Amakusa Medical Center Amakusa, Kumamoto, Japan.
Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Acta Radiol. 2022 Apr;63(4):458-466. doi: 10.1177/02841851211001539. Epub 2021 Mar 12.
The low-tube-voltage scan generally needs a higher tube current than the conventional 120 kVp to maintain the image noise. In addition, the low-tube-voltage scan increases the photoelectric effect, which increases the radiation absorption in organs.
To compare the organ radiation dose caused by iodine contrast medium between low tube voltage with low contrast medium and that of conventional 120-kVp protocol with standard contrast medium.
After the propensity-matching analysis, 66 patients were enrolled including 33 patients with 120 kVp and 600 mgI/kg and 33 patients with 80 kVp and 300 mgI/kg (50% iodine reduction). The pre- and post-contrast phases were assessed in all patients. The Monte Carlo simulation tool was used to simulate the radiation dose. The computed tomography (CT) numbers for 10 organs and the organ doses were measured. The organ doses were normalized by the volume CT dose index, and the 120-kVp protocol was compared with the 80-kVp protocol.
On contrast-enhanced CT, there were no significant differences in the mean CT numbers of the organs between 80-kVp and 120-kVp protocols except for the pancreas, kidneys, and small intestine. The normalized organ doses at 80 kVp were significantly lower than those of 120 kVp in all organs (e.g. liver, 1.6 vs. 1.9; pancreas, 1.5 vs. 1.8; spleen, 1.7 vs. 2.0) on contrast-enhanced CT.
The low tube voltage with low-contrast-medium protocol significantly reduces organ doses at the same volume CT dose index setting compared with conventional 120-kVp protocol with standard contrast medium on contrast-enhanced CT.
低管电压扫描通常需要比常规 120 kVp 更高的管电流来保持图像噪声。此外,低管电压扫描增加了光电效应,从而增加了器官的辐射吸收。
比较低管电压低浓度造影剂与常规 120 kVp 协议标准浓度造影剂引起的器官辐射剂量。
经过倾向评分匹配分析,纳入 66 例患者,其中 120 kVp 组 600 mgI/kg 33 例,80 kVp 组 300 mgI/kg(碘浓度降低 50%)33 例。所有患者均进行了增强前后的评估。使用蒙特卡罗模拟工具模拟辐射剂量。测量 10 个器官的 CT 数和器官剂量。通过体积 CT 剂量指数对器官剂量进行归一化,将 120 kVp 方案与 80 kVp 方案进行比较。
在增强 CT 上,除胰腺、肾脏和小肠外,80 kVp 和 120 kVp 方案的各器官平均 CT 数无显著差异。在增强 CT 上,80 kVp 时各器官的归一化器官剂量均明显低于 120 kVp(如肝脏,1.6 比 1.9;胰腺,1.5 比 1.8;脾脏,1.7 比 2.0)。
在相同体积 CT 剂量指数设置下,与常规 120 kVp 协议标准造影剂相比,低管电压低浓度造影剂方案可显著降低增强 CT 上的器官剂量。