Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies: Feasibility and diagnostic accuracy

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Abstract

Objectives: To assess evaluability and diagnostic accuracy of a low dose CT angiography (CTA) protocol for carotid arteries using latest Iterative Reconstruction (IR) algorithm in comparison with standard 100 kVp protocol using previous generation CT and IR. Materials and methods: 105 patients, referred for CTA of the carotid arteries were prospectively enrolled in our study and underwent CTA with 80 kVp and latest IR algorithm (group 1). Data were retrospectively compared with 100 consecutive patients with similar examination indications that had previously undergone CTA of carotid arteries with a standard 100 kVp protocol and a first generation IR algorithm (group 2). Image quality was evaluated with a 4-point Likert-scale. For each exam CT number, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) at level of common carotid artery (CCA), internal carotid artery (ICA) and at level of Circle of Willis and Effective Dose (ED) were evaluated. 62 Group 1 patients underwent a clinically indicated DSA and results were compared with CTA. Results: No exams reported as not diagnostic. The overall mean CT number value of all arterial segments was above 450 HU in both groups. Significant lower noise, and higher SNR and CNR values were found in group 1 in comparison with group 2 despite the use of 80 kVp. In 62-group 1 patients studied by DSA, CTA showed in a segment-based analysis a sensitivity, negative predictive value and accuracy of 100%, 100% and 99% respectively. Mean ED in group 1 was 0.54 ± 0.1 mSv with a dose reduction up to 86%. Conclusions: CTA for carotid arteries using latest IR algorithm allows to perform exams with submillisievert radiation exposure maintaining good image quality, overall evaluability and diagnostic accuracy.

Original languageEnglish
JournalJournal of Cardiovascular Computed Tomography
DOIs
Publication statusAccepted/In press - Jan 1 2019

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Carotid Arteries
Technology
Noise
Signal-To-Noise Ratio
Circle of Willis
Common Carotid Artery
Internal Carotid Artery
Computed Tomography Angiography

Keywords

  • Atherosclerosis
  • Carotid arteries
  • Computed tomography angiography
  • Dose reduction
  • Iterative reconstruction algorithm

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{d01e027860c647e8b808c789325a762e,
title = "Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies: Feasibility and diagnostic accuracy",
abstract = "Objectives: To assess evaluability and diagnostic accuracy of a low dose CT angiography (CTA) protocol for carotid arteries using latest Iterative Reconstruction (IR) algorithm in comparison with standard 100 kVp protocol using previous generation CT and IR. Materials and methods: 105 patients, referred for CTA of the carotid arteries were prospectively enrolled in our study and underwent CTA with 80 kVp and latest IR algorithm (group 1). Data were retrospectively compared with 100 consecutive patients with similar examination indications that had previously undergone CTA of carotid arteries with a standard 100 kVp protocol and a first generation IR algorithm (group 2). Image quality was evaluated with a 4-point Likert-scale. For each exam CT number, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) at level of common carotid artery (CCA), internal carotid artery (ICA) and at level of Circle of Willis and Effective Dose (ED) were evaluated. 62 Group 1 patients underwent a clinically indicated DSA and results were compared with CTA. Results: No exams reported as not diagnostic. The overall mean CT number value of all arterial segments was above 450 HU in both groups. Significant lower noise, and higher SNR and CNR values were found in group 1 in comparison with group 2 despite the use of 80 kVp. In 62-group 1 patients studied by DSA, CTA showed in a segment-based analysis a sensitivity, negative predictive value and accuracy of 100{\%}, 100{\%} and 99{\%} respectively. Mean ED in group 1 was 0.54 ± 0.1 mSv with a dose reduction up to 86{\%}. Conclusions: CTA for carotid arteries using latest IR algorithm allows to perform exams with submillisievert radiation exposure maintaining good image quality, overall evaluability and diagnostic accuracy.",
keywords = "Atherosclerosis, Carotid arteries, Computed tomography angiography, Dose reduction, Iterative reconstruction algorithm",
author = "Annoni, {Andrea Daniele} and Piero Montorsi and Daniele Andreini and Gianluca Pontone and Mancini, {Maria Elisabetta} and Giuseppe Muscogiuri and Alberto Formenti and Saima Mushtaq and Piero Trabattoni and Luca Dainese and Mauro Pepi",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jcct.2019.01.009",
language = "English",
journal = "Journal of Cardiovascular Computed Tomography",
issn = "1934-5925",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies

