Evaluation of Deep Vein Thrombosis With Reduced Radiation and Contrast Material Dose at Computed Tomography Venography - Clinical Application of a Combined Iterative Reconstruction and Low-Tube-Voltage Technique

Background: Computed tomography venography (CTV) is clinically useful and widely available for the detection of deep vein thrombosis. Disadvantages of CTV are the need for a larger amount of i.v. contrast material (CM) and radiation exposure. A low-tube-voltage technique with iterative reconstruction may overcome this problem. The aim of this study was to investigate the effects of hybrid iterative reconstruction (HIR) on image quality at low-tube-voltage CTV. Methods and Results: Forty patients (26 women, 14 men; mean age, 59.2 +/- 18.3 years) underwent CTV under an 80- or 120-kV protocol (CT dose index volume=10.3 mGy vs. 14.9 mGy, CM dose=540 mgl/kg vs. 690 mgl/kg) on a 64-detector CT. Quantitative parameters (ie, venous attenuation, image noise, and contrast-to-noise ratio [CNR]) were calculated and the image quality was scored on a 4-point scale. In step 1, the 80- and 120-kV protocols were compared under filtered back projection (FBP). In step 2, the 80-kV protocol with HIR was compared with the 120-kV protocol with FBP. In step 1, the visual scores were significantly higher under the 120-kV protocol; there was no significant difference in CNR between the protocols. In step 2, CNR was significantly higher under the 80-kV protocol with HIR than the 120-kV protocol with FBP. The visual scores of the 2 protocols were comparable. Conclusions: The 80-kV CTV with HIR allows for a reduction in the radiation dose by 30% and the CM dose by 20% without image quality degradation. (Circ J 2012; 76: 2614-2622)