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document
Reducing iodine load in hepatic CT for patients with chronic liver disease with a combination of low-tube-voltage and adaptive statistical iterative reconstruction . PURPOSE To prospectively assess the effect of reduced iodine load to contrast enhancement , image quality , and detectability of hepatocellular carcinomas ( HCCs ) in hepatic CT with a combination of 80 kVp tube voltage setting and adaptive statistical iterative reconstruction ( ASIR ) technique in patients with chronic liver disease . MATERIALS AND METHODS This HIPAA-compliant study was approved by our institutional review board and written informed consent was obtained in all patients . During a recent 9-month period , 170 consecutive patients ( 114 men and 56 women ; age range , 40-85 years ; mean , 67.7 years ) with suspected chronic liver diseases were randomized into three CT groups according to the following iodine-load and tube-voltage protocols : 600 milligram per kilogram body weight ( mg/kg ) iodine load and 120 peak kilovolt ( kVp ) tube voltage setting ( 600-120 group ) , 500 mg/kg and 80 kVp ( 500-80 group ) , and 400mg/kg and 80 kVp ( 400-80 group ) . Analysis of variance was conducted to evaluate differences in CT number , background noise , signal-to-noise ratio ( SNR ) , effective dose , HCC-to-liver contrast-to-noise ratio ( CNR ) , and figure of merit ( FOM ) . Sensitivity , specificity , and area under the receiver-operating-characteristic curve ( AUC ) were compared to assess the detectability of HCCs . RESULTS Vascular and hepatic enhancement in the 400-80 and 500-80 groups was comparable to or greater than that in the 600-120 group ( P < .05 ) . Subjective image quality was comparable among the three groups . Sensitivity , specificity , and AUC for detecting HCCs were comparable among the groups . The effective dose was kept low ( 3.3-4.1 mSv ) in all three groups . CONCLUSION Iodine load can be reduced by 33 % in CT of the liver with a combination of 80 kVp tube voltage setting and ASIR technique , without compromising the contrast enhancement , image quality , and detection of HCCs .
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Intervention_Physical
combination of low-tube-voltage and adaptive statistical iterative reconstruction .
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Intervention_Physical
80 kVp tube voltage setting
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Intervention_Physical
adaptive statistical iterative reconstruction ( ASIR ) technique
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Intervention_Physical
iodine-load and tube-voltage protocols : 600 milligram per kilogram body weight ( mg/kg ) iodine load
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Intervention_Physical
120 peak kilovolt ( kVp ) tube voltage setting ( 600-120 group )
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Intervention_Physical
500 mg/kg and 80 kVp ( 500-80 group ) , and 400mg/kg and 80 kVp ( 400-80 group )
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Intervention_Physical
80 kVp tube voltage setting and ASIR technique
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Outcome_Physical
CT number
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Outcome_Other
background noise
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Outcome_Physical
signal-to-noise ratio ( SNR
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Outcome_Other
effective dose
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Outcome_Other
HCC-to-liver contrast-to-noise ratio ( CNR )
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Outcome_Other
figure of merit ( FOM )
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Outcome_Physical
Vascular and hepatic enhancement
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Outcome_Other
Subjective image quality
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Outcome_Other
Sensitivity , specificity , and AUC
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Outcome_Other
contrast enhancement , image quality
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Outcome_Other
detection of HCCs .
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Participant_Condition
chronic liver disease
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Participant_Condition
patients with chronic liver disease .
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Participant_Sample-size
170
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Participant_Sample-size
114
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Participant_Sex
men
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Participant_Sample-size
56
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Participant_Sex
women
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Participant_Age
40-85 years