Manual adjustment of tube voltage from 120 to 100 kVp during abdominal CT in patients with body weights ≤75 kg: assessment of image quality and radiation dose in a prospective, randomised trial.

AIM: To assess image quality and radiation dose in patients with body weights ≤75 kg undergoing abdominal computed tomography (CT) with a tube voltage of either 120 or 100 kVp. MATERIALS AND METHODS: Eighty patients weighing ≤75 kg were prospectively assigned to receive either 120 or 100 kVp abdominal CT in the portal-venous phase. Attenuation values of abdominal organs and image noise were measured, and the contrast-to-noise ratios (CNRs) were calculated. Subjective image quality was assessed by three independent radiologists. Radiation exposure was assessed by size-specific dose estimate (SSDE). RESULTS: The mean attenuation of the kidney increased by 20% at 100 kVp (p<0.0001), and the mean image noise was 27% higher in the 100 kVp (p=0.003). The CNR did not significantly differ between the groups (120 kVp, 6.6±2.8; 100 kVp, 7.4±3.6; p=0.26). Except for subjective image noise (p<0.001), no other subjective quality parameters (e.g., contrast, artefacts) were significantly different between the two groups (p between 0.094 and 0.761). The mean SSDE in the 100-kVp group (9.8±1.8 mGy) was reduced by 19% compared to the 120-kVp group (12.1±1.8 mGy; p<0.0001). CONCLUSION: Manual reduction of tube voltage from the standard 120 to 100 kVp for portal-venous phase CT in patients with body weights ≤75 kg resulted in a 19% dose reduction while maintaining objective and subjective image quality.

Comparison of Optimized 3D-SPACE and 3D-TSE Sequences at 1.5T MRCP in the Diagnosis of Choledocholithiasis.

PURPOSE: The aim of the study was to evaluate whether or not MRCP using a 3D-SPACE sequence allows for better image quality and a higher level of diagnostic confidence than a conventional 3D-TSE sequence at 1.5 T regarding the diagnosis of choledocholithiasis in a routine clinical setting. MATERIALS AND METHODS: 3D-SPACE and 3D-TSE sequences were performed in 42 consecutive patients with suspected choledocholithiasis undergoing MRCP. Evaluation of image quality and diagnostic confidence was done on the pancreaticobiliary tree which was subdivided into 10 segments. They were scored and statistically evaluated separately for visibility and diagnostic certainty by three radiologists with differing levels of experience on a five-point scale of 1 to 5 and -2 to 2, respectively. Student t-test was performed, and the interobserver agreement was also calculated. RESULTS: Image quality for each segment was significantly better for the 3D-SPACE sequence compared to the 3D-TSE sequence (4.48 ±â€Š0.94 vs. 3.98 ±â€Š1.20; 5-point scale p < 0.01). Diagnostic confidence for the reporting radiologist was also significantly better for 3D-SPACE than for 3D-TSE (1.68 ±â€Š0.56 vs. 1.46 ±â€Š0.70; 3-point scale; p < 0.01). The interobserver agreement was high in both sequences, 0.62 - 0.83 and 0.64 - 0.82, respectively. CONCLUSION: The optimized 3D-SPACE sequence allows for better image quality in 1.5 T MRCP examinations and leads to a higher diagnostic confidence for choledocholithiasis compared to the conventional 3D-TSE sequence. KEY POINTS: • 3D-SPACE allows for better image quality in 1.5 T MRCP.• This leads to a higher diagnostic confidence particularly in the periampullary region.• 3D-SPACE should be considered to substitute conventional 3D-TSE sequences in clinical routine MRCP.