Tsuchiya General Hospital
| | - Yoriaki Matsumoto
- Department of Radiological Technology, Tsuchiya General Hospital.,Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Takanori Masuda
- Department of Radiological Technology, Tsuchiya General Hospital.,Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yukari Kikuhara
- Department of Radiological Technology, Tsuchiya General Hospital
| | - Yukie Kobayashi
- Department of Radiological Technology, Tsuchiya General Hospital
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Yoshiura T, Masuda T, Matsumoto Y, Sato T, Kikuhara Y, Kobayashi Y, Ishibashi T, Oku T, Funama Y. [New Potential Method for Optimizing the ATCM Technique in Pediatric CT Examination]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:802-807. [PMID: 32814735 DOI: 10.6009/jjrt.2020_jsrt_76.8.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To compare the radiation dose and image quality using the conventional method for performing the front and side scout view and a new method for performing the side scout view, and then correct the table height at the scan isocenter and perform the front scout view. METHODS We retrospectively analyzed fifty-six children who had underwent computed tomography (CT) examination between June 2014 and August 2018. We divided them into two groups. The conventional method was performed in 3 steps: 1. obtain the front scout view, 2. obtain the side scout view, and 3. main scan. Without table position correction, the new method was performed in 4 steps: 1. obtain the side scout view with table position correction, 2. patient correction at the scan isocenter, 3. obtain the front scout view, and 4. main scan. We used a 64-row CT scanner (LightSpeed VCT; GE Healthcare). Scan parameters were tube voltage 80 kV, automatic tube current modulation, noise index 16, slice thickness 5 mm, rotation time 0.4 s/rot, helical pitch 1.375, and reconstruction kernel standard. We recorded the volume dose index (CTDIvol) and dose length product (DLP) on the CT console and compared the radiation dose in both groups. To evaluate the image quality in both groups, the mean standard deviation of CT number (SD value) was measured within an approximately 5-10 mm2 circular region of interest. We measured the scan length of the pediatric patient and accuracy of pediatric positioning at the CT examination. A grid was displayed on the CT axial image, taken to evaluate the error from the scan isocenter during alignment, and the error between the height of half the body thickness and the scan isocenter was recorded. RESULTS Scan lengths were median (minimum-maximum) values of 16.2 cm (10.8-21.5 cm) and 16.8 cm (11.5-23.0 cm). There were no significant differences in the scan length between both groups (p=0.47). In the group with table position correction, median (minimum-maximum) values for CTDIvol, DLP and SD value were 0.40 mGy (0.3-0.7 mGy), 7.6 mGy・cm (4.4-11.5 mGy・cm), and 24.0 HU (18.3-37.5 HU), respectively. In the group without the table position correction, median (minimum-maximum) values for CTDIvol, DLP and SD value were 0.40 mGy (0.3-0.6 mGy), 7.1 mGy・cm (4.2-13.8 mGy・cm), and 20.3 HU (11.3-28.8 HU), respectively. There were no significant differences in the CTDIvol and DLP values between both groups (p=0.42 and p=0.44, respectively); however, there were significant differences in the SD value in both groups (p<0.01). The error for the accuracy of pediatric positioning was 0 mm (0 to 0 mm) and 10 mm (-16 to+59 mm) using the conventional and new methods (p<0.01), respectively. CONCLUSIONS It was suggested that the optimum image could be obtained during CT scan with automatic tube current modulation by using this potential new method (1. obtain the side scout view, 2. patient correction at the scan isocenter, 3. obtain the side scout view, and 4. main scan).
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Affiliation(s)
| | | | | | - Tomoyasu Sato
- Department of Medical Technology, Tsuchiya General Hospital
| | | | | | | | - Takayuki Oku
- Department of Medical Technology, Tsuchiya General Hospital
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University
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