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Computed Tomography Imaging under Artificial Intelligence Reconstruction Algorithm Used in Recovery of Sports Injury of the Knee Anterior Cruciate Ligament. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:1199841. [PMID: 35685654 PMCID: PMC9167137 DOI: 10.1155/2022/1199841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/23/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to analyze the influence of artificial intelligence (AI) reconstruction algorithm on computed tomography (CT) images and the application of CT image analysis in the recovery of knee anterior cruciate ligament (ACL) sports injuries. A total of 90 patients with knee trauma were selected for enhanced CT scanning and randomly divided into three groups. Group A used the filtered back projection (FBP) reconstruction algorithm, and the tube voltage was set to 120 kV during CT scanning. Group B used the iDose4 reconstruction algorithm, and the tube voltage was set to 120 kV during CT scanning. In group C, the iDose4 reconstruction algorithm was used, and the tube voltage was set to 100 kV during CT scanning. The noise, signal-to-noise ratio (SNR), carrier-to-noise ratio (CNR), CT dose index volume (CTDI), dose length product (DLP), and effective radiation dose (ED) of the three groups of CT images were compared. The results showed that the noise of groups B and C was smaller than that of group A (P < 0.05), and the SNR and CNR of groups B and C were higher than those of group A. The images of patients in group A with the FBP reconstruction algorithm were noisy, and the boundaries were not clear. The noise of the images obtained by the iDose4 reconstruction algorithm in groups B and C was improved, and the image resolution was also higher. The agreement between arthroscopy and CT scan results was 96%. Therefore, the iterative reconstruction algorithm of iDose4 can improve the image quality. It was of important value in the diagnosis of knee ACL sports injury.
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Cheng D, Ghita M, Menard D, Chen MK. Determining the minimal ultra-low dose CT for reliable attenuation correction of 18F-FDG PET-CT: a phantom study. J Nucl Med Technol 2021; 50:jnmt.121.262943. [PMID: 34750234 DOI: 10.2967/jnmt.121.262943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
To investigate minimal required sub milli-Sievert (mSv) ultra-low dose CT and corresponding tube current and voltage for reliable attenuation correction and semi- quantitation in 18F-FDG PET-CT in an effort for radiation dose reduction. Methods: We performed a PET-CT investigational study using a NEMA torso phantom containing six spheres (diameter: 10, 13, 17, 22, 28, 37 mm) filled with a fixed concentration of 60 kBq/ml and a background of 15 kBq/ml of 18F-FDG. Two sets of PET images, separated by 2 hours, were acquired for 3 minutes in a single bed position using 3-D mode with and without time-of-flight in a GE D-690 scanner. Several sets of CT images were acquired for attenuation correction with different combinations of tube voltage (80, 100, 120 kVp) and effective mAs (tube current-time product divided by pitch), using the maximum beam collimation (64 x 0.625 mm). The lowest CT acquisition technique available on this scanner is 10 mA, 0.4 s and 1.375 for the tube current, tube rotation time and pitch, respectively. The CT radiation dose was estimated based on the computed tomography dose index volume (CTDIvol) measurements performed following the standard methodology and the Imaging Performance Assessment of CT Scanners (ImPACT) calculator. Each of the CT techniques was used for attenuation correction to the same PET acquisition, using ordered-subset expectation maximum (OSEM) algorithm with 24 subsets and 2 iterations. The maximal and average radioactivity (kBq/ml) and standardized uptake values (SUV) of the spheres were measured. The minimal ultra-low dose CT for attenuation correction was determined by reproducible SUV measurements (±10%) compared to our reference CT protocol of 100 kVp and 80 mA for 0.5 s rotation. Results: The minimal ultra-low dose of CT for reproducible quantification in all spheres (<10% relative difference) was determined to be 0.3 mSv for a combination of 100 kVp and 10 mA at 0.5 s rotation, 0.984 helical pitch (0.26 mGy measured CTDIvol) . Based on these results we could confidently determine the CT parameters for reliable attenuation correction of PET images while significantly reducing the associated radiation dose. Conclusion: Our phantom study provided guidance in using ultra-low dose CT for precise attenuation correction and semi-quantification of 18F-FDG PET imaging, which can further reduce CT dose and radiation exposure to patients in clinical PET-CT studies. Clinical application: Based on the data, we can further reduce the radiation dose to sub-mSv using an ultra-low dose CT protocol for reliable attenuation correction in clinical 18F-FDG PET-CT studies.
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Affiliation(s)
| | - Monica Ghita
- Virginia Commonwealth University School of Medicine, United States
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Wang G, Hu X. Low-dose CT denoising using a Progressive Wasserstein generