Double Low-Dose Dual-Energy Liver CT in Patients at High-Risk of HCC: A Prospective, Randomized, Single-Center Study

Objectives The aim of this study was to investigate the clinical feasibility of the simultaneous reduction of radiation and contrast doses using spectral computed tomography (CT) in patients at high-risk for hepatocellular carcinoma. Materials and Methods Between May 2017 and March 2018, this prospective study recruited participants at risk of hepatocellular carcinoma with body mass indexes less than 30 and randomly assigned them to either the standard-dose group or the double low-dose group, which targeted 30% reductions in both radiation and contrast media (NCT03045445). Lesion conspicuity as a primary endpoint and lesion detection rates were then compared between hybrid iterative reconstruction (iDose) images of standard-dose group and low monoenergetic (50 keV) images of double low-dose group. Qualitative and quantitative image noise and contrast were also compared between the 2 groups. Participants and reviewers were blinded for scan protocols and reconstruction algorithms. Lesion conspicuity was analyzed using generalized estimating equation analysis. Lesion detection was evaluated using weighted jackknife alternative free-response receiver operating characteristic analysis. Results Sixty-seven participants (male-to-female ratio, 59:8; mean age, 64 ± 9 years) were analyzed. Compared with the standard-dose group (n = 32), significantly lower CTDIvol (8.8 ± 1.7 mGy vs 6.1 ± 0.6 mGy) and contrast media (116.9 ± 15.7 mL vs 83.1 ± 9.9 mL) were utilized in the do...
Source: Investigative Radiology - Category: Radiology Tags: Original Articles Source Type: research