Abdominal Dynamic CT in Patients with Renal Dysfunction: Contrast Agent Dose Reduction with Low Tube Voltage and High Tube Current-Time Product Settings at 256-Detector Row CT

Purpose: To evaluate the feasibility of a low-contrast agent dose protocol at abdominal dynamic computed tomography (CT) with a low tube voltage high tube current-time product technique and a 256-detector row CT unit. Materials and Methods: This prospective study received institutional review board approval; written informed consent to participate was obtained from all patients. The study included 151 patients; 117 had an estimated glomerular filtration rate (eGFR) greater than or equal to 60 mL/min/1.73 m(2). These patients were examined with the conventional 120-kVp protocol. The other 34 patients underwent scanning with an 80-kVp tube voltage, a high tube current-time product, and a 40% reduction in contrast agent dose. Effective dose (ED), image noise, attenuation, contrast-to-noise ratio (CNR), and figure of merit of the aorta in the arterial phase and of the portal vein and hepatic parenchyma in the portal venous phase in the two groups were compared with the Student t test. Results: Estimated ED was about 20% lower with the 80-kVp protocol than with the 120-kVp protocol. There were no significant differences in CNR in any region of interest between the 80-kVp protocol and the 120-kVp protocol (abdominal aorta: 36.9 +/- 9.7 [standard deviation] vs 36.1 +/- 8.1, P = .63; portal vein: 13.4 +/- 3.2 vs 13.1 +/- 3.2, P = .65; hepatic parenchyma: 6.4 +/- 2.6 vs 6.7 +/- 2.3, P = .51). Conclusion: Contrast dose at hepatic dynamic 256-detector row CT in patients with renal dysfunction can be decreased by 40% with this protocol by using the 80-kVp setting and a high tube current-time product. (C) RSNA, 2011