Introduction: Use of CT in the investigation of pulmonary embolism in radiosensitive patients such as pregnant and young female patients entails the need for protocol optimization. The aim of this study was to analyze the dose reduction and image quality achieved by using 80 kV instead of 100 kV in CT pulmonary angiography protocols.Methods: 80 examinations of non-obese patients were analyzed (40 consecutive patients for each protocol, equally distributed on two CT scanners). Objective image quality was assessed by measurements of HU values (average and standard deviation) in five ROIs in pulmonary arteries and calculations of signal-to-noise (SNR) and contrast-to-noise ratios (CNR). Subjective image quality was independently evaluated by two radiologists in terms of perceived noise, sharp reproduction of pulmonary arteries and overall diagnostic quality. Radiation dose parameters (CTDIvol, DLP, SSDE and effective dose) and effective risk were compared. Differences in radiation dose and objective measures of image quality for the two protocols were assessed using the independent t test; comparison of subjective grading of image quality was performed with the Mann-Whitney U test.Results: Use of 80 kV significantly increased both arterial contrast enhancement and image noise. Differences in SNR and CNR between protocols were not statistically significant. Achieved dose reduction by using 80kV was significant on both scanners (SSDE reduction 35% and 46%, p<0.001; effective dose reduction 40% and 53%, p<0.001). Conclusion:Use of 80 kV protocols for CT examinations of pulmonary arteries in non-obese patients with bodyweight below 80kg results in significant reduction of radiation doses without compromising image quality.
Objectives: The aim of this study was to evaluate the effect of the choice of kernel on the image quality in abdominal CT images with focus on liver lesion visibility. Methods: In this comparative study 84 abdominal CT examinations of patients with liver lesions that included parallel series reconstructed with two different kernels (B30 and B45) were analyzed. The subjective assessment of image quality was performed using visual grading analysis based on anatomical criteria, liver lesion visibility and perceived image quality. Objective image quality was assessed by measurements of Hounsfield unit (HU) values (average and standard deviation) in abdominal organs and calculations of contrast-to-noise ratios (CNR). Results: B30 kernel performed significantly better than B45 in all criteria except for sharpness. The most considerable improvement of the image quality was in terms of subjective experienced image noise, overall diagnostic image quality and visually sharp reproduction of liver lesions. The physical measurements showed that CNR increased by up to 46% when using B30. Conclusions: Using a B30 kernel algorithm for image reconstruction reduces noise and by that improves image quality and diagnostic accuracy significantly when compared to B45.
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