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Liver Ct And Dose

  • Radiation Hepatitis: Facts
    - Develops 2 weeks to 4 months after radiation therapy
    - It is a form of veno-occlusive disease
    - Usually has a sharp boundary corresponding to the radiation ports, not vascular enhancement
    - Key differential diagnosis are hepatic infarction and focal fatty infiltration

     

  • "Image noise increased from 5.7 to 11.4 HU as the tube voltage decreased from 140 to 80 kVp resulting in a significantly lower image quality score (4.0 vs 3.0) with protocol B according to all readers. At the same time protocol B yielded significantly higher CNR and lesion conspicuity scores than protocol A, along with a lower effective dose (5.1 vs 17.5 mSv)"

    conclusion
    Lower kVp studies increase the "brightness" of vascular lesions while increasing image noise and giving a general lower image quality. However the doses may be 50% or gretaer lower with the lower kVp

    Hypervascular Liver Tumors: Low Tube Voltage, High Tube Current Multidetector CT during Late Hepatic Arterial Phase for Detection-Initial Clinical Experience
    Marin D et al.
    Radiology 2009; 251:771-779

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  • "By substantially increasing the tumor to liver CNR (contrast to noise ratio), a low tube voltage, high tube current CT technique improves the conspicuity of malignant hypervascular liver tumors during the late hepatic arterial phase while significantly reducing patient radiation dose."

    Hypervascular Liver Tumors: Low Tube Voltage, High Tube Current Multidetector CT during Late Hepatic Arterial Phase for Detection-Initial Clinical Experience
    Marin D et al.
    Radiology 2009; 251:771-779