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Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection--initial clinical experience.

Publication ,  Journal Article
Marin, D; Nelson, RC; Samei, E; Paulson, EK; Ho, LM; Boll, DT; DeLong, DM; Yoshizumi, TT; Schindera, ST
Published in: Radiology
June 2009

PURPOSE: To intraindividually compare a low tube voltage (80 kVp), high tube current computed tomographic (CT) technique with a standard CT protocol (140 kVp) in terms of image quality, radiation dose, and detection of malignant hypervascular liver tumors during the late hepatic arterial phase. MATERIALS AND METHODS: This prospective single-center HIPAA-compliant study had institutional review board approval, and written informed consent was obtained. Forty-eight patients (31 men, 17 women; age range, 35-77 years) with 60 malignant hypervascular liver tumors (mean diameter, 20.1 mm +/- 16.4 [standard deviation]) were enrolled. Pathologic proof of focal lesions was obtained with histopathologic analysis for 33 nodules and imaging follow-up after a minimum of 12 months for 27 nodules. Patients underwent dual-energy 64-section multi-detector row CT. By using vendor-specific software, two imaging protocols-140 kVp and 385 mA (protocol A) and 80 kVp and 675 mA (protocol B)-were compared during the late hepatic arterial phase of contrast enhancement. Paired t tests were used to compare tumor-to-liver contrast-to-noise ratio (CNR) for each lesion, mean image noise, and effective dose between the two data sets. Three readers qualitatively assessed the two data sets in a blinded and independent fashion. Lesion detection and characterization and reader confidence were recorded, as well as readers' subjective evaluations of image quality. Wilcoxon-Mann-Whitney statistical analysis was performed on this assessment. RESULTS: Image noise increased from 5.7 to 11.4 HU as the tube voltage decreased from 140 to 80 kVp (P < .0001), resulting in a significantly lower image quality score (4.0 vs 3.0, respectively) with protocol B according to all readers (P < .001). At the same time, protocol B yielded significantly higher CNR (8.2 vs 6.4) and lesion conspicuity scores (4.6 vs 4.1) than protocol A, along with a lower effective dose (5.1 vs 17.5 mSv) (P < .001 for all). CONCLUSION: By substantially increasing the tumor-to-liver CNR, a low tube voltage, high tube current CT technique improves the conspicuity of malignant hypervascular liver tumors during the late hepatic arterial phase while significantly reducing patient radiation dose.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

June 2009

Volume

251

Issue

3

Start / End Page

771 / 779

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Statistics, Nonparametric
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiation Dosage
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Iopamidol
 

Citation

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Marin, D., Nelson, R. C., Samei, E., Paulson, E. K., Ho, L. M., Boll, D. T., … Schindera, S. T. (2009). Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection--initial clinical experience. Radiology, 251(3), 771–779. https://doi.org/10.1148/radiol.2513081330
Marin, Daniele, Rendon C. Nelson, Ehsan Samei, Erik K. Paulson, Lisa M. Ho, Daniel T. Boll, David M. DeLong, Terry T. Yoshizumi, and Sebastian T. Schindera. “Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection--initial clinical experience.Radiology 251, no. 3 (June 2009): 771–79. https://doi.org/10.1148/radiol.2513081330.
Marin, Daniele, et al. “Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection--initial clinical experience.Radiology, vol. 251, no. 3, June 2009, pp. 771–79. Pubmed, doi:10.1148/radiol.2513081330.
Marin D, Nelson RC, Samei E, Paulson EK, Ho LM, Boll DT, DeLong DM, Yoshizumi TT, Schindera ST. Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection--initial clinical experience. Radiology. 2009 Jun;251(3):771–779.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

June 2009

Volume

251

Issue

3

Start / End Page

771 / 779

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Statistics, Nonparametric
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiation Dosage
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Iopamidol