Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms

Fellows’ Journal Club

A cohort of 204 patients were randomly divided into 2 groups. Patients in group A (n = 102) underwent 80-kVp CTA with 30 mL of contrast agent, while patients in group B (n = 102) underwent conventional CTA (120 kVp, 60 mL of contrast agent). With DSA as a reference standard, diagnostic accuracy on a per-aneurysm basis was 89.9% for group A and 93.9% for group B. The authors conclude that in detecting intracranial aneurysms, 80-kVp/30-mL contrast CTA provides the same diagnostic accuracy as conventional CTA with substantial radiation dose and contrast agent reduction.

Abstract

Figure 1 from paper
Comparison of the 2 CTA protocols for detecting an aneurysm in the posterior communicating artery. A and B, An 80-kVp cerebral CTA with 30 mL of contrast agent in a 49-year-old woman. A volume-rendered digital subtraction CTA image (A) shows an aneurysm in the left posterior communicating artery (red arrow), which is confirmed by 3D-DSA (B). C and D, A 120-kVp cerebral CTA with 60 mL of contrast agent in a 66-year-old woman. C, Volume-rendered digital subtraction CTA image (C) shows an aneurysm in the right posterior communicating artery (red arrow), which is confirmed by 2D-DSA (D).

BACKGROUND AND PURPOSE

Multidetector row CTA has become the primary imaging technique for detecting intracranial aneurysms. Technical progress enables the use of cerebral CTA with lower radiation doses and contrast media. We evaluated the diagnostic accuracy of 80-kV(peak) cerebral CTA with 30 mL of contrast agent for detecting intracranial aneurysms.

MATERIALS AND METHODS

Two hundred four patients were randomly divided into 2 groups. Patients in group A (n = 102) underwent 80-kVp CTA with 30 mL of contrast agent, while patients in group B (n = 102) underwent conventional CTA (120 kVp, 60 mL of contrast agent). All patients underwent DSA. Image quality, diagnostic accuracy, and radiation dose between the 2 groups were compared.

RESULTS

Diagnostic image quality was obtained in 100 and 99 patients in groups A and B, respectively (P = .65). With DSA as reference standard, diagnostic accuracy on a per-aneurysm basis was 89.9% for group A and 93.9% for group B. For evaluating smaller aneurysms ( .05) or between the 2 CTA groups (all, P > .05). The effective dose in group A was reduced by 72.7% compared with group B.

CONCLUSIONS

In detecting intracranial aneurysms with substantial radiation dose and contrast agent reduction, 80-kVp/30-mL contrast CTA provides the same diagnostic accuracy as conventional CTA.

 

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Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms
Jeffrey Ross
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