T2 - Feasibility and diagnostic accuracy

AU - Annoni, Andrea Daniele

AU - Montorsi, Piero

AU - Andreini, Daniele

AU - Pontone, Gianluca

AU - Mancini, Maria Elisabetta

AU - Muscogiuri, Giuseppe

AU - Formenti, Alberto

AU - Mushtaq, Saima

AU - Trabattoni, Piero

AU - Dainese, Luca

AU - Pepi, Mauro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: To assess evaluability and diagnostic accuracy of a low dose CT angiography (CTA) protocol for carotid arteries using latest Iterative Reconstruction (IR) algorithm in comparison with standard 100 kVp protocol using previous generation CT and IR. Materials and methods: 105 patients, referred for CTA of the carotid arteries were prospectively enrolled in our study and underwent CTA with 80 kVp and latest IR algorithm (group 1). Data were retrospectively compared with 100 consecutive patients with similar examination indications that had previously undergone CTA of carotid arteries with a standard 100 kVp protocol and a first generation IR algorithm (group 2). Image quality was evaluated with a 4-point Likert-scale. For each exam CT number, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) at level of common carotid artery (CCA), internal carotid artery (ICA) and at level of Circle of Willis and Effective Dose (ED) were evaluated. 62 Group 1 patients underwent a clinically indicated DSA and results were compared with CTA. Results: No exams reported as not diagnostic. The overall mean CT number value of all arterial segments was above 450 HU in both groups. Significant lower noise, and higher SNR and CNR values were found in group 1 in comparison with group 2 despite the use of 80 kVp. In 62-group 1 patients studied by DSA, CTA showed in a segment-based analysis a sensitivity, negative predictive value and accuracy of 100%, 100% and 99% respectively. Mean ED in group 1 was 0.54 ± 0.1 mSv with a dose reduction up to 86%. Conclusions: CTA for carotid arteries using latest IR algorithm allows to perform exams with submillisievert radiation exposure maintaining good image quality, overall evaluability and diagnostic accuracy.

AB - Objectives: To assess evaluability and diagnostic accuracy of a low dose CT angiography (CTA) protocol for carotid arteries using latest Iterative Reconstruction (IR) algorithm in comparison with standard 100 kVp protocol using previous generation CT and IR. Materials and methods: 105 patients, referred for CTA of the carotid arteries were prospectively enrolled in our study and underwent CTA with 80 kVp and latest IR algorithm (group 1). Data were retrospectively compared with 100 consecutive patients with similar examination indications that had previously undergone CTA of carotid arteries with a standard 100 kVp protocol and a first generation IR algorithm (group 2). Image quality was evaluated with a 4-point Likert-scale. For each exam CT number, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) at level of common carotid artery (CCA), internal carotid artery (ICA) and at level of Circle of Willis and Effective Dose (ED) were evaluated. 62 Group 1 patients underwent a clinically indicated DSA and results were compared with CTA. Results: No exams reported as not diagnostic. The overall mean CT number value of all arterial segments was above 450 HU in both groups. Significant lower noise, and higher SNR and CNR values were found in group 1 in comparison with group 2 despite the use of 80 kVp. In 62-group 1 patients studied by DSA, CTA showed in a segment-based analysis a sensitivity, negative predictive value and accuracy of 100%, 100% and 99% respectively. Mean ED in group 1 was 0.54 ± 0.1 mSv with a dose reduction up to 86%. Conclusions: CTA for carotid arteries using latest IR algorithm allows to perform exams with submillisievert radiation exposure maintaining good image quality, overall evaluability and diagnostic accuracy.

KW - Atherosclerosis

KW - Carotid arteries

KW - Computed tomography angiography

KW - Dose reduction

KW - Iterative reconstruction algorithm

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U2 - 10.1016/j.jcct.2019.01.009

DO - 10.1016/j.jcct.2019.01.009

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SN - 1934-5925

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