Klambauer Konstantin, Flohr Thomas, Moser Lukas Jakob, Mergen Victor, Eberhard Matthias, Prokein Andreas, Alkadhi Hatem, Pietsch Hubertus, Jost Gregor
Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Eur Radiol Exp. 2025 Mar 24;9(1):37. doi: 10.1186/s41747-025-00577-y.
Reducing radiation and contrast media (CM) doses in computed tomography angiography (CTA) is especially relevant for potentially vulnerable populations. Low tube voltage photon-counting detector CT (PCD-CT) offers an improved iodine contrast-to-noise ratio (CNR) as compared to conventional CT scanners. We investigated optimized radiation and CM doses of PCD-CT angiography at low tube voltage in an animal model.
Six minipigs (median weight: 32.5 kg; IQR: 29.8-34.6 kg) underwent thoracoabdominal CTA using a clinical dual-source PCD-CT at 70 kVp with three scan protocols: (A) reference (100% CM and radiation dose), (B) increased radiation (233%) and reduced CM (56%) dose, and (C) reduced radiation (50%) and increased CM (141%) dose. CNR, subjective image quality, and radiation doses were assessed, with statistical analysis including Mann-Whitney U-test and Kruskal-Wallis tests.
CTDI was 1.7 mGy (IQR: 1.5-1.8) for scan A, 4.3 mGy (IQR: 3.8-4.7) for scan B, and 0.9 mGy (IQR: 0.8-1.0) for scan C (p < 0.001). CM volumes were 16 mL (IQR: 15-17) for scan A, 10 mL (IQR: 8-10) for scan B, and 23 mL (IQR: 21-24) for scan C. No significant differences in CNR were found between scans, with medians of 26 (IQR: 24-28) for scan A, 23 (IQR: 22-26) for scan B, and 26 (IQR: 24-30) for scan C (p = 0.276). Subjective image quality was similar across scans (p = 0.342).
Low tube voltage PCD-CT angiography allows substantial reductions in radiation and CM dose while maintaining stable and improved CNR, which allows further dose flexibility for individualized CTA protocols.
PCD-CT at low tube voltage provides a high CNR and great flexibility in dose optimization, making it particularly effective for applications where minimizing radiation and CM exposure is a priority.
Low tube voltage imaging with photon counting detector (PCD)-CT enables flexible contrast and radiation dose optimization strategies in thoracoabdominal CT angiography (CTA). The CNR for thoracoabdominal CTA remains stable with appropriate contrast and radiation dose adjustments at low tube voltage PCD-CT. Low tube voltage PCD-CT consistently yields diagnostic image quality in thoracoabdominal angiography even at reduced contrast or radiation doses.
在计算机断层血管造影（CTA）中降低辐射和造影剂（CM）剂量对于潜在的脆弱人群尤为重要。与传统CT扫描仪相比，低管电压光子计数探测器CT（PCD-CT）可提高碘对比噪声比（CNR）。我们在动物模型中研究了低管电压下PCD-CT血管造影的优化辐射和CM剂量。
六只小型猪（中位体重：32.5千克；四分位间距：29.8-34.6千克）使用临床双源PCD-CT在70 kVp下进行胸腹CTA，采用三种扫描方案：（A）参考方案（100%CM和辐射剂量），（B）增加辐射（233%）和减少CM（56%）剂量，以及（C）减少辐射（50%）和增加CM（141%）剂量。评估了CNR、主观图像质量和辐射剂量，并进行了包括Mann-Whitney U检验和Kruskal-Wallis检验在内的统计分析。
扫描A的CTDI为1.7 mGy（四分位间距：1.5-1.8），扫描B为4.3 mGy（四分位间距：3.8-4.7），扫描C为0.9 mGy（四分位间距：0.8-1.0）（p<0.001）。扫描A的CM体积为16 mL（四分位间距：15-
