A completed audit cycle of the lateral scan projection radiograph in CT pulmonary angiography (CTPA); the impact on scan length and radiation dose

Background: The aim of this study is to perform a systematic review of the feasibility and clinical application of double low-dose CT pulmonary angiography (CTPA) in the diagnosis of patients with suspected pulmonary embolism. Discussion: A total of 13 studies were found to meet selection criteria reporting both low radiation dose (70 or 80 kVp versus 100 or 120 kVp) and low contrast medium dose CTPA protocols. Lowdose CTPA resulted in radiation dose reduction from 29.6% to 87.5% in 12 studies (range: 0.4 to 23.5 mSv), while in one study, radiation dose was increased in the dual-energy CT group when compared to the standard 120 kVp group. CTPA with use of low contrast medium volume (range: 20 to 75 ml) was compared to standard CTPA (range: 50 to 101 ml) in 12 studies with reduction between 25 and 67%, while in the remaining study, low iodine concentration was used with 23% dose reduction achieved. Quantitative assessment of image quality (in terms of signal-to-noise ratio and contrast-to-noise ratio) showed that low-dose CTPA was associated with higher, lower and no change in image quality in 3, 3 and 6 studies, respectively when compared to the standard CTPA protocol. The subjective assessment indicated similar image quality in 11 studies between low-dose and standard CTPA groups, and improved image quality in 1 study with low-dose CTPA. Conclusion: This review shows that double low-dose CTPA is feasible in the diagnosis of pulmonary embolism with significant reductions in both radiation and contrast medium doses, without compromising diagnostic image quality.

Download Full-text

CT pulmonary angiography using organ dose modulation with an iterative reconstruction algorithm and 3D Smart mA in different body mass indices: image quality and radiation dose

La radiologia medica ◽

10.1007/s11547-018-0899-y ◽

2018 ◽

Vol 123 (9) ◽

pp. 676-685 ◽

Cited By ~ 7

Author(s):

Yongxia Zhao ◽

Ziwei Zuo ◽

Shujie Cheng ◽

Yanmin Wu

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Body Mass ◽

Iterative Reconstruction ◽

Reconstruction Algorithm ◽

Organ Dose ◽

Pulmonary Angiography ◽

Ct Pulmonary Angiography ◽

Iterative Reconstruction Algorithm ◽

Dose Modulation

Download Full-text

Effects of patient size on radiation dose reduction and image quality in low-kVp CT pulmonary angiography performed with reduced IV contrast dose

Emergency Radiology ◽

10.1007/s10140-012-1046-z ◽

2012 ◽

Vol 19 (5) ◽

pp. 437-445 ◽

Cited By ~ 38

Author(s):

Aaron Sodickson ◽

Michael Weiss

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Dose Reduction ◽

Pulmonary Angiography ◽

Radiation Dose Reduction ◽

Ct Pulmonary Angiography ◽

Contrast Dose ◽

Patient Size ◽

Low Kvp

Download Full-text

Single- and dual-energy CT pulmonary angiography using second- and third-generation dual-source CT systems: comparison of radiation dose and image quality

European Radiology ◽

10.1007/s00330-018-5982-1 ◽

2019 ◽

Vol 29 (9) ◽

pp. 4603-4612 ◽

Cited By ~ 7

Author(s):

Lukas Lenga ◽

Franziska Trapp ◽

Moritz H. Albrecht ◽

Julian L. Wichmann ◽

Addison A. Johnson ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Pulmonary Angiography ◽

Dual Energy ◽

Dual Energy Ct ◽

Third Generation ◽

Dual Source Ct ◽

Ct Pulmonary Angiography ◽

Dual Source

Download Full-text

Iterative reconstruction in single source dual-energy CT pulmonary angiography: Is it sufficient to achieve a radiation dose as low as state-of-the-art single-energy CTPA?

European Journal of Radiology ◽

10.1016/j.ejrad.2015.07.010 ◽

2015 ◽

Vol 84 (11) ◽

pp. 2314-2320 ◽

Cited By ~ 11

Author(s):

M. Ohana ◽

A. Labani ◽

M.Y. Jeung ◽

S.El Ghannudi ◽

S. Gaertner ◽

...

Keyword(s):

Radiation Dose ◽

Iterative Reconstruction ◽

State Of The Art ◽

Pulmonary Angiography ◽

Dual Energy ◽

Dual Energy Ct ◽

Single Source ◽

Ct Pulmonary Angiography

Download Full-text

Effect of iterative reconstruction algorithm levels on noise index and figure-of-merit in CT pulmonary angiography examinations

Journal of X-Ray Science and Technology ◽

10.3233/xst-200699 ◽

2020 ◽

Vol 28 (5) ◽

pp. 893-903

Author(s):

H.H. Harun ◽

M.K.A. Karim ◽

Z. Abbas ◽

A. Sabarudin ◽

S.C. Muniandy ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Pulmonary Artery ◽

Iterative Reconstruction ◽

Figure Of Merit ◽

Pulmonary Angiography ◽

Volume Data ◽

Ct Pulmonary Angiography ◽

Increase With Increase ◽

The Mean

PURPOSE: To evaluate the influence of iterative reconstruction (IR) levels on Computed Tomography (CT) image quality and to establish Figure of Merit (FOM) value for CT Pulmonary Angiography (CTPA) examinations. METHODS: Images of 31 adult patients who underwent CTPA examinations in our institution from March to April 2019 were retrospectively collected. Other data, such as scanning parameters, radiation dose and body habitus information from the subjects were also recorded. Six different levels of IR were applied to the volume data of the subjects. Five circles of the region of interest (ROI) were drawn in five different arteries namely, pulmonary trunk, right pulmonary artery, left pulmonary artery, ascending aorta and descending aorta. The mean Signal-to-noise ratio (SNR) was obtained, and the FOM was calculated in a fraction of the SNR2 divided by volume-weighted CT dose index (CTDIvol) and SNR2 divided by the size-specific dose estimates (SSDE). RESULTS: Overall, we observed that the mean value of CTDIvol and SSDE were 13.79±7.72 mGy and 17.25±8.92 mGy, respectively. Notably, SNR values significantly increase with increase of the IR level (p < 0.05). There are also significant differences (p < 0.05) in the FOM for both SNR2/SSDE and SNR2/CTDIvol attained in different IR levels. CONCLUSION: We successfully evaluate the value of radiation dose and image quality performance and set up a figure of merit for both parameters to further verify scanning protocols by radiology personnel.

Download Full-text