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

Sang Youn Kim, Jeong Yeon Cho, Joongyub Lee, Sung Il Hwang, Min Hoan Moon, Eun Ju Lee, Seong Sook Hong, Chan Kyo Kim, Kyeong Ah Kim, Sung Bin Park, Deuk Jae Sung, Yongsoo Kim, You Me Kim, Sung Il Jung, Sung Eun Rha, Dong Won Kim, Hyun Lee, Youngsup Shim, Inpyeong Hwang, Sungmin WooHyuck Jae Choi

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4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1119-1129
Number of pages11
JournalKorean journal of radiology
Volume19
Issue number6
DOIs
Publication statusPublished - 2018 Nov 1

Keywords

  • Computed tomography
  • Contrast media
  • Double dose reduction
  • Low dose
  • Urography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Kim, S. Y., Cho, J. Y., Lee, J., Hwang, S. I., Moon, M. H., Lee, E. J., Hong, S. S., Kim, C. K., Kim, K. A., Park, S. B., Sung, D. J., Kim, Y., Kim, Y. M., Jung, S. I., Rha, S. E., Kim, D. W., Lee, H., Shim, Y., Hwang, I., ... Choi, H. J. (2018). 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. Korean journal of radiology, 19(6), 1119-1129. https://doi.org/10.3348/kjr.2018.19.6.1119