Reduced Z-axis coverage multidetector CT angiography for suspected acute pulmonary embolism could decrease dose and maintain diagnostic accuracy

Multidetector computed tomographic angiography (MDCTA) is the method of choice for evaluation of suspected acute pulmonary embolism (PE) in most patients because it is accurate and widely available. The use of computed tomography, including MDCTA for PE, has risen dramatically over the last several years with an attendant rise in radiation exposure. Many methods currently employed to reduce radiation dose may affect image quality and potentially affect diagnostic accuracy. Reducing Z-axis coverage would decrease radiation dose without any effect on image quality. This study was performed to assess the effect on the accuracy of MDCTA for suspected acute PE if the Z-axis coverage was reduced to the anatomic range from the top of the aortic arch through the heart. Two hundred ninety-five examinations were performed on a 64-detector-row MDCT and interpreted as positive for PE from July 2005 to February 2008. When the anatomic range of these data sets were retrospectively reduced and reinterpreted for PE, no case was interpreted as negative for PE. The Z-axis coverage was reduced by 37%. In the interest of keeping radiation doses as low as reasonably achievable, further research in this area is warranted.