Abstract
We compared the image quality according to the radiation dose on computed tomography (CT) venography at 80 kVp using advanced modeled iterative reconstruction for deep vein thrombus and other specific clinical conditions considering standard-, low-, and ultralow-dose CT. In this retrospective study, 105 consecutive CT venography examinations were included using a third-generation dual-source scanner in the dual-source mode in tubes A (reference mAs, 210 mAs at 70%) and B (reference mAs, 90 mAs at 30%) at a fixed 80 kVp. Two radiologists independently reviewed each observation of standard- (100% radiation dose), low- (70%), and ultralow-dose (30%) CT. The objective quality of large veins and subjective image quality regarding lower-extremity veins and deep vein thrombus were compared between images according to the dose. In addition, the CT dose index volumes were displayed from the images. From the patients, 24 presented deep vein thrombus in 69 venous segments of CT examinations. Standard-dose CT provided the lowest image noise at the inferior vena cava and femoral vein compared with low- and ultralow-dose CT (p < 0.001). There were no differences regarding subjective image quality between the images of popliteal and calf veins at the three doses (e.g., 3.8 ± 0.7, right popliteal vein, p = 0.977). The image quality of the 69 deep vein thrombus segments showed equally slightly higher scores in standard- and low-dose CT (4.0 ± 0.2) than in ultralow-dose CT (3.9 ± 0.4). The CT dose index volumes were 4.4 ± 0.6, 3.1 ± 0.4, and 1.3 ± 0.2 mGy for standard-, low-, and ultralow-dose CT, respectively. Low- and ultralow-dose CT venography at 80 kVp using an advanced model based iterative reconstruction algorithm allows to evaluate deep vein thrombus and perform follow-up examinations while showing an acceptable image quality and reducing the radiation dose.
Highlights
Venous thromboembolism is the third main cause of cardiovascular disease [1], and its incidence has sharply increased over the last two decades [2]
Standard-dose computed tomography (CT) provided the lowest image noise at the inferior vena cava and femoral vein compared with low- and ultralow-dose CT (p < 0.001)
It occurs in two forms, deep vein thrombosis (DVT) and pulmonary embolism
Summary
Venous thromboembolism is the third main cause of cardiovascular disease [1], and its incidence has sharply increased over the last two decades [2]. It occurs in two forms, deep vein thrombosis (DVT) and pulmonary embolism. DVT is often related with recurrent venous thromboembolism and pulmonary embolism according to the disease process [3]. Disease recurrence occurs in 20–36% of the DVT patients as the disease progresses [4, 5]. Venous bleeding, and death are the major consequences that may occur during the clinical course of DVT. Along with ultrasonography, computed tomography (CT) venography of the lower extremity is common for DVT diagnosis and follow-up
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