Optimisation of the CT pulmonary angiogram (CTPA) protocol using a low kV technique combined with high iterative reconstruction (IR): A phantom study

Bellizzi, Annalise; Bezzina, Paul; Zarb, Francis

doi:10.1016/j.radi.2022.11.011

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…In order to reduce radiation damage, recent studies tried to adopt a machine-learning radiomics model based on radiographic features observed on non-enhanced CT scans or low-dose CT scans to recognize pulmonary consolidation in the early stage of NP in children [ 96 , 97 ]. Moreover, studies have found that lower kV combined with high Iterative Reconstruction in the CT pulmonary angiogram can maintain image quality [ 98 , 99 ].…”

Section: Prediction and Early Recognitionmentioning

confidence: 99%

Necrotizing Pneumonia in Children: Early Recognition and Management

Chen

Wang

et al. 2023

JCM

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Necrotizing pneumonia (NP) is an uncommon complicated pneumonia with an increasing incidence. Early recognition and timely management can bring excellent outcomes. The diagnosis of NP depends on chest computed tomography, which has radiation damage and may miss the optimal treatment time. The present review aimed to elaborate on the reported predictors for NP. The possible pathogenesis of Streptococcus pneumoniae, Staphylococcus aureus, Mycoplasma pneumoniae and coinfection, clinical manifestations and management were also discussed. Although there is still a long way for these predictors to be used in clinical, it is necessary to investigate early predictors for NP in children.

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Section: Prediction and Early Recognitionmentioning

confidence: 99%

Necrotizing Pneumonia in Children: Early Recognition and Management

Chen

Wang

et al. 2023

JCM

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Low dose CTPA using a low kV technique combined with high IR: A clinical study

2023

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Application value of individualized tube voltage, contrast injection, and adaptive statistical iterative reconstruction V algorithm based on body mass index in renal computed tomography angiography for radiation and iodinated contrast dose reduction

Li,

Xiao,

Cao

et al. 2024

British Journal of Radiology

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Objectives To explore the application value of body mass index (BMI)-based kilovoltage peak (kVp) selection and contrast injection protocol combined with different adaptive statistical iterative reconstruction V (ASIR-V) strengths in renal computed tomography angiography (CTA) in reducing radiation and contrast medium (CM) doses. Methods One-hundred renal CTA patients were prospectively enrolled and were divided into individualized kVp group (group A, n = 50) and conventional 100 kVp group (group B, n = 50), both with automatic tube current modulation and CM of Iohexol at 350 mgI/mL concentration. Group A: 70 kVp, noise index (NI) of 18 and CM dose rate of 17 mgI/kg/s for 10 s for BMI <25 kg/m2 patients; 80 kVp, NI = 17, and CM dose rate of 19 mgI/kg/s for 10 s for 25 kg/m2≤BMI≤30 kg/m2 patients. Group B: 100 kVp, 50 mL of CM at the flow rate of 4.5 mL/s. The objective image quality, effective radiation dose, CM dose, injection rate, and image quality were compared between the 2 groups. Results There was no significant difference in patient characteristics between the 2 groups (P > .05). Compared to group B, group A significantly reduced effective radiation dose by 28.4%, CM dose by 27.2%, and injection rate by 22.7% (all P < .001). The 2 groups had similar SD values in erector spine (P > .05). Group A had significantly higher CT values, SNR, and CNR values of the renal arteries than group B (all P < .001). The 2 radiologists had excellent agreement (Kappa value > 0.8) in the subjective scores of renal CTA images and showed no statistically significant difference between the 2 groups (4.57 ± 0.42 vs 4.41 ± 0.49) (P > .05). Conclusions BMI-based scan and reconstruction protocol in renal CTA significantly reduces radiation and contrast doses while maintaining diagnostic image quality. Advances in knowledge (i) BMI-based individualized tube voltage selection and contrast injection protocol in renal CTA reduces both radiation and contrast doses over conventional protocol. (ii) The combination of lower kVp and higher weight ASIR-V maybe used to improve image quality in terms of contrast enhancement and image noise under lower radiation and contrast dose conditions. (iii) Renal CTA of normal size (BMI ≤ 30 kg/m2) patients acquired at low radiation dosage and low iodine contrast dose through the combination of low tube voltage and ASIR-V algorithm achieves excellent diagnostic image quality with a good inter-rater agreement.

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Optimisation of the CT pulmonary angiogram (CTPA) protocol using a low kV technique combined with high iterative reconstruction (IR): A phantom study

Cited by 4 publications

References 15 publications

Necrotizing Pneumonia in Children: Early Recognition and Management

Necrotizing Pneumonia in Children: Early Recognition and Management

Low dose CTPA using a low kV technique combined with high IR: A clinical study

Application value of individualized tube voltage, contrast injection, and adaptive statistical iterative reconstruction V algorithm based on body mass index in renal computed tomography angiography for radiation and iodinated contrast dose reduction

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