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Application of 80-kVp scan and raw data-based iterative reconstruction for reduced iodine load abdominal–pelvic CT in patients at risk of contrast-induced nephropathy referred for oncological assessment: effects on radiation dose, image quality and renal function

2018; Wiley; Volume: 91; Issue: 1085 Linguagem: Inglês

10.1259/bjr.20170632

1748-880X

Yasunori Nagayama, Shota Tanoue, Akinori Tsuji, Joji Urata, M Furusawa, Seitaro Oda, Takeshi Nakaura, Daisuke Utsunomiya, Eri Yoshida, Morikatsu Yoshida, Masafumi Kidoh, Machiko Tateishi, Yasuyuki Yamashita,

MRI in cancer diagnosis

To evaluate the image quality, radiation dose, and renal safety of contrast medium (CM)-reduced abdominal-pelvic CT combining 80-kVp and sinogram-affirmed iterative reconstruction (SAFIRE) in patients with renal dysfunction for oncological assessment.We included 45 patients with renal dysfunction (estimated glomerular filtration rate 60 ml per lmin per 1.73 m2) who underwent standard oncological abdominal-pelvic CT (600 mgI kg-1, 120-kVp, filtered-back projection) were included as controls. CT attenuation, image noise, and contrast-to-noise ratio (CNR) were compared. Two observers performed subjective image analysis on a 4-point scale. Size-specific dose estimate and renal function 1-3 months after CT were measured.The size-specific dose estimate and iodine load of 80-kVp protocol were 32 and 41%,, respectively, lower than of 120-kVp protocol (p < 0.01). CT attenuation and contrast-to-noise ratio of parenchymal organs and vessels in 80-kVp images were significantly better than those of 120-kVp images (p < 0.05). There were no significant differences in quantitative or qualitative image noise or subjective overall quality (p > 0.05). No significant kidney injury associated with CM administration was observed.80-kVp abdominal-pelvic CT with SAFIRE yields diagnostic image quality in oncology patients with renal dysfunction under substantially reduced iodine and radiation dose without renal safety concerns. Advances in knowledge: Using 80-kVp and SAFIRE allows for 40% iodine load and 32% radiation dose reduction for abdominal-pelvic CT without compromising image quality and renal function in oncology patients at risk of contrast-induced nephropathy.