Improved image quality and low radiation dose with hybrid iterative reconstruction with 80kV CT pulmonary angiography

Laqmani, Azien; Regier, Marc; Veldhoen, Simon; Backhaus, Alexandra; Wassenberg, Felicia; Sehner, Susanne; Groth, Michael; Nagel, H. D.; Adam, Gerhard; Henes, Frank Oliver

doi:10.1016/j.ejrad.2014.06.016

Cited by 43 publications

(37 citation statements)

References 30 publications

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“…Dose reduction has been reported through reduction of milliampere seconds, 4,14,15 reduction of kVp [16][17][18] or application of iterative reconstruction. 19,20 Furthermore, high-pitch protocols in combination with automated tube potential selection have been shown to enable a significant dose reduction compared with standard protocols.…”

Section: Discussionmentioning

confidence: 99%

CT pulmonary angiography: simultaneous low-pitch dual-source acquisition mode with 70 kVp and 40 ml of contrast medium and comparison with high-pitch spiral dual-source acquisition with automated tube potential selection

Boos

Kröpil

Lanzman

et al. 2016

BJR

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Section: Discussionmentioning

confidence: 99%

CT pulmonary angiography: simultaneous low-pitch dual-source acquisition mode with 70 kVp and 40 ml of contrast medium and comparison with high-pitch spiral dual-source acquisition with automated tube potential selection

Boos

Kröpil

Lanzman

et al. 2016

BJR

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“…Already some advancements have been made using lower kV settings in CTA. [25][26][27][36][37][38] A decrease in kV increases intraarterial CM attenuation, because the higher photon energy at lower kV settings is closer to the iodine k-edge of keV. 4,24,39,40 Many studies focused on low kV protocols; however, one must ensure to concordantly increase mAs to avoid excessive image noise.…”

Section: Discussionmentioning

confidence: 99%

“…19,24 A further improvement in CNR could be achieved by alteration of reconstruction methods, for example, with the implementation of iterative reconstruction. [25][26][27] However, subjective image quality will not always be experienced as superior owing to possible loss of contrast between different densities.…”

Section: Discussionmentioning

confidence: 99%

Individually tailored contrast enhancement in CT pulmonary angiography

Hendriks

Kok

Mihl

et al. 2016

BJR

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Objective: The purpose was to evaluate individually shaped contrast media (CM) delivery in CT pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). Methods: 100 consecutive emergency patients with clinical suspicion of PE were evaluated. High-pitch CTPA was performed on a second-generation dual-source CT using the following parameters: 100 kV, 200-250 mAsref, rotation time 0.28 s, 128 3 0.6 mm col. and image reconstruction 1.0/0.8 mm (B30f). Group 1 (n 5 50) then received a fixed CM bolus (300 5 mgI ml 21, volume 5 90 ml and flow rate 5 6 ml s 21 ); Group 2 (n 5 50) received a body weightadapted CM bolus determined by dedicated contrast injection software. For analysis, groups were further subdivided into low-weight (40-75 kg) and high-weight (76-117 kg) groups. Technical image quality was graded using a four-point Likert scale (1 5 non-diagnostic; 2 5 diagnostic; 3 5 good and 4 5 excellent image quality) at the level of the pulmonary trunk and pulmonary arteries. Objective image quality analysis was performed by measuring contrast enhancement in Hounsfield units (HU) at the same levels. Attenuation levels . 180 HU were considered diagnostic. Results: All examinations were graded as diagnostic at each level. The individual minimum pulmonary attenuation was 184 and 270 HU for Group 1 and 2, respectively. Mean attenuation was as follows: Group 1: 475 6 105 HU (40-75 kg) and 402 6 115 HU (76-117 kg), p , 0.03. Group 2: 424 6 76 HU (40-75 kg) and 418 6 100 HU (76-117 kg), p 5 0.8. For Group 2, CM volumes were: 55 6 5 ml (40-75 kg) and 66 6 5 ml (76-117 kg), leading to 16-51% CM reduction. Conclusion: Even under emergency conditions, individualized CM protocols can provide diagnostic and robust image quality in CTPA for PE with a substantial reduction of CM volume for lower weight patients, compared with a fixed CM protocol. Advances in knowledge: CM volume can substantially be reduced by using individualized CM protocols in CT angiography for PE without compromising the diagnostic image quality.

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“…Segmental and subsegmental PE can be reliably detected with latest CT scanners having superior spatial and temporal resolution [22,23]. Low-dose CTPA protocol has been increasingly used with significant reduction of radiation and contrast medium doses while still achieving acceptable diagnostic images [24][25][26][27][28][29][30][31][32][33][34][35]. This has led to the increasing use of CTPA in patients with suspected PE which raises the concern of inappropriately increased use of this examination in patients with low probability of PE.…”

Section: Research Articlementioning

confidence: 99%

Diagnostic yield of CT pulmonary angiography in the diagnosis of pulmonary embolism: A single center experience

Sun¹,

Lei²

2017

Interventional-Cardiology

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The purpose of this study was to investigate the clinical application of computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary embolism (PE) based on a single-center experience. Medical records and radiological reports of 450 patients (272 men and 178 women; mean age 58.9 years; range 14-95 years) with suspected PE who underwent CTPA and triple rule-out CT scans over a period of 6 months were retrospectively reviewed. Prevalence of PE was analysed to determine the diagnostic yield of CT in these two scanning protocols. Of 450 patient records, the positive rate of PE was 30.7%. Triple rule-out CT protocol was performed in 75 out of 450 patients with the diagnostic yield of PE being only 8% (6 out of 75 patients had PE), which is significantly lower than the 35.2% as shown in the CTPA group (132 out of 375 had PE). Mean effective dose was 2.8±2.6 mSv and 13.5±7.8 mSv for CTPA and triple rule-out protocols, respectively. This study shows that CTPA has high diagnostic yield in the diagnosis of pulmonary embolism, hence justifying its appropriateness as a routine imaging modality. However, triple rule-out CT is not recommended due to the low diagnostic yield. Further reduction in radiation and contrast medium doses is necessary.

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Improved image quality and low radiation dose with hybrid iterative reconstruction with 80kV CT pulmonary angiography

Cited by 43 publications

References 30 publications

CT pulmonary angiography: simultaneous low-pitch dual-source acquisition mode with 70 kVp and 40 ml of contrast medium and comparison with high-pitch spiral dual-source acquisition with automated tube potential selection

CT pulmonary angiography: simultaneous low-pitch dual-source acquisition mode with 70 kVp and 40 ml of contrast medium and comparison with high-pitch spiral dual-source acquisition with automated tube potential selection

Individually tailored contrast enhancement in CT pulmonary angiography

Diagnostic yield of CT pulmonary angiography in the diagnosis of pulmonary embolism: A single center experience

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