Evidence map›Paper›PMID 29493282›Full record

ArticleThe British journal of radiology2018

Diagnostic yield of 90-kVp low-tube-voltage carotid and intracerebral CT-angiography: effects on radiation dose, image quality and diagnostic performance for the detection of carotid stenosis.

Doris Leithner, Julian L Wichmann, Scherwin Mahmoudi, Simon S Martin, Moritz H Albrecht, Thomas J Vogl, Jan-Erik Scholtz

Open access · greenAbstract read
In one paragraph

Article in The British journal of radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Doris Leithner1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.
Julian L Wichmann1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.ORCID 0000-0001-5724-7344
Scherwin Mahmoudi1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.
Simon S Martin1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.
Moritz H Albrecht1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.
Thomas J Vogl1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.
Jan-Erik Scholtz1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.
Goethe University Frankfurt · DEUniversity Hospital Frankfurt · DEHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the impact of low-tube-voltage 90-kVp acquisition combined with advanced modeled iterative reconstruction algorithm (Admire) on radiation exposure, image quality, artifacts, and assessment of stenosis in carotid and intracranial CT angiography (CTA).

methodsDual-energy CTA studies of 43 patients performed on a third-generation 192-slice dual-source CT were retrospectively evaluated. Intraindividual comparison of 90-kVp and linearly blended 120-kVp equivalent image series (M_0.6, 60% 90-kVp, 40% Sn-150-kVp) was performed. Contrast-to-noise and signal-to-noise ratios of common carotid artery, internal carotid artery, middle cerebral artery, and basilar artery were calculated. Qualitative image analysis included evaluation of artifacts and suitability for angiographical assessment at shoulder level, carotid bifurcation, siphon, and intracranial by three independent radiologists. Detection and quantification of carotid stenosis were performed. Radiation dose was expressed as dose-length product (DLP).

resultsContrast-to-noise values of all arteries were significantly increased in 90-kVp compared to M_0.6 (p < 0.001). Suitability for angiographical evaluation was rated excellent with low artifacts for all levels in both image series. Both 90-kVp and M_0.6 showed excellent accordance for detection and grading of carotid stenosis with almost perfect interobserver agreement (carotid stenoses in 32 of 129 segments; intraclass correlation coefficient, 0.94). dose-length product was reduced by 40.3% in 90-kVp (110.6 ± 32.1 vs 185.4 ± 47.5 mGy·cm, p < 0.001).

conclusion90-kVp carotid and intracranial CTA with Admire provides increased quantitative and similarly good qualitative image quality, while reducing radiation exposure substantially compared to M_0.6. Diagnostic performance for arterial stenosis detection and quantification remained excellent. Advances in knowledge: 90-kVp carotid and intracranial CTA with an advanced iterative reconstruction algorithm results in excellent image quality and reduction of radiation exposure without limiting diagnostic performance.

Indexed as

AlgorithmsArtifactsCarotid StenosisComputed Tomography AngiographyFemaleHumansMaleMiddle AgedRadiation DosageRadiographic Image EnhancementRadiographic Image Interpretation, Computer-AssistedRetrospective Studies

Identifiers

PMID29493282
PMCPMC6223293
OpenAlexW2793347288

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.