Application value of 60 kVp tube voltage combined with artificial intelligence iterative reconstruction in head and neck CT angiography
ZHAO Minjie
ZHOU Changsheng
BAO Xueqin
YI Dongna
LIAO Anyu
ZHU Wusheng
CHENG Xiaoqing
ZHANG Longjiang
Abstract：Objective To investigate the feasibility of 60 kVp ultra-low tube voltage combined with artificial intelligence iterative reconstruction(AIIR)in head and neck CT angiography(CTA).Methods A total of 120 patients undergoing head and neck CTA were prospectively enrolled and randomly divided into 4 groups(30 cases per group):Group A[100 kVp,40 mL contrast agent,hybrid iterative reconstruction(HIR)],Group B(80 kVp,40 mL contrast agent,HIR),Group C(60 kVp,40 mL contrast agent,AIIR level 3 and 4,recorded as C3 and C4),and Group D(60 kVp,20 mL contrast agent,AIIR level 3 and 4,recorded as D3 and D4).Subjective image quality scores(5-point scale),objective parameters[noise,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)],radiation dose[CT dose index(CTDIvol),dose-length product(DLP),and effective dose(ED)]were compared among groups.Diagnostic accuracy was assessed using digital subtraction angiography(DSA)as the reference standard.Continuous variables were analyzed using one-way ANOVA or the Kruskal-Wallis test,categorical variables using the chi-square test,and interobserver agreement was assessed using Cohen's Kappa test.Results Baseline characteristics were well balanced among the 4 groups(all P>0.05).The subjective image quality scores were≥3 in all groups,with no significant differences among groups(all P>0.05),and inter-reader agreement was good(all κ≥0.675).Compared with Group A,image noise was significantly reduced in Group C3,C4,D3,and D4(all P<0.05).while SNR and CNR were significantly increased(all P<0.05).No significant difference was found between Groups B and A(P>0.05).The mean CT values in the low-dose groups were comparable to or significantly higher than those in Group A.Thirteen patients underwent DSA examination,and comparison with DSA demonstrated a diagnostic accuracy of 100%for CTA in all groups.Compared with Group A,radiation dose was reduced by 44.7%,77.3%,and 77.3%in Groups B,C,and D,respectively.Conclusion The 60 kVp head and neck CTA protocol combined with AIIR can maintain diagnostic-level image quality while reducing radiation dose by 77%and contrast agent volume by 50%.
Keywords：Low-doseTomographyX-ray computedHead and neck CT angiographyRadiation doseArtificial intelligence iterative reconstruction
Publication Date：2026-03-15
Online Publishing Date：2026-04-01(First online date of this platform, not the publication date of the document)
Pages：6( 125-130 )