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Indirect Computed Tomography Venography With a Low-Tube-Voltage Technique: Reduction in the Radiation and Contrast Material Dose-A Prospective Randomized Study

Oda, Seitaro MD*; Utsunomiya, Daisuke MD*; Awai, Kazuo MD; Takaoka, Hiroko MD*; Nakaura, Takeshi MD; Katahira, Kazuhiro MD§; Morishita, Syoji MD§; Namimoto, Tomohiro MD*; Yamashita, Yasuyuki MD*

Journal of Computer Assisted Tomography: September-October 2011 - Volume 35 - Issue 5 - p 631-636
doi: 10.1097/RCT.0b013e31822a563d
Cardiovascular Imaging

Objective: The objective of the study was to investigate the effects of low-tube-voltage computed tomography (CT) venography on qualitative and quantitative image parameters and the radiation dose.

Methods: Eighty-eight studies on 84 patients underwent pelvic and lower-extremity CT venography under protocol A (standard 120 kV with 150 mL of contrast material, n = 44) or protocol B (80 kV with 100 mL of contrast material, n = 44) on a 64-detector CT scanner. We compared the dose length product in the 2 protocols. Two blinded observers measured CT attenuation in the veins, the image noise, contrast-to-noise ratio, and figure of merit.

Results: The mean dose length product was significantly lower under protocol B than A (603.2 [SD, 67.2] vs 1131.7 [SD, 67.0] mGy × cm) (P < 0.01). Mean CT attenuation of the veins was significantly greater with protocol B (125.3 [SD, 16.2] vs 106.1 [SD, 16.0] Hounsfield units) (P < 0.01), and the mean image noise was also significantly higher under protocol B (6.6 [SD, 0.8] vs 4.9 [SD, 0.7] Hounsfield units) (P < 0.01). There was no difference in contrast-to-noise ratio (P = 0.46). Figure of merit was significantly higher under protocol B (P < 0.01).

Conclusions: Computed tomography venography with a low-tube-voltage technique allows reducing the radiation dose and the amount of contrast material without image quality degradation.

From the *Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto; †Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima; ‡Department of Diagnostic Radiology, Amakusa Regional Medical Center; and §Department of Diagnostic Radiology, Kumamoto Chuo Hospital, Kumamoto, Japan.

Received for publication April 8, 2011; accepted June 21, 2011.

Reprints: Seitaro Oda, MD, Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan (e-mail:

We have no direct or indirect financial interest in the products under investigation or subject matter discussed in this article.

© 2011 Lippincott Williams & Wilkins, Inc.