Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial. for Comparison with Conventional. CT Urography
- Authors
- Kim, Sang Youn; Cho, Jeong Yeon; Lee, Joongyub; Hwang, Sung Il; Moon, Min Hoan; Lee, Eun Ju; Hong, Seong Sook; Kim, Chan Kyo; Kim, Kyeong Ah; Park, Sung Bin; Sung, Deuk Jae; Kim, Yongsoo; Kim, You Me; Jung, Sung Il; Rha, Sung Eun; Kim, Dong Won; Lee, Hyun; Shim, Youngsup; Hwang, Inpyeong; Woo, Sungmin; Choi, Hyuck Jae
- Issue Date
- Nov-2018
- Publisher
- KOREAN RADIOLOGICAL SOC
- Keywords
- Computed tomography; Low dose; Urography; Contrast media; Double dose reduction
- Citation
- KOREAN JOURNAL OF RADIOLOGY, v.19, no.6, pp.1119 - 1129
- Journal Title
- KOREAN JOURNAL OF RADIOLOGY
- Volume
- 19
- Number
- 6
- Start Page
- 1119
- End Page
- 1129
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3141
- DOI
- 10.3348/kjr.2018.19.6.1119
- ISSN
- 1229-6929
- Abstract
- Objective: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. Materials and Methods: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. Results: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose (5.73 +/- 4.04 vs. 8.43 +/- 4.38 mSv) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score >= 3), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. Conclusion: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.
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