Pulmonary embolism: Low dose contrast MSCT pulmonary angiography with modified test bolus technique

Kamr, Wael Hamza; El-Tantawy, Amir Monier; Harraz, Mohamed M.; Tawfik, Ahmed Ibrahim

doi:10.1016/j.ejro.2020.100254

Cited by 3 publications

(11 citation statements)

References 17 publications

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“…found no significant differences in pulmonary artery enhancement between both techniques. The results from this study are in contrast with Kamr et al 11 . who performed a large prospective study on 600 patients comparing both techniques.…”

Section: Discussioncontrasting

confidence: 97%

“…research demonstrated that bolus track resulted in a higher mean enhancement of the pulmonary artery. These findings differ from research by Kamr et al 11 . who recommend the test bolus protocol and Kerl et al 12 .…”

Section: Introductioncontrasting

confidence: 99%

“…who performed a large prospective study on 600 patients comparing both techniques. In Kamr et al 11 . study, the average HU density in the main pulmonary artery was 260.5 HU in the bolus track group and increased to 320 HU in the test bolus group ( P < 0.002).…”

Section: Discussionmentioning

confidence: 86%

“…study, the average HU density in the main pulmonary artery was 260.5 HU in the bolus track group and increased to 320 HU in the test bolus group ( P < 0.002). However, unique to Kamr et al 11 . study, an extra step was added to the routine bolus track technique.…”

Section: Discussionmentioning

confidence: 99%

“…and Rodrigues et al 9 . Kamr et al 11 . analysed area's including the ascending and descending aorta however a test bolus protocol unique to their study was used.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of bolus track and test bolus computed tomography pulmonary angiography and the implications on pulmonary and aortic vessel enhancement, effective dose and suboptimal scan rate

Murphy,

White

2023

J of Medical Radiation Sci

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IntroductionBolus track and test bolus are the most commonly used contrast timing protocols to undertake computed tomography pulmonary angiography (CTPA). The aim of this study was to compare test bolus and bolus track contrast enhancement protocols in terms of enhancement of the pulmonary vessels and aorta, radiation dose and suboptimal scan rate to determine the optimal technique for CTPA.MethodsA total of 200 CTPA examinations (100 using each protocol) performed between January and February 2021 were assessed retrospectively. All scans were performed on a 2x128 Dual Source Siemens Drive Scanner. CT attenuation was measured in Hounsfield Units (HU), with measurements taken from the main pulmonary trunk, right pulmonary artery and left pulmonary artery, ascending and descending aorta. The mean effective dose was calculated from the dose‐length product (DLP). The suboptimal scan rate was calculated as the percentage of examinations below 210HU.ResultsThe average HU of the pulmonary arteries was 358 HU ± SD 129.2 in the test bolus group and increased to 394 HU ± SD 133.9 in the bolus track group with a P value of ≤0.05. The average HU of the aorta was 235 HU ± SD 82.8 in the test bolus group and increased to 319 HU ± SD 91.8 in the bolus track group with a P value of <0.001. Although not statistically significant, the mean effective dose was reduced by 4.2% for the bolus track protocol (2.4 mSv vs. 2.5 mSv, P > 0.05). Fewer suboptimal scans were performed with the bolus track protocol (5 scans <210HU Bolus Track vs. 9 scans <210HU Test Bolus).ConclusionThe bolus track protocol results in increased enhancement of the pulmonary arteries and aorta, with the added benefits of a lower suboptimal scan rate and lower effective dose.

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Section: Discussioncontrasting

confidence: 97%

Section: Introductioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

“…and Rodrigues et al 9 . Kamr et al 11 . analysed area's including the ascending and descending aorta however a test bolus protocol unique to their study was used.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations