Diagnostic confidence and image quality of CT pulmonary angiography at 100 kVp in overweight and obese patients

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.

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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

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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

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Radiation dose and image quality of high-pitch emergency abdominal CT in obese patients using third-generation dual-source CT (DSCT)

Scientific Reports ◽

10.1038/s41598-019-52454-5 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Robert Forbrig ◽

Michael Ingrisch ◽

Robert Stahl ◽

Katharina Stella Winter ◽

Maximilian Reiser ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Third Generation ◽

Obese Patients ◽

Dual Source Ct ◽

High Pitch ◽

Subjective Image Quality ◽

Dual Source ◽

Group A

Abstract In this third-generation dual-source CT (DSCT) study, we retrospectively investigated radiation dose and image quality of portal-venous high-pitch emergency CT in 60 patients (28 female, mean age 56 years) with a body mass index (BMI) ≥ 30 kg/m2. Patients were dichotomized in groups A (median BMI 31.5 kg/m2; n = 33) and B (36.8 kg/m2; n = 27). Volumetric CT dose index (CTDIvol), size-specific dose estimate (SSDE), dose length product (DLP) and effective dose (ED) were assessed. Contrast-to-noise ratio (CNR) and dose-independent figure-of-merit (FOM) CNR were calculated. Subjective image quality was assessed using a five-point scale. Mean values of CTDIvol, SSDE as well as normalized DLP and ED were 7.6 ± 1.8 mGy, 8.0 ± 1.8 mGy, 304 ± 74 mGy * cm and 5.2 ± 1.3 mSv for group A, and 12.6 ± 3.7 mGy, 11.0 ± 2.6 mGy, 521 ± 157 mGy * cm and 8.9 ± 2.7 mSv for group B (p < 0.001). CNR of the liver and spleen as well as each calculated FOM CNR were significantly higher in group A (p < 0.001). Subjective image quality was good in both groups. In conclusion, third-generation abdominal high-pitch emergency DSCT yields good image quality in obese patients. Radiation dose increases in patients with a BMI > 36.8 kg/m2.

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