Quantifying image quality in chest computed tomography angiography: Evaluation of different contrast-to-noise ratio measurement methods

2021 ◽  
pp. 028418512110418
Author(s):  
Vasiliki Chatzaraki ◽  
Rahel A Kubik-Huch ◽  
Michael Thali ◽  
Tilo Niemann
Keyword(s):  
Computed Tomography ◽  
Standard Deviation ◽  
Image Quality ◽  
Computed Tomography Angiography ◽  
Pulmonary Arteries ◽  
Measurement Methods ◽  
Image Noise ◽  
Ratio Measurement ◽  
Chest Computed Tomography ◽  
Noise Ratio

Background Contrast-to-noise ratio is used to objectively evaluate image quality in chest computed tomography angiography (CTA). Different authors define and measure contrast-to-noise ratio using different methods. Purpose To summarize and evaluate the different contrast-to-noise ratio calculation formulas in the current literature. Material and Methods A systematic review of the recent literature for studies using contrast-to-noise ratio was performed. Contrast-to-noise ratio measurement methods reported by the different authors were recorded and reproduced in three patients who underwent chest CTA in our department for exploring variations among the different measurement methods. Results The search resulted in 109 articles, of which 26 were included. The studies involved 69 different measurements and overall, three different formula patterns. In all three, aorta and pulmonary arteries comprised the objects of interest in the numerator. In the denominator, standard deviation of the attenuation of the object of interest itself or of another background were used to reflect image noise. Some authors averaged the ratio values at different levels to obtain global ratio values. Using the object of interest itself for image noise calculation in the denominator compared to the usage of another background caused the most prominent variances of contrast-to-noise ratio between the two different protocols used for the reproduction of the measurements. Conclusion We recommend using the standard deviation of the attenuation of a background indicator as image noise rather than the object of interest itself for more reliable and comparative values. Global contrast-to-noise ratios based on averaging the values of different measurement levels should be avoided.

An open label, prospective, multicenter, non-interventional study of iodixanol 270 mg I/mL for use in individuals undergoing computed tomography angiography in real-world clinical practice

2018 ◽  
Vol 60 (2) ◽  
pp. 177-185
Author(s):  
Xiangying Du ◽  
Bin Lu ◽  
Daoyu Hu ◽  
Bin Song ◽  
Kuncheng Li
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Iterative Reconstruction ◽  
Computed Tomography Angiography ◽  
Pulmonary Arteries ◽  
Open Label ◽  
Tube Voltage ◽  
Effective Radiation Dose ◽  
Noise Ratio

Background Concern about radiation exposure is leading to an increasing interest in low-concentration contrast medium administration. Purpose To evaluate the image quality and safety profile after administration of iodixanol 270 mg I/mL at 100-kVp tube voltage with iterative reconstruction in subjects undergoing computed tomography angiography (CTA). Material and Methods Patients who completed CTA examination using iodixanol 270 mg I/mL and 100-kVp tube voltage along with iterative reconstruction for coronary, aortic, head and neck, renal, or pulmonary arteries were included. Image quality was qualitatively and quantitatively evaluated. Incidence of adverse events (AEs) and adverse drug reactions (ADRs) within seven days and radiation dose were also analyzed. Results A total of 4513 individuals in 42 centers in China were enrolled, among which 4367 were included in efficacy analysis. The mean image quality score was 4.8 ± 0.45 across all arteries (all above 4.6) and 99.7% of the individuals’ images were classified as evaluable. The CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the regions of interest (ROIs) were 431.79 ± 99.018, 18.29 ± 11.947, and 28.21 ± 19.535 HU, respectively. Of all the participants, 68 (1.5%) and 65 (1.4%) experienced AEs and ADRs, respectively. No serious AEs or AEs leading to discontinuation occurred. The average effective radiation dose was 3.13 ± 2.550 mSv. Conclusion Iodixanol 270 mg I/mL in combination with 100-kVp tube voltage and iterative reconstruction could be safely applied in CTA and yield high-quality and evaluable images with reduced radiation dose.

scholarly journals Effect of Tube Voltage (100 vs. 120 kVp) on Radiation Dose and Image Quality using Prospective Gating 320 Row Multi-detector Computed Tomography Angiography

2013 ◽  
Vol 3 ◽  
pp. 62 ◽  
Author(s):  
Atif N. Khan ◽  
Faisal Khosa ◽  
Waqas Shuaib ◽  
Khurram Nasir ◽  
Ron Blankstein ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Computed Tomography Angiography ◽  
Tube Voltage ◽  
Prospective Gating ◽  
Noise Ratio ◽  
Group 2 ◽  
Multi Detector Computed Tomography ◽  
Group 1

Objectives: The objective of the following study is to evaluate the effect of reducing tube voltage from 120 to 100 kVp using prospective gating 320 row multi-detector computed tomography angiography on image quality and reduction in radiation dose. Materials and Methods: A total of 78 sequential patients were scanned with prospective electrocardiogram gating. A total of 45 patients (Group 1) with mean body mass index (BMI) 29 ± 2 and heart rate (HR) 57 ± 7 beats per minute (BPM) were scanned at 120 kVp. 33 patients (Group 2) with mean BMI 23 ± 3 and HR 58 ± 6 bpm were scanned at 100 kVp. Effective dose was calculated using dose length product and factor (k = 0.014). Quantitative assessment of image quality was calculated by measuring signal to noise ratio (SNR) and contrast to noise ratio (CNR) in the left ventricle and left main coronary artery. Two experienced cardiac radiologists using a three-point ordinal scale assessed subjectively image quality. Results: In Group 1, the median radiation dose was 5.31 mSv (95% confidence interval [CI]: 4.86-6.09) and for Group 2 (P = 0.009) the mean radiation dose was 3.71 mSv (95% CI: 2.76-4.87), representing 30% decrease in radiation dose. In multivariate analyses, adjusting for age, gender, HR, BMI, tube current and scan length, an absolute median reduction of 2.21 mSv (1.13-3.29 mSv) was noted in patients scanned with 100 kVp (P < 0.0001). The quantitative image quality (SNR and CNR) was not statistically significant between the groups. Subjective image quality was rated as good or excellent in 99% of coronary segments for both groups (P value was considered as non-significant). Conclusion: Our study suggests that radiation dose may be lowered from 120 to 100 kVp with preservation of image quality in patient's whose BMI is ≤27.

scholarly journals Comparison of image quality and radiation dose using different pre-ASiR-V and post-ASiR-V levels in coronary computed tomography angiography

2020 ◽  
pp. 1-10
Author(s):  
Yongxia Zhao ◽  
Dongxue Li ◽  
Zhichao Liu ◽  
Xue Geng ◽  
Tianle Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Effective Radiation Dose ◽  
Dose Length Product ◽  
Coronary Computed Tomography ◽  
Significant Difference ◽  
Noise Ratio

OBJECTIVE: To determine the optimal pre-adaptive and post-adaptive level statistical iterative reconstruction V (ASiR-V) for improving image quality and reducing radiation dose in coronary computed tomography angiography (CCTA). METHODS: The study was divided into two parts. In part I, 150 patients for CCTA were prospectively enrolled and randomly divided into 5 groups (A, B, C, D, and E) with progressive scanning from 40% to 80% pre-ASiR-V with 10% intervals and reconstructing with 70% post-ASiR-V. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was assessed using a 5-point scale. The CT dose index volume (CTDIvol) and dose-length product (DLP) of each patient were recorded and the effective radiation dose (ED) was calculated after statistical analysis by optimizing for the best pre-ASiR-V value with the lowest radiation dose while maintaining overall image quality. In part II, the images were reconstructed with the recommended optimal pre-ASiR-V values in part I (D group) and 40%–90% of post-ASiR-V. The reconstruction group (D group) was divided into 6 subgroups (interval 10%, D0:40% post-ASiR-V, D1:50% post - ASiR-V, D2:60% post-ASiR-V, D3:70% post-ASiR-V, D4:80% post-ASiR-V, and D5:90% post-ASiR-V).The SNR and CNR of D0-D5 subgroups were calculated and analyzed using one-way analysis of variance, and the consistency of the subjective scores used the k test. RESULTS: There was no significant difference in the SNRs, CNRs, and image quality scores among A, B, C, and D groups (P > 0.05). The SNR, CNR, and image quality scores of the E group were lower than those of the A, B, C, and D groups (P < 0.05). The mean EDs in the B, C, and D groups were reduced by 7.01%, 13.37%, and 18.87%, respectively, when compared with that of the A group. The SNR and CNR of the D4–D5 subgroups were higher than the D0-D3 subgroups, and the image quality scores of the D4 subgroups were higher than the other subgroups (P < 0.05). CONCLUSION: The wide-detector combined with 70% pre-ASiR-V and 80% post-ASiR-V significantly reduces the radiation dose of CCTA while maintaining overall image quality as compared with the manufacture’s recommendation of 40% pre-ASiR-V.

scholarly journals Computed Tomography Angiography with a 192-slice Dual-source Computed Tomography System: Improvements in Image Quality and Radiation Dose

2016 ◽  
Vol 6 ◽  
pp. 44 ◽  
Author(s):  
Philip V M Linsen ◽  
Adriaan Coenen ◽  
Marisa M Lubbers ◽  
Marcel L Dijkshoorn ◽  
Mohamed Ouhlous ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Heart Rate ◽  
Image Quality ◽  
Radiation Dose ◽  
Computed Tomography Angiography ◽  
Signal To Noise Ratio ◽  
High Pitch ◽  
Subjective Image Quality ◽  
Dual Source ◽  
Noise Ratio

Purpose: This study aims to compare image quality, radiation dose, and the influence of the heart rate on image quality of high-pitch spiral coronary computed tomography angiography (CCTA) using 128-slice (second generation) dual-source CT (DSCT) and a 192-slice DSCT (third generation) scanner. Materials and Methods: Two consecutive cohorts of fifty patients underwent CCTA by high-pitch spiral scan mode using 128 or 192-slice DSCT. The 192-slice DSCT system has a more powerful roentgen tube (2 × 120 kW) that allows CCTA acquisition at lower tube voltages, wider longitudinal coverage for faster table speed (732 m/s), and the use of iterative reconstruction. Objective image quality was measured as the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality was evaluated using a Likert scale. Results: While the effective dose was lower with 192-slice DSCT (1.2 ± 0.5 vs. 0.6 ± 0.3 mSv; P < 0.001), the SNR (18.9 ± 4.3 vs. 11.0 ± 2.9; P < 0.001) and CNR (23.5 ± 4.8 vs. 14.3 ± 4.1; P < 0.001) were superior to 128-slice DSCT. Although patients scanned with 192-slice DSCT had a faster heart rate (59 ± 7 vs. 56 ± 6; P = 0.045), subjective image quality was scored higher (4.2 ± 0.8 vs. 3.0 ± 0.7; P < 0.001) compared to 128-slice DSCT. Conclusions: High-pitch spiral CCTA by 192-slice DSCT provides better image quality, despite a higher average heart rate, at lower radiation doses compared to 128-slice DSCT.

scholarly journals Image Quality and Dose Reduction by Dual Source Computed Tomography Coronary Angiography: Protocol Comparison

Dose-Response ◽  
2018 ◽  
Vol 16 (4) ◽  
pp. 155932581880583 ◽  
Author(s):  
Ernesto Forte ◽  
Serena Monti ◽  
Chiara Anna Parente ◽  
Lukas Beyer ◽  
Roberto De Rosa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Coronary Angiography ◽  
Effective Dose ◽  
Computed Tomography Coronary Angiography ◽  
Correct Selection ◽  
Dual Source ◽  
Group A ◽  
Noise Ratio ◽  
Dual Source Computed Tomography

Purpose: To compare image quality and radiation dose among different protocols in patients who underwent a 128-slice dual source computed tomography coronary angiography (DSCT-CTCA). Methods: Ninety patients were retrospectively grouped according to heart rate (HR): 26 patients (group A) with stable HR ≤60 bpm were acquired using high pitch spiral mode (FLASH); 48 patients (group B) with irregular HR ≤60 bpm or stable HR between 60 and 70 bpm using step and shoot mode; and 16 patients (group C) with irregular HR >60 bpm or stable HR ≥70 bpm by retrospective electrocardiogram pulsing acquisition. Signal to noise ratio (SNR) and contrast to noise ratio (CNR) were measured for the main vascular structures. Moreover, the dose-length product and the effective dose were assessed. Results: Both SNR and CNR were higher in group A compared to group C (18.27 ± 0.32 vs 11.22 ± 0.50 and 16.75 ± 0.32 vs 10.17 ± 0.50; P = .001). The effective dose was lower in groups A and B (2.09 ± 1.27 mSv and 4.60 ± 2.78 mSv, respectively) compared to group C (9.61 ± 5.95 mSv) P < .0001. Conclusion: The correct selection of a low-dose, HR-matched CTCA scan protocol with a DSCT scanner provides substantial reduction of radiation exposure and better SNR and CNR.

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