Image Quality and Radiation Exposure at Pulmonary CT Angiography with 100- or 120-kVp Protocol: Prospective Randomized Study

Heyer, C. M.; Mohr, P.; Lemburg, Stefan P.; Peters, Sören; Nicolas, Volkmar

doi:10.1148/radiol.2452061919

Cited by 256 publications

(141 citation statements)

References 45 publications

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“…-cerebral CT angiography [30,31] -pulmonary CT angiography [32][33][34] -aorto-iliac CT angiography [8,35,36] • Lowering of the tube voltage and/or tube current for non-contrast CT [37] • Reduction of the total number of imaging phases (e.g. split-bolus technique) [38,39] • Adjustment of image quality reference values of the automatic tube current modulation for oversized patients [40] • Reduction of the tube voltage and/or tube current for survey CT [41,42] • Positioning of the X-ray tube below the table for the survey CT (e.g.…”

Section: Resultsmentioning

confidence: 99%

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

et al. 2011

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Objectives To establish an education and training programme for the reduction of CT radiation doses and to assess this programme's efficacy. Methods Ten radiological institutes were counselled. The optimisation programme included a small group workshop and a lecture on radiation dose reduction strategies. The radiation dose used for five CT protocols (paranasal sinuses, brain, chest, pulmonary angiography and abdomen) was assessed using the dose-length product (DLP) before and after the optimisation programme. The mean DLP values were compared with national diagnostic reference levels (DRLs). Results The average reduction of the DLP after optimisation was 37% for the sinuses (180 vs. 113 mGycm, P< 0.001), 9% for the brain (982 vs. 896 mGycm, P<0.05), 24% for the chest (425 vs. 322 mGycm, P<0.05) and 42% for the pulmonary arteries (352 vs. 203 mGycm, P<0.001). No significant change in DLP was found for abdominal CT. The post-optimisation DLP values of the sinuses, brain, chest, pulmonary arteries and abdomen were 68%, 10%, 20%, 55% and 15% below the DRL, respectively. Conclusions The education and training programme for radiological institutes is effective in achieving a substantial reduction in CT radiation dose.

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Section: Resultsmentioning

confidence: 99%

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

et al. 2011

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“…Concerning third generation DSCT scanners, there is currently only one study by Sabel et al demonstrating that high-pitch CTPA in single-energy mode is feasible with this scanner generation, even though no distinct decrease in radiation dose was observed compared to standard pitch cohorts [18]. Independent of the vendor, scanner generation, and protocol used, several basic strategies have been proposed for effectively decreasing radiation exposure in chest examinations, for example limiting the scan volume from the aortic arch to the right diaphragm [31,32].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Petritsch¹,

Kosmala²,

Gassenmaier³

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZiel Das Potential der Dritt-Generation Dual-Source CT (DSCT) in der Lungenemboliediagnostik wurde bis dato noch nicht ausführlich untersucht. Ziel dieser Studie war es, Strahlendosisparameter sowie subjektive und objektive Bildqualität des aktuellsten DSCT Scanners im Single-Energy und Dual-Energy (DE) Modus mit einem herkömmlichen pulmonalen Standard CTA Protokoll am 64-Zeilen CT (SSCT) zu vergleichen. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Material und Methoden▪ Die Dual-Energy CT bietet potentiell zusätzliche Informationen durch die Erstellung von farbcodierten Jod-Karten. ABSTR AC TPurpose To compare radiation dose, subjective and objective image quality of 3 rd generation dual-source CT (DSCT) and dual-energy CT (DECT) with conventional 64-slice singlesource CT (SSCT) for pulmonary CTA.Materials and Methods 180 pulmonary CTA studies were performed in three patient cohorts of 60 patients each. Group 1: conventional SSCT 120 kV (ref.); group 2: single-energy DSCT 100 kV (ref.); group 3: DECT 90/Sn150 kV. CTDIvol, DLP, effective radiation dose were reported, and CT attenuation (HU) was measured on three central and peripheral levels. The signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) were calculated. Two readers assessed subjective image quality according to a five-point scale.Results Mean CTDIvol and DLP were significantly lower in the dual-energy group compared to the SSCT group (p < 0.001 [CTDIvol]; p < 0.001 [DLP]) and the DSCT group (p = 0.003 [CTDIvol]; p = 0.003 [DLP]), respectively. The effective dose in the DECT group was 2.79 ± 0.95 mSv and significantly smaller than in the SSCT group (4.60 ± 1.68 mSv, p < 0.001) and the DSCT group (4.24 ± 2.69 mSv, p = 0.003). The SNR and CNR were significantly higher in the DSCT group (p < 0.001).Subjective image quality did not differ significantly among the three protocols and was rated good to excellent in 75 % (135/180) of cases with an inter-observer agreement of 80 %.Conclusion Dual-energy pulmonary CTA protocols of 3 rd generation dual-source scanners allow for significant reduction of radiation dose while providing excellent image quality and potential additional information by means of perfusion maps. Key Points:▪ Dual-energy CT with 90/Sn150 kV configuration allows for significant dose reduction in pulmonary CTA. ▪ Subjective image quality was similar among the three evaluated CT-protocols (64-slice SSCT, single-energy DSCT, 90/Sn150 kV DECT) and was rated good to excellent in 75% of cases.

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“…This has the effect of maintaining the contrast-to-noise ratio, despite the increase in image noise consequent upon quantum mottle owing to reduced photon transmission. 38,39 Scope for lowering the radiation dose from Figure 3. A 30-year-old female who was 15 weeks pregnant presented with a sudden onset of pleuritic chest and back pain, a cough and small amounts of haemoptysis.…”

Section: Dosimetrymentioning

confidence: 99%

Diagnosing venous thromboembolism in pregnancy

Grüning

Mingo

Gosling

et al. 2016

BJR

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Objective: We report the imaging outcomes of all pregnant patients referred for suspected thromboembolism over a 43-month period. Methods: We identified 168 patients who underwent ventilation/perfusion (VQ) single-photon emission CT (SPECT), CT pulmonary angiography (CTPA) or a Doppler ultrasound scan of the lower legs, as well as a control group of 89 non-pregnant age-and sex-matched patients who underwent VQ SPECT during the same period. Imaging outcomes were recorded, and radiation doses were calculated for individual patients. Results: VQ SPECT and CTPA were equally likely to diagnose pulmonary embolism (PE) in about one patient out of every seven patients investigated. One in three CTPA scans was of suboptimal quality. A Doppler ultrasound examination of the legs will find deep venous thrombosis much less often, in about 1 patient out of every 15 patients investigated. The prevalence of PE in pregnant patients (as diagnosed by VQ SPECT) was similar to that in the non-pregnant, age-and sex-matched control group. The effective dose and the absorbed radiation dose to the maternal breast were lower with VQ SPECT. The foetal dose is comparable for both VQ SPECT and CTPA. Conclusion: VQ SPECT and CTPA provide a similar diagnostic yield for diagnosing PE during pregnancy, but VQ SPECT does so with a lower radiation dose to the mother (effective dose and breast dose). Advances in knowledge: Ours is the first report of the diagnostic performance of VQ SPECT, rather than planar VQ scans, in pregnancy in a routine clinical setting.

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Image Quality and Radiation Exposure at Pulmonary CT Angiography with 100- or 120-kVp Protocol: Prospective Randomized Study

Abstract: Reduction of kilovoltage from 120 to 100 kVp resulted in significant reduction of effective dose at pulmonary CT angiography, without significant loss of objective or subjective image quality.

Cited by 256 publications

References 45 publications

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Diagnosing venous thromboembolism in pregnancy

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