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KMID : 0880420180190061119
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Korean Journal of Radiology
2018 Volume.19 No. 6 p.1119 ~ p.1129
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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
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Kim Sang-Youn
Cho Jeong-Yeon
Lee Joong-Yub
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 Yong-Soo
Kim You-Me
Jung Sung-Il
Rha Sung-Eun
Kim Dong-Won
Lee Hyun
Shim Young-Sup
Hwang In-Pyeong
Woo Sung-Min
Choi Hyuck-Jae
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Abstract
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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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KEYWORD
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Computed tomography, Low dose, Urography, Contrast media, Double dose reduction
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