Achille Mileto MD, Presenter: Nothing to Disclose

Daniele Marin MD, Abstract Co-Author: Nothing to Disclose

Juan Carlos Ramirez Giraldo PhD, Abstract Co-Author: Employee, Siemens AG

Christian Eusemann PhD, Abstract Co-Author: Employee, Siemens AG

Emanuele Scribano, Abstract Co-Author: Nothing to Disclose

Giorgio Ascenti MD, Abstract Co-Author: Nothing to Disclose

To compare the image quality of a dual-energy nonlinear image blending technique, at reduced load of contrast medium, with a full-dose simulated 120 kVp linear blending technique during the portal venous phase of the abdomen.

Forty-five patients (25 men, 20 women; mean age, 65.6±9.7 years; mean body weight, 74.9±12.4) underwent contrast-enhanced single-phase dual energy CT of the abdomen by a random assignment to one of three different contrast medium dose injection protocols using iomeprol 400 mgI/mL: (a) 1.3 mL of per kilogram of body weight (full dose, 100%), (b) 1.0 mL per kilogram of body weight (75%), and (c) 0.65 mL per kilogram of body weight (50%). Simulated 120 kVp linear blended images at full contrast dose, and nonlinear blended images at 75% and 50% contrast medium doses were reconstructed. Contrast-to-noise ratio and noise (at portal vein, liver, aorta, and kidney) were compared between the different datasets, using the analysis of variance. Three readers qualitatively assessed image quality for all data sets in a blinded and independent fashion. 

Nonlinear blended images at 75% contrast medium dose allows for a significant improvement in contrast-to-noise ratio (P < .05 for all comparisons) compared with simulated 120 kVp linear blended images at full dose. No statistically significant difference existed in contrast-to-noise ratio and noise between nonlinear blended images at 50% contrast medium dose and simulated 120 kVp linear blended images at full dose. Nonlinear blended images at 50% contrast medium dose were considered acceptable, by all readers.

Dual energy nonlinear image blending allows for reducing the dose of contrast medium up to 50% during portal venous phase, while preserving image quality.

The possibility of obtaining clinically adequate image quality with a 50% reduction of the contrast medium dose may be clinically exploited to minimize patient risks while containing costs.

Mileto, A, Marin, D, Ramirez Giraldo, J, Eusemann, C, Scribano, E, Ascenti, G, Impact of Nonlinear Image Blending Techniques for Contrast Medium Dose Reduction during Abdominal Dual Energy MDCT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007971.html