| Gao Kai,Ma Zepeng,Zhang Tianle,et al.The value of gemstone spectral imaging (GSI) in abdominal CT enhancement scanning of overweight and obese patients[J].Chinese Journal of Radiological Medicine and Protection,2024,44(11):971-978 |
| The value of gemstone spectral imaging (GSI) in abdominal CT enhancement scanning of overweight and obese patients |
| Received:January 25, 2024 |
| DOI：10.3760/cma.j.cn112271-20240125-00031 |
| KeyWords:Abdominal CT enhancement scanning Spectral imaging Low tube voltage Low contrast medium concentration Radiation dose |
| FundProject:河北省2020年度重点研发计划项目(20377765D);河北省2020年度医学科学研究课题计划项目(20200572);河北省医学适用技术跟踪项目(GZ2023093);河北大学医学学科培育项目(2021A10);保定市科技计划项目(2141ZF307);大学生创新创业项目(202310075014) |
| Author Name | Affiliation | E-mail | | Gao Kai | Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China
Department of Radiology, Affiliated Hospital of Hebei University, Baoding 071000, China | | | Ma Zepeng | Department of Radiology, Affiliated Hospital of Hebei University, Baoding 071000, China | | | Zhang Tianle | Department of Radiology, Affiliated Hospital of Hebei University, Baoding 071000, China | | | Liu Ziyan | Department of Radiology, Affiliated Hospital of Hebei University, Baoding 071000, China | | | Ding Wei | Department of Radiology, Affiliated Hospital of Hebei University, Baoding 071000, China | | | Zhao Yongxia | Department of Radiology, Affiliated Hospital of Hebei University, Baoding 071000, China | zyx_zyx999@163.com |
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| Abstract:: |
| Objective To compare the image quality, radiation dose, and total iodine content of abdominal computed tomography (CT) enhancement scanning of overweight and obese patients with different scanning protocols, and to explore the optimal keV image serial for abdominal CT. Methods A total of 90 overweight or obese patients [24 kg/m2 ≤ body mass index (BMI) < 28 kg/m2 or BMI ≥ 28 kg/m2] were divied into groups A, B and C, with 30 patients in each group. Group A used Gemstone spectral imaging (GSI) mode and contrast medium with 320 mg I/ml, group B used low tube voltage mode (100 kVp) and contrast medium with 370 mg I/ml, and group C used conventional tube voltage mode (120 kVp) and contrast medium with 370 mg I/ml. Monochromatic energy images at 50-70 keV (5 keV interval) were reconstructed for the arterial and portal vein phases of group A. Radiation dose and total iodine content were recorded and calculated for the 3 groups. The region of interest was placed on the organ, blood vessel, and erector spinae muscle at same level. The CT values and image noise values were measured, and the contrast-to-noise ratio (CNR) was calculated. All images were scored subjectively in double-blinded by two radiologists. One-way analysis of variance or Kruskal-Wallis H test were used to compare The CT values, CNRs, and subjective scores of each subgroup image in group A, group B and group C, and the radiation doses and total iodine contents in 3 groups were compared. The optimal keV value for group A was selected. Results At 50-60 keV, the CT values and CNRs of arterial and portal vein phases in group A were higher (P < 0.05) than or similar to those in groups B and C (P > 0.05), and the subjective scores were lower than those of groups B and C at 50 and 55 keV (H = 34.47, 41.27, P < 0.05), whereas there was no statistically significant difference at 60 keV (P > 0.05). At 65 and 70 keV, only the CT value and CNR of the renal cortex in group A at the 65 keV of arterial phase were higher than those in groups B and C (F = 102.38, 29.47, P < 0.001). The subjective scores were not significantly between groups B and C (P > 0.05). There were no statistically significant difference between CT values, CNRs, or subjective scores in group B and group C (P > 0.05). The effective doses in groups A and B were 24.72% and 25.78% lower than those in group C, respectively. Compared to groups B and C, the total iodine content in group A decreased by 12.50% and 13.34%, respectively. Conclusions GSI model combined with a low-concentration contrast medium in abdominal CT for overweight and obese patients can meet the image quality requirements while reducing patient total iodine content and radiation dose. The optimal keV value of enhanced abdominal CT for double phases was 60 keV. |
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