Effect of Low Tube Voltage (100 kV) Combined with ASIR-V on the Visualization and Image Quality of the Adamkiewicz Artery: A Comparison with 120 kV Protocol

Objective: To evaluate the effect of low tube voltage (100 kV) combined with adaptive statistical iterative reconstruction-V (ASIR-V) on the visualization and image quality of the Adamkiewicz artery (AKA). Methods: One hundred patients were prospectively enrolled and randomly assigned into two groups (both n = 50). Group A (100 kV) was reconstructed with filtered back projection (FBP) and ASIR-V from 10% to 100% with 10% intervals. Group B (120 kV) was only reconstructed with FBP. The objective image quality was evaluated by using CT values of the aorta (CT(Aorta)), background noise, signal-to-noise ratio of the descending aorta (SNR(Aorta)), and contrast-to-noise ratio of the spinal cord (CNR(Spinal cord)). The subjective image quality and visualization scores of the AKA were assessed on a 5-point scale. Results: CT(Aorta) was significantly higher in Group A than in Group B (p < 0.001). When ASIR-V weights were ≥60%, significant differences were found in the background noise, SNR(Aorta), and CNR(Spinal cord) between the two groups (all p < 0.05). In Group A, compared with FBP, the subjective score gradually increased as ASIR-V increased to 80%, which decreased when ASIR-V exceeded 80%. The visualization scores of the AKA (≥60%) and the ability to detect vessel continuity (≥80%) gradually increased as the ASIR-V weights increased (p < 0.05). The effective radiation dose was reduced by about 40.36% in Group A compared to Group B. Conclusions: compared with conventional scanning protocol, using a combination of low tube voltage (100 kV) and 80% ASIR-V protocol could not only increase the visualization of the AKA, but also improve image quality and reduce the radiation doses.