Exponentially Decelerated Contrast Media Injection Rate Combined With a Novel Patient-Specific Contrast Formula Reduces Contrast Volume Administration and Radiation Dose During Computed Tomography Pulmonary Angiography

2016 ◽  
Vol 40 (3) ◽  
pp. 370-374 ◽  
Author(s):  
Charbel Saade ◽  
Ahmad Mayat ◽  
Fadi El-Merhi
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Contrast Media ◽  
Pulmonary Angiography ◽  
Injection Rate ◽  
Patient Specific ◽  
Computed Tomography Pulmonary Angiography ◽  
Contrast Volume

scholarly journals Effect of Lowering Tube Potential and Increase Iodine Concentration of Contrast Medium on Radiation Dose and Image Quality in Computed Tomography Pulmonary Angiography Procedure: A Phantom Study

2021 ◽  
Vol 47 (3) ◽  
pp. 1211-1224
Author(s):  
Justin E Ngaile ◽  
Peter K Msaki ◽  
Evarist M Kahuluda ◽  
Furaha M Chuma ◽  
Jerome M Mwimanzi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Contrast Medium ◽  
Iodine Concentration ◽  
Pulmonary Angiography ◽  
Computed Tomography Pulmonary Angiography ◽  
Iodinated Contrast ◽  
Tube Potential ◽  
Tube Current

The aim of the study was to examine the effect of lowering tube potential and increase iodine concentration on image quality and radiation dose in computed tomography pulmonary angiography procedure. The pulmonary arteries were simulated by three syringes. The syringes were filled with 1:10 diluted solutions of 300 mg, 350 mg and 370 mg of iodine per millilitre concentration in three water-filled phantoms simulating thin, intermediate and thick patients. The phantoms were scanned at 80 kVp, 110 kVp and 130 kVp and 0.6 second rotation time using a 16 slice computed tomography (CT) scanner. The tube current was either fixed at 80, 100, 200, 250 and 300 mA or automatically adjusted with quality reference tube current-time product (mAsQR). In comparison with 130 kVp, images acquired at 80 kVp and 110 kVp, respectively, showed 76.2% to 99% and 19% to 26% enhancement in CT attenuation of iodinated contrast material. A volume CT dose index (CTDIvol) reduction by 35.3% was attained in small phantom with the use of 80 kVp, while in the medium phantom, a CTDIvol reduction by 29.9% was attained with the use of 110 kVp instead of 130 kVp. In light of the above, lowering tube potential and increase iodinated CM could substantially reduce the dose to small-sized adults and children. Keywords: Angiography; Computed tomography; Low tube potential; Iodinated contrast medium; Radiation dose

scholarly journals Computed Tomography Pulmonary Angiography during Pregnancy: Radiation Dose of Commonly Used Protocols and the Effect of Scan Length Optimization

2019 ◽  
Vol 20 (2) ◽  
pp. 313 ◽  
Author(s):  
Babs M.F. Hendriks ◽  
Roald S. Schnerr ◽  
Gianluca Milanese ◽  
Cécile R.L.P.N. Jeukens ◽  
Sandra Niesen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Pulmonary Angiography ◽  
Computed Tomography Pulmonary Angiography ◽  
Length Optimization ◽  
Scan Length

P2719The impact of “diseased only coronary artery” invasive diagnostics strategy on contrast and radiation dose in patients with coronary artery disease following coronary computed tomography angiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M A Debski ◽  
M Kruk ◽  
S Bujak ◽  
Z Dzielinska ◽  
M Demkow ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Radiation Dose ◽  
Contrast Media ◽  
Coronary Arteries ◽  
Coronary Computed Tomography Angiography ◽  
Contrast Volume ◽  
Diseased Vessel ◽  
Artery Disease

Abstract Background Coronary computed tomography angiography (CTA) has high diagnostic accuracy in ruling out significant stenosis of coronary arteries in patients with intermediate probability of coronary artery disease. Based on CTA result, some patients are scheduled for invasive coronary angiography (ICA). As no specyfic guidelines exist for such situations, during ICA contrast media is routinely injected into both coronary arteries, irrespectively of CTA result. Conceivably, patients scheduled for ICA with one vessel disease may benefit from invasive interrogation limited to the diseased vessel only, presumably resulting in less contrast, lower radiation dose and less complications related to catheterization. Purpose The aim of this study was to analyse the potential trade-off between the benefits and costs of a “diseased-vessel-only” (>50% DS in CTA) invasive diagnostic approach in patients undergoing ICA following coronary CTA, as compared to the traditional “total ICA” (including both arteries regardless of CTA result) approach. The potential benefits were defined as contrast and radiation doses reduction during ICA and the costs were defined as missing significant coronary stenosis. Methods In 85 patients who underwent CTA and subsequently ICA we precisely measured contrast volume and radiation dose used to visualise each vessel during ICA. Then we proposed excluding a vessel (either left or right coronary artery) without >50% diameter stenosis in CTA from ICA, and studied how it would affect ICA contrast and radiation values. DS in CTA and ICA were assessed quantitatively. Results CTA sensitivity, specificity, positive predictive value and negative predictive value in diagnosing >50%DS as assessed by ICA were 95.2%, 96.2%, 91.6% and 97.9%, respectively. Applying <50% DS in CTA as a threshold not to visualise the artery during ICA would reduce contrast volume by 47% (27ml, Fig. 1) and radiation dose by 51% (3.14mSv, Fig.2, both p<0.0001). No significant (>50%DS in ICA) stenosis would be missed by CTA. Figures 1 and 2 Conclusion These real-world data support the concept that vessels with <50%DS in CTA do not need to be visualised during ICA. Such approach would result in significant reduction in contrast media volume and patient's exposure to radiation during ICA, without underdiagnosing any of the patients.

