Quantitative and qualitative evaluation of low-dose craniocervical computed tomography angiography with a lower tube voltage protocol. (October 2019)

• Record Type: Journal Article
• Authors: Chen, Po-An; Chen, Chih-Wei; Chou, Chiung-Chen; Fu, Jui-Hsun; Wang, Po-Chin; Hsu, Shuo-Hsiu; Lai, Ping-Hong
• Is Part Of: Acta radiologica. Volume 60:Number 10(2019)
• Page Start: 1380
• Page End: 1389
• Publication Date: 2019-10
• Subjects: Computed tomography angiography -- radiation dosage -- neck -- carotid arteries; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185119825488
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Craniocervical computed tomography angiography (CCCTA) is widely used for the clinical assessment of craniocervical vessels. Purpose: To investigate and compare the image quality and radiation doses associated with lower-dose (100 and 80 kVp) CCCTA protocols versus the conventional 120-kVp protocol. Material and Methods: This study enrolled 120 patients and randomly divided them into three groups: group A = 120 kVp; group B = 100 kVp; and group C = 80 kVp. Patients in all three groups were scanned in a 256-slice CT machine at a slice thickness of 0.625 mm. We compared the quantitative and qualitative image quality and radiation doses among the groups. The κ test was used to estimate the inter-observer reliability of image quality evaluations performed independently by two experienced radiologists. Results: Arterial attenuation of the head, neck, and shoulder regions was significantly higher in both groups B and C than in group A. In addition, no significant inter-group differences were observed in the signal-to-noise ratio or contrast-to-noise ratio in the head and neck regions. Both groups B and C had a lower CT dose index and dose-length product relative to group A. Regarding subjective image quality, group B yielded significantly better image quality than group A and C, while groups A and C did not differ significantly. The subjective quality analysis had good inter-observer reliability (κ = 0.785). Conclusion: In CCCTA, the 100-kVp protocol increased arterial enhancement, reduced the radiation dose, and would not cause prominent streak artifacts. This protocol should be considered for CCCTA.