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A Comparison of the Image Quality and Radiation Dose With Routine Computed Tomography and the Latest Gemstone Spectral Imaging Combination of Different Scanning Protocols in Computed Tomography Angiography of the Kidney

Zhao, Yong-Xia PhD; Suo, Hong-Na MM; Zuo, Zi-Wei MM; Xu, Ying-jin MD; Chang, Jin PhD, MD

Journal of Computer Assisted Tomography: March/April 2017 - Volume 41 - Issue 2 - p 263–270
doi: 10.1097/RCT.0000000000000510
Abdominal Imaging

Objective The objective of our study was to compare the image quality and radiation dose of computed tomography angiography (CTA) of the kidney in patients with different body mass indexes using routine CT and the latest gemstone spectral imaging (GSI) combination of different scanning protocols with the adaptive statistical iterative reconstruction 2.0 algorithm.

Methods A total of 90 patients who had undergone a CTA of the kidney were divided into 3 groups (A, B, and C), with 30 patients in each group. Group A underwent a routine CT examination, whereas groups B and C underwent GSI with different scanning protocols. All images were restructured using the adaptive statistical iterative reconstruction 2.0. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were calculated when the kidney CTA was completed. Each subjective image evaluation used a 5-point scoring method and was conducted by 2 independent radiologists. The CT dose index of volume and the dose-length product were recorded, and the mean value was calculated. The dose-length product was converted to the effective dose. All data were compared with a 1-way analysis of variance.

Results The SNR, CNR, and subjective image quality in group A were significantly lower than those in groups B and C (P < 0.01). There were no significant differences in SNR, CNR, and subjective image quality between groups B and C. The effective dose of group C decreased by 46.05% and 15.03% relative to those of groups A and B, respectively (P < 0.01).

Conclusions The latest GSI with different scanning protocols can more effectively reduce the radiation dose than can the routine CT scan mode for a kidney CTA while still maintaining diagnostic image quality.

From the *Department of Radiology, The Affiliated Hospital of Hebei University; and †Medicine School, Hebei University, Baoding; and ‡School of Precision Instrument and Opto-Electronics Engineering, School of Life Science, Tianjin University, Tianjin, PR China.

Received for publication April 18, 2016; accepted June 15, 2016.

Correspondence to: Yong-Xia Zhao, PhD, Department of Radiology, The Affiliated Hospital of Hebei University, Baoding City 071000, Hebei Province, PR China (e-mail:

The authors declare no conflict of interest.

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