학술논문

Low-iodine 40-keV virtual monoenergetic CT angiography of the lower extremities
Document Type
article
Source
Frontiers in Cardiovascular Medicine, Vol 10 (2023)
Subject
DECT
CT angiography
lower extremities
40-keV
monoenergetic
peripheral artery disease
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
2297-055X
Abstract
IntroductionTo evaluate a reduced iodine volume protocol for lower extremity CT angiography (CTA) using dual-energy CT (DECT).MethodsThis retrospective study included consecutive patients who underwent lower extremity CTA from June to December 2022. A 10 ml 1:1 mixed test bolus was performed, followed by a 40 ml full bolus at a 2.5/s injection rate, using 400 mg/ml iodine contrast media. Conventional and 40 keV virtual monoenergetic images (VMI) were reconstructed. For both reconstructions, five main artery segments were assessed with a 3-point image quality score as well as quantitative attenuation, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements with diagnostic quality thresholds (respectively >150 HU and >3).ResultsForty patients were included in the study (mean age 68 ± 12 yo). 200 artery segments were assessed. Median qualitative image scores were 3 [IQR, 3, 3] for both reconstructions. 40 keV VMI upgraded qualitative scores for 51 (26%) of patients, including 9 (5%) from nondiagnostic to diagnostic quality. 40 keV VMI obtained attenuation and CNR diagnostic quality for respectively 100% and 100% of segments, compared with 96% and 98% for conventional images (p