scholarly journals Patient-Specific Radiation Dose and Cancer Risk Estimate in Computed Tomography Pulmonary Angiography Examinations Based on Lung Effective Diameter

2019 ◽  
Author(s):  
Hanif Haspi Harun ◽  
Muhammad Khalis Abdul Karim ◽  
Zulkifly Abbas ◽  
Sarawana Chelwan Muniandy ◽  
Akmal Sabarudin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Cancer Risk ◽  
Radiation Exposure ◽  
Effective Dose ◽  
Organ Dose ◽  
Pulmonary Angiography ◽  
Effective Diameter ◽  
Computed Tomography Pulmonary Angiography ◽  
Radiation Dose Exposure

Computed Tomography (CT) scan examinations has greater demands especially in CT Pulmonary Angiography (CTPA) owing to the public and radiology personnel worries towards CT radiation exposure and risks. The aim of present study is to evaluate the comprehensive radiation exposure in computed tomography pulmonary angiography (CTPA) and its cancer risk. The records of 100 patients who had undergone CTPA were retrieved. The radiation dose exposure, scanning acquisition protocol as well as patient characteristics were noted. Radiation exposure were presented as Volume Computed Tomography Dose Index (CTDIvol), Size-Specific Dose Estimate (SSDE), Dose-Length Product (DLP), and effective dose (E) and organ dose. Effective cancer risk per million procedure was calculated by referring to the International Commission on Radiological Protection Publication 103. The CTDIvol, SSDE, DLP were comparable within different effective diameter groups. The average effective dose received by a patient was 8.68 mSv. The organ dose and effective cancer risk attained for breast, lung and liver were 17.05 &plusmn; 10.40 mGy (194 per one million procedure), 17.55 &plusmn; 10.86 mGy (192 per one million procedure) and 15.04 &plusmn; 9.75 mGy (53 per one million procedure), respectively. In conclusion, CTDIvol was undervalued and SSDE was more accurate in describing radiation dose exposure. The lungs and breast of subjects with large effective diameter were higher risk of developing cancer as they received the highest exposure. Therefore, extra safety measures should be considered for large-sized patients undergoing CTPA.Purpose: This study evaluates the comprehensive radiation exposure in computed tomography pulmonary angiography (CTPA) and its cancer risk.

Simultaneous bilateral contrast injection in computed tomography pulmonary angiography

2012 ◽  
Vol 53 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Stefan Bulla ◽  
Gregor Pache ◽  
Thorsten Bley ◽  
Mathias Langer ◽  
Philipp Blanke
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Image Quality ◽  
Pulmonary Artery ◽  
Contrast Media ◽  
Pulmonary Angiography ◽  
Computed Tomography Pulmonary Angiography ◽  
Fixed Amount ◽  
Institutional Review ◽  
Group A

Background Computed tomography pulmonary angiography (CTPA) has evolved as the gold standard for diagnosing pulmonary embolism. However, subsegmental arteries are often not assessed to do insufficient attenuation. Purpose To evaluate the influence of simultaneous bilateral versus unilateral injection of a fixed amount of contrast media on pulmonary artery opacification and image quality in CTPA. Material and Methods In this institutional review board-approved prospective study, 180 patients (91 women, mean age 61.9 ± 16.5 years) referred for CTPA (100 kV) due to suspected pulmonary embolism were randomized in groups of 45 patients each, with either unilateral (A:4 mL/s; B:6 mL/s) or bilateral (C: 6 mL/s; D: 8 mL/s) (Y-shaped line) injection of 50 mL contrast media. Attenuation was assessed including the subsegmental arteries (4th order). Image quality was evaluated by two readers in consensus using a three-point grading scale (3 = excellent image quality, no artifacts, 1 = non-diagnostic). Results Mean pulmonary artery attenuation was significantly higher with bilateral injection (1st to 3rd order: A: 303.6 ± 8.8HU; B: 371.1 ± 11.0HU vs. C: 443.2 ± 24.1HU; D: 562.3 ± 15.3HU, P < 0.001). Evaluation of subsegmental arteries was feasible for all patients in groups B–D, but only in 36/45 (80%) patients in group A. Subsegmental attenuation was significantly higher with bilateral injection (A: 284.7 ± 12.1HU; B: 367.4 ± 12.1HU vs. C: 494.2 ± 21.5HU; D: 562.3 ± 26.7HU, P < 0.001). Image quality was diagnostic for all patients but best for group C (A: 2.15 ± 0.4; B: 2.14 ± 0.5; C: 2.92 ± 0.3, and D: 2.51 ± 0.5). Conclusion Using the same amount of contrast media, bilateral injection yields higher pulmonary artery attenuation and better image quality than unilateral injection. This technique may improve subsegmental pulmonary artery assessment.

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