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01-10-2011 | Chest

Dose and image quality at CT pulmonary angiography—comparison of first and second generation dual-energy CT and 64-slice CT

Authors: Ralf W. Bauer, Sebastian Kramer, Matthias Renker, Boris Schell, Maya Christina Larson, Martin Beeres, Thomas Lehnert, Volkmar Jacobi, Thomas J. Vogl, Josef Matthias Kerl

Published in: European Radiology | Issue 10/2011

Abstract

Objective

To compare dose and image quality of 64-slice, first and second generation dual-energy CT (DECT) for CT pulmonary angiography (CTPA).

Methods

Totally 120 patients, 30 in each group, underwent CTPA on a first generation (group 1: single-energy, 120 kV/145 mAs; group 2: DE, 140/80 kV, 70/350 mAs) or second generation dual-source DECT device (group 3: DE, 100/Sn140 kV, 120/102 mAs; group 4: DE, 80/Sn140 kV, 202/86 mAs). CTDIvol, DLP, background noise (BN), thorax diameter and attenuation in the pulmonary trunk were compared.

Results

Thorax diameter and attenuation in the pulmonary trunk did not differ significantly (p > 0.4 and >0.19) between the groups. Mean CTDIvol and DLP were significantly lower (p < 0.003) in group 4 (6.2 ± 1.6 mGy/170 ± 41 mGycm) compared to group 1 (8.5 ± 2.6 mGy/235 ± 117 mGycm), group 2 (9.2 ± 3.3 mGy/224 ± 122 mGycm) and group 3 (8.7 ± 2.8 mGy/246 ± 86 mGycm). BN was significantly lower (p < 0.0001) in group 4 (12 ± 3 HU) and group 1 (13 ± 6 HU) compared to group 3 and 2 (16 ± 6 HU and 23 ± 9).

Conclusion

The use of second generation DECT in 80/Sn140 kV configuration allows for significant dose reduction with image quality similar to 120 kV CTPA.

Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 158:585–593PubMedCrossRef

Tapson VF (2008) Acute pulmonary embolism. N Engl J Med 358:1037–1052PubMedCrossRef

Dalen JE (2002) Pulmonary embolism: what have we learned since Virchow? Natural history, pathophysiology, and diagnosis. Chest 122:1440–1456PubMedCrossRef

Dauphine C, Omari B (2005) Pulmonary embolectomy for acute massive pulmonary embolism. Ann Thorac Surg 79:1240–1244PubMedCrossRef

Ota M, Nakamura M, Yamada N, Yazu T, Ishikura K, Hiraoka N, Tanaka H, Fujioka H, Isaka N, Nakano T (2002) Prognostic significance of early diagnosis in acute pulmonary thromboembolism with circulatory failure. Heart Vessels 17:7–11PubMedCrossRef

Remy-Jardin M, Pistolesi M, Goodman LR, Gefter WB, Gottschalk A, Mayo JR, Sostman HD (2007) Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology 245:315–329PubMedCrossRef

Schaefer-Prokop C, Prokop M (2005) MDCT for the diagnosis of acute pulmonary embolism. Eur Radiol 15(Suppl 4):D37–D41PubMed

Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galie N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JP, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Zamorano JL, Andreotti F, Ascherman M, Athanassopoulos G, De Sutter J, Fitzmaurice D, Forster T, Heras M, Jondeau G, Kjeldsen K, Knuuti J, Lang I, Lenzen M, Lopez-Sendon J, Nihoyannopoulos P, Perez Isla L, Schwehr U, Torraca L, Vachiery JL (2008) Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 29:2276–2315PubMedCrossRef

Petersilka M, Bruder H, Krauss B, Stierstorfer K, Flohr TG (2008) Technical principles of dual source CT. Eur J Radiol 68:362–368PubMedCrossRef

10.

Johnson TR, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D, Fink C, Weckbach S, Lenhard M, Schmidt B, Flohr T, Reiser MF, Becker CR (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef

11.

Zatz LM (1976) The effect of the kVp level on EMI values. Selective imaging of various materials with different kVp settings. Radiology 119:683–688PubMed

12.

Bauer RW, Kerl JM, Weber E, Weisser P, Korkusuz H, Lehnert T, Jacobi V, Vogl TJ (2010) Lung perfusion analysis with dual energy CT in patients with suspected pulmonary embolism—influence of window settings on the diagnosis of underlying pathologies of perfusion defects. Eur J Radiol. doi:10.1016/j.ejrad.2010.09.009

13.

Fink C, Johnson TR, Michaely HJ, Morhard D, Becker C, Reiser MF, Nikolaou K (2008) Dual-energy CT angiography of the lung in patients with suspected pulmonary embolism: initial results. Rofo 180:879–883PubMed

14.

Pontana F, Faivre JB, Remy-Jardin M, Flohr T, Schmidt B, Tacelli N, Pansini V, Remy J (2008) Lung perfusion with dual-energy multidetector-row CT (MDCT): feasibility for the evaluation of acute pulmonary embolism in 117 consecutive patients. Acad Radiol 15:1494–1504PubMedCrossRef

15.

Thieme SF, Becker CR, Hacker M, Nikolaou K, Reiser MF, Johnson TR (2008) Dual energy CT for the assessment of lung perfusion—correlation to scintigraphy. Eur J Radiol 68:369–374PubMedCrossRef

16.

Thieme SF, Johnson TR, Lee C, McWilliams J, Becker CR, Reiser MF, Nikolaou K (2009) Dual-energy CT for the assessment of contrast material distribution in the pulmonary parenchyma. Am J Roentgenol 193:144–149CrossRef

17.

Zhang LJ, Chai X, Wu SY, Zhao YE, Hu XB, Hu YX, Xue YB, Yang GF, Zhu H, Lu GM (2009) Detection of pulmonary embolism by dual energy CT: correlation with perfusion scintigraphy and histopathological findings in rabbits. Eur Radiol 19:2844–2854PubMedCrossRef

18.

Ferda J, Ferdova E, Mirka H, Baxa J, Bednarova A, Flohr T, Schmidt B, Matejovic M, Kreuzberg B (2009) Pulmonary imaging using dual-energy CT, a role of the assessment of iodine and air distribution. Eur J Radiol. doi:10.1016/j.ejrad.2009.08.005

19.

Pansini V, Remy-Jardin M, Faivre JB, Schmidt B, Dejardin-Bothelo A, Perez T, Delannoy V, Duhamel A, Remy J (2009) Assessment of lobar perfusion in smokers according to the presence and severity of emphysema: preliminary experience with dual-energy CT angiography. Eur Radiol. doi:10.1007/s00330-009-1475-6 PubMed

20.

Pontana F, Remy-Jardin M, Duhamel A, Faivre JB, Wallaert B, Remy J (2010) Lung perfusion with dual-energy multi-detector row CT: can it help recognize ground glass opacities of vascular origin? Acad Radiol 17:587–594PubMedCrossRef

21.

Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284PubMedCrossRef

22.

Mettler FA Jr, Wiest PW, Locken JA, Kelsey CA (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359PubMedCrossRef

23.

Wiest PW, Locken JA, Heintz PH, Mettler FA (2002) CT scanning: a major source of radiation exposure. Semin Ultrasound CT MR 23:402–410PubMedCrossRef

24.

Schenzle JC, Sommer WH, Neumaier K, Michalski G, Lechel U, Nikolaou K, Becker CR, Reiser MF, Johnson TR (2010) Dual energy CT of the chest: how about the dose? Invest Radiol 45:347–353PubMed

25.

Dodd JD, Kalva S, Pena A, Bamberg F, Shapiro MD, Abbara S, Cury RC, Brady TJ, Hoffmann U (2008) Emergency cardiac CT for suspected acute coronary syndrome: qualitative and quantitative assessment of coronary, pulmonary, and aortic image quality. Am J Roentgenol 191:870–877CrossRef

26.

Halpern EJ (2009) Triple-rule-out CT angiography for evaluation of acute chest pain and possible acute coronary syndrome. Radiology 252:332–345PubMedCrossRef

27.

Wittram C (2007) How I do it: CT pulmonary angiography. Am J Roentgenol 188:1255–1261CrossRef

28.

Heyer CM, Mohr PS, Lemburg SP, Peters SA, Nicolas V (2007) Image quality and radiation exposure at pulmonary CT angiography with 100- or 120-kVp protocol: prospective randomized study. Radiology 245:577–583PubMedCrossRef

29.

Schueller-Weidekamm C, Schaefer-Prokop CM, Weber M, Herold CJ, Prokop M (2006) CT angiography of pulmonary arteries to detect pulmonary embolism: improvement of vascular enhancement with low kilovoltage settings. Radiology 241:899–907PubMedCrossRef

30.

Szucs-Farkas Z, Kurmann L, Strautz T, Patak MA, Vock P, Schindera ST (2008) Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100- and 80-kVp protocols. Invest Radiol 43:871–876PubMedCrossRef

31.

Szucs-Farkas Z, Verdun FR, von Allmen G, Mini RL, Vock P (2008) Effect of X-ray tube parameters, iodine concentration, and patient size on image quality in pulmonary computed tomography angiography: a chest-phantom-study. Invest Radiol 43:374–381PubMedCrossRef

32.

Bjorkdahl P, Nyman U (2010) Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality. Acta Radiol 51:260–270PubMedCrossRef

33.

Sigal-Cinqualbre AB, Hennequin R, Abada HT, Chen X, Paul JF (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174PubMedCrossRef

34.

Szucs-Farkas Z, Strautz T, Patak MA, Kurmann L, Vock P, Schindera ST (2009) Is body weight the most appropriate criterion to select patients eligible for low-dose pulmonary CT angiography? Analysis of objective and subjective image quality at 80 kVp in 100 patients. Eur Radiol 19:1914–1922PubMedCrossRef

35.

MacKenzie JD, Nazario-Larrieu J, Cai T, Ledbetter MS, Duran-Mendicuti MA, Judy PF, Rybicki FJ (2007) Reduced-dose CT: effect on reader evaluation in detection of pulmonary embolism. Am J Roentgenol 189:1371–1379CrossRef

36.

Quiroz R, Kucher N, Zou KH, Kipfmueller F, Costello P, Goldhaber SZ, Schoepf UJ (2005) Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review. JAMA 293:2012–2017PubMedCrossRef

37.

Schoepf UJ, Costello P (2004) CT angiography for diagnosis of pulmonary embolism: state of the art. Radiology 230:329–337PubMedCrossRef

Title: Dose and image quality at CT pulmonary angiography—comparison of first and second generation dual-energy CT and 64-slice CT
Authors: Ralf W. Bauer
Sebastian Kramer
Matthias Renker
Boris Schell
Maya Christina Larson
Martin Beeres
Thomas Lehnert
Volkmar Jacobi
Thomas J. Vogl
Josef Matthias Kerl
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2162-y

At a glance: The STEP trials

Springer Medicine

Dose and image quality at CT pulmonary angiography—comparison of first and second generation dual-energy CT and 64-slice CT

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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