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1.
Diagnostics (Basel) ; 13(13)2023 Jun 30.
Article in English | MEDLINE | ID: mdl-37443622

ABSTRACT

OBJECTIVE: Double-low CT aortography (DLCTA) is increasingly used in follow-up studies of aortic aneurysm after endovascular aneurysm repair (EVAR). However, whether DLCTA can reliably detect the presence of endoleak is not clear. METHODS: From February 2014 to October 2019, patients who received EVAR, underwent CT surveillance, and had at least one standard CTA protocol (120 kVp, 400 mg I/kg) and one DLCTA (70-80 kVp, 200 mg I/kg) were included. The integrated findings of the standard CTA and sequential change were considered as the reference standard for the presence of endoleak. RESULTS: In all, 36 patients received TEVAR and 24 patients received EVAR; 62 standard CTA and 167 DLCTA results were analyzed. There were 2 type I (3.3%) and 12 type II (20.0%) endoleaks in 14 patients (23.3%). The performance of DLCTA in the diagnosis of endoleak reached 100% accuracy compared to that of standard CTA in case of the correction of CT findings by an expert second reading. Compared to the standard CTA, DLCTA scan reduced the radiation dose by 71% and the iodine dose by 50%. CONCLUSIONS: DLCTA with 70-80 kVp and 200 mg I/kg can reliably detect the presence of endoleak after TEVAR/EVAR.

2.
J Xray Sci Technol ; 31(3): 453-461, 2023.
Article in English | MEDLINE | ID: mdl-36806539

ABSTRACT

PURPOSE: This study aims to introduce a novel low-dose abdominal computed tomography (CT) protocol adapted with model-based iterative reconstruction (MBIR), To validate the adaptability of this protocol, objective image quality and subjective clinical scores of low-dose MBIR images are compared with the normal-dose images. METHODS: Normal-dose abdominal CT images of 58 patients and low-dose abdominal CT images of 52 patients are reconstructed using both conventional filtered back projection (FBP) and MBIR methods with and without smooth applying. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) are used to compare image quality between the normal-dose and low-dose CT scans. CT dose indices (CTDI) of normal-dose and low-dose abdominal CT images on post-contrast venous phase are also compared. RESULTS: The SNR, CNR and clinical score of low-dose MBIR images all show significant higher values (Bonferroni p < 0.05) than those of normal-dose images with conventional FBP method. A total of around 40% radiation dose reduction (CTDI: 5.3 vs 8.7 mGy) could be achieved via our novel abdominal CT protocol. CONCLUSIONS: With the higher SNR/CNR and clinical scores, the low-dose CT abdominal imaging protocol with MBIR could effectively reduce the radiation for patients and provide equal or even higher image quality and also its adaptability in clinical abdominal CT image diagnosis.


Subject(s)
Abdomen , Tomography, X-Ray Computed , Humans , Radiation Dosage , Tomography, X-Ray Computed/methods , Abdomen/diagnostic imaging , Signal-To-Noise Ratio , Radionuclide Imaging , Radiographic Image Interpretation, Computer-Assisted/methods , Algorithms
3.
J Cardiovasc Comput Tomogr ; 12(5): 404-410, 2018.
Article in English | MEDLINE | ID: mdl-29861397

ABSTRACT

BACKGROUND: To evaluate the frequency of renal artery dissection (RAD) and renal hypoperfusion in aortic dissection (AD) and its effect on subsequent renal atrophy in patients who did not undergo therapeutic intervention. METHODS: Initial CT data of 155 patients with acute AD (Stanford type A = 88, B = 67) were retrospectively analyzed. The false lumen statuses were patent (n = 94), partially thrombosed (n = 25), and completely thrombosed (n = 36) (also called as intramural hematoma (IMH)). Follow-up CT images of the surviving 122 patients (6-62.6 months, median, 28.9 months) were reviewed for analysis of sequential changes in renal volume. A regional decrease of ≧20 Hounsfield units in the renal cortex was defined as a renal hypo-enhancement sign (RHS). Simplified CT estimations of renal volume and estimated glomerular filtration rates (eGFR) were calculated. The generalized estimating equations (GEE) method was used to predict renal atrophy. RESULTS: Fifty of the 122 patients presented with 59 RAD in the current study, and a positive RHS was noted in 33.9% (20/59) of these involved kidneys. GEE analysis showed hypertension, surgical treatment for AD, presence of RAD, and positive RHS as significant risk factors for renal atrophy. Patients with RHS had the most severe form of renal atrophy. The severity of renal atrophy was mildly correlated with GFR change (γ2 = 0.044, p < 0.001). CONCLUSION: Renal atrophy in AD was predicted by the CT findings of RAD and RHS. The severity of renal atrophy was weakly reflected by eGFR.


Subject(s)
Aortic Aneurysm/diagnostic imaging , Aortic Dissection/diagnostic imaging , Aortography/methods , Computed Tomography Angiography , Kidney Diseases/diagnostic imaging , Kidney/blood supply , Multidetector Computed Tomography , Renal Artery/diagnostic imaging , Acute Disease , Aged , Aortic Dissection/epidemiology , Aortic Dissection/physiopathology , Aortic Aneurysm/epidemiology , Aortic Aneurysm/physiopathology , Atrophy , Female , Glomerular Filtration Rate , Humans , Kidney/pathology , Kidney/physiopathology , Kidney Diseases/epidemiology , Kidney Diseases/physiopathology , Male , Middle Aged , Predictive Value of Tests , Prevalence , Radiographic Image Interpretation, Computer-Assisted , Renal Artery/physiopathology , Renal Circulation , Retrospective Studies , Risk Factors , Severity of Illness Index , Taiwan/epidemiology
4.
Eur Radiol ; 23(5): 1226-33, 2013 May.
Article in English | MEDLINE | ID: mdl-23239060

ABSTRACT

OBJECTIVES: To validate the reliability of the visual coronary artery calcification score (VCACS) on low-dose CT (LDCT) for concurrent screening of CAC and lung cancer. METHODS: We enrolled 401 subjects receiving LDCT for lung cancer screening and ECG-gated CT for the Agatston score (AS). LDCT was reconstructed with 3- and 5-mm slice thickness (LDCT-3mm and LDCT-5mm respectively) for VCACS to obtain VCACS-3mm and VCACS-5mm respectively. After a training session comprising 32 cases, two observers performed four-scale VCACS (absent, mild, moderate, severe) of 369 data sets independently, the results were compared with four-scale AS (0, 1-100, 101-400, >400). RESULTS: CACs were present in 39.6 % (146/369) of subjects. The sensitivity of VCACS-3mm was higher than for VCACS-5mm (83.6 % versus 74.0 %). The median of AS of the 24 false-negative cases in VCACS-3mm was 2.3 (range 1.1-21.1). The false-negative rate for detecting AS ≥ 10 on LDCT-3mm was 1.9 %. VCACS-3mm had higher concordance with AS than VCACS-5mm (k = 0.813 versus k = 0.685). An extended test of VCACS-3mm for four junior observers showed high inter-observer reliability (intra-class correlation = 0.90) and good concordance with AS (k = 0.662-0.747). CONCLUSIONS: This study validated the reliability of VCACS on LDCT for lung cancer screening and showed that LDCT-3mm was more feasible than LDCT-5mm for CAD risk stratification. KEY POINTS: • Low-dose computed tomography (LDCT) rarely misses significant coronary artery calcification (CAC). • Visual scoring of CAC on LDCT is highly concordant with Agatston scoring. • LDCT-3mm is more feasible than LDCT-5mm for CAD risk stratification. • CAC assessment enriched the screening information for LDCT lung cancer screening.


Subject(s)
Calcinosis/diagnostic imaging , Calcinosis/epidemiology , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/epidemiology , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/epidemiology , Tomography, X-Ray Computed/statistics & numerical data , Comorbidity , Female , Humans , Incidence , Male , Mass Screening/statistics & numerical data , Middle Aged , Reproducibility of Results , Risk Assessment , Sensitivity and Specificity , Taiwan/epidemiology
5.
AJR Am J Roentgenol ; 190(4): 923-8, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18356438

ABSTRACT

OBJECTIVE: Coronary artery calcification (CAC) is frequently detected on low-dose ungated MDCT performed for lung cancer screening. We aimed to determine the concordance of CAC scores on low-dose ungated and regular-dose ECG-gated MDCT. SUBJECTS AND METHODS: The subjects were 513 patients consecutively registered for health screening and undergoing both low-dose ungated (120 kVp, 20 mAs) and regular-dose ECG-gated MDCT (120 kVp, 150 mAs, retrospective ECG gating). The first 30 cases were used for protocol optimization and a training session. Agatston score on regular-dose ECG-gated and low-dose ungated MDCT in the other 483 cases (320 men; mean age, 62.2 +/- 13.2 [SD] years) was calculated by two observers in a blinded manner. Interobserver and intertechnique scoring variability and concordance were calculated. RESULTS: The mean of interobserver scoring variability for regular-dose ECG-gated MDCT was 3.6% and for low-dose ungated MDCT was 9.6%. Regular-dose ECG-gated MDCT depicted CAC in 221 (46%) of the subjects. With low-dose ungated MDCT, observers 1 and 2, respectively, had five and seven false-positive and five and four false-negative predictions. All the miscategorized scores were 12 or less. The negative predictive values of CAC on low-dose ungated MDCT were 98% and 99% for observers 1 and 2, respectively. For patients with CAC, the mean intertechnique scoring variability was 40-43%. For all 483 subjects, the intertechnique concordance of the four major score ranks (0, 1-100, 101-400, > 400) was high (kappa = 0.89 for the two observers). CONCLUSION: Low-dose ungated MDCT with an optimized protocol is reliable for prediction of the presence of CAC and categorization of the four major Agatston score ranks. This technique may be useful for coronary artery disease risk stratification of persons undergoing low-dose ungated MDCT for lung cancer screening.


Subject(s)
Calcinosis/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Electrocardiography , False Negative Reactions , False Positive Reactions , Female , Humans , Male , Middle Aged , Prospective Studies , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted , Statistics, Nonparametric
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