Study on the Feasibility of Brain CT Perfusion with 70 kV Tube Voltage_West China Medical Journal

Authors：

 LIWan-jiang , ZHANGKai , PENGLi-qing ,  LIZhen-lin

Department of Radiology, West China Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIZhen-lin, Email: lzlcd01@126.com

Keywords：

Brain; Tomography; X-ray computed; Perfusion; Radiation dose

DOI：

10.7507/1002-0179.20150546

Video：

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Objective To investigate the influence of 70 kV low-dose CT perfusion technique on brain CT perfusion parameter maps and image quality. Methods Retrospective analysis of all patients who underwent CT perfusion of brain between October 2013 and February 2014 was carried out. The patients were randomly divided into two groups according to diTherent CT examination dose: group A (80 kV, 200 mAs) and group B (70 kV, 200 mAs). All patients were scanned on a dual-source-CT (Siemens Definition Flash). Fifteen normal subjects without brain diseases in each group were selected to be studied. Region of interest (ROI) with an area of 80 mm² was placed in the nucleus, putamen, thalamus, periventricular white matter of the frontal lobe and temporo-occipital area, and the parameters in the ROI including cerebral blood flow, cerebral blood volume, mean transit time and time to peak were detected. The carrierto-noise ratio and signal-to-noise ratio of thalamus and periventricular white matter of the frontal lobe were contrasted. The image quality of perfusion was assessed by two senior radiologists using 5 point system for blind assessment (5=best, 1=worst). The measurement of radiation dose was studied through effective dose, volume CT dose index (CTDIVOL) and dose length product (DLP). Statistical analysis was performed by independent sample t test. Results There was no significant difference between group A and group B in brain CT perfusion parameters (P>0.05). There was no significant diTherence in image quality between the two groups in the objective and subjective assessment (P>0.05). In comparison with group A, the measured effective dose, CTDIVOL and DLP for group B decreased by 35%. Conclusion There was no significant influence on the brain CT perfusion parameters and image quality using 70 kV tube voltage, and radiation dose is decreased obviously.

Citation： LIWan-jiang, ZHANGKai, PENGLi-qing, LIZhen-lin. Study on the Feasibility of Brain CT Perfusion with 70 kV Tube Voltage. West China Medical Journal, 2015, 30(10): 1910-1913. doi: 10.7507/1002-0179.20150546 Copy

1.	Juluru K, Shih JC, Raj A, et al. Effects of increased image noise on image quality and quantitative interpretation in brain CT perfusion[J]. AJNR Am J Neuroradiol, 2013, 34(8):1506-1512.
2.	Wintermark M, Reichhart M, Thiran JP, et al. Prognostic accuracy of cerebral blood flow measurements by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients[J]. Ann Neurol, 2002, 51(4):417-432.
3.	Goh V, Halligan S, Bartram CI. Quantitative tumor perfusion assessment with multi-detector CT:are measurements from two commercial software package interchangeable?[J]. Radiology, 2007, 242(3):777-782.
4.	Gillard JH, Antoun NM, Burnet NG, et al. Reproducibility of quantitative CT perfusion imaging[J]. Br J Radiol, 2001, 74(882):552-555.
5.	张金玲, 王雪红, 马志文. 迭代重建方法在低剂量全脑灌注成像及血管成像的可行性探讨[J]. 哈尔滨医科大学学报, 2013, 47(5):449-451.
6.	Marin D, Nelson RC, Schindera ST, et al. Low-tube-voltage, high-tube-current multi-detector abdominal CT:improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm-initial clinical experience[J].Radiology, 2010, 254(1):145-153.
7.	Bodelle B, Klement D, Kerl JM, et al. 70 kV computed tomography of the thorax:valence for computer-assisted nodule evaluation and radiation dose-first clinical results[J]. Acta Radiol, 2014, 55(9):1056-1062.
8.	ICRP. The 2007 recommendations of the International Commission on Radiological Protection. ICRP Publication 103[J]. Ann ICRP, 2007, 37(2/3/4):1-332.
9.	Hoang JK, Wang C, Frush DP, et al. Estimation of radiation exposure for brain perfusion CT:standard protocol compared with deviations in protocol[J]. AJR Am J Roentgenol, 2013, 201(5):W730-W734.
10.	United States Food and Drug Administration website. Safety investigation of CT brain perfusion scans:update 11/9/2010[EB/OL]. (2010-11-09)[2013-07-05]. http://www.fda.gov/medicaldevicesmedicaldevices/safety/alertsandnotices/ucm185898.htm.
11.	Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure[J]. N Engl J Med, 2007, 357(22):2277-2284.
12.	Zhang J, Wang J, Geng D, et al. Whole-brain CT perfusion and CT angiography assessment of moyamoya disease before and after surgical revascularization:preliminary study with 256-slice CT[J]. PLoS One, 2013, 8(2):e57595.
13.	Sakamoto S, Ohba S, Shibukawa M, et al. CT perfusion imaging for childhood moyamoya disease before and after surgical revascularization[J]. Acta Neurochir (Wien), 2006, 148(1):77-81.
14.	Wintermark M, Maeder P, Verdun FR, et al. Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow[J]. AJNR Am J Neuroradiol, 2000, 21(10):1881-1884.
15.	Koenig M, Bueltmann E, Hering von Diepenbroick V, et al. Increase of contrast signal by means of low-tube voltage in CT perfusion imaging of the brain[J]. Radiology, 2001, 221(Suppl):346.
16.	罗沛霖, 李龙, 周毅方, 等. 不同管电流对正常颅脑CT灌注参数和辐射剂量的影响[J]. 临床放射学杂志, 2013, 31(2):277-282.

1. Juluru K, Shih JC, Raj A, et al. Effects of increased image noise on image quality and quantitative interpretation in brain CT perfusion[J]. AJNR Am J Neuroradiol, 2013, 34(8):1506-1512.
2. Wintermark M, Reichhart M, Thiran JP, et al. Prognostic accuracy of cerebral blood flow measurements by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients[J]. Ann Neurol, 2002, 51(4):417-432.
3. Goh V, Halligan S, Bartram CI. Quantitative tumor perfusion assessment with multi-detector CT:are measurements from two commercial software package interchangeable?[J]. Radiology, 2007, 242(3):777-782.
4. Gillard JH, Antoun NM, Burnet NG, et al. Reproducibility of quantitative CT perfusion imaging[J]. Br J Radiol, 2001, 74(882):552-555.
5. 张金玲, 王雪红, 马志文. 迭代重建方法在低剂量全脑灌注成像及血管成像的可行性探讨[J]. 哈尔滨医科大学学报, 2013, 47(5):449-451.
6. Marin D, Nelson RC, Schindera ST, et al. Low-tube-voltage, high-tube-current multi-detector abdominal CT:improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm-initial clinical experience[J].Radiology, 2010, 254(1):145-153.
7. Bodelle B, Klement D, Kerl JM, et al. 70 kV computed tomography of the thorax:valence for computer-assisted nodule evaluation and radiation dose-first clinical results[J]. Acta Radiol, 2014, 55(9):1056-1062.
8. ICRP. The 2007 recommendations of the International Commission on Radiological Protection. ICRP Publication 103[J]. Ann ICRP, 2007, 37(2/3/4):1-332.
9. Hoang JK, Wang C, Frush DP, et al. Estimation of radiation exposure for brain perfusion CT:standard protocol compared with deviations in protocol[J]. AJR Am J Roentgenol, 2013, 201(5):W730-W734.
10. United States Food and Drug Administration website. Safety investigation of CT brain perfusion scans:update 11/9/2010[EB/OL]. (2010-11-09)[2013-07-05]. http://www.fda.gov/medicaldevicesmedicaldevices/safety/alertsandnotices/ucm185898.htm.
11. Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure[J]. N Engl J Med, 2007, 357(22):2277-2284.
12. Zhang J, Wang J, Geng D, et al. Whole-brain CT perfusion and CT angiography assessment of moyamoya disease before and after surgical revascularization:preliminary study with 256-slice CT[J]. PLoS One, 2013, 8(2):e57595.
13. Sakamoto S, Ohba S, Shibukawa M, et al. CT perfusion imaging for childhood moyamoya disease before and after surgical revascularization[J]. Acta Neurochir (Wien), 2006, 148(1):77-81.
14. Wintermark M, Maeder P, Verdun FR, et al. Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow[J]. AJNR Am J Neuroradiol, 2000, 21(10):1881-1884.
15. Koenig M, Bueltmann E, Hering von Diepenbroick V, et al. Increase of contrast signal by means of low-tube voltage in CT perfusion imaging of the brain[J]. Radiology, 2001, 221(Suppl):346.
16. 罗沛霖, 李龙, 周毅方, 等. 不同管电流对正常颅脑CT灌注参数和辐射剂量的影响[J]. 临床放射学杂志, 2013, 31(2):277-282.

West China Medical Journal

Study on the Feasibility of Brain CT Perfusion with 70 kV Tube Voltage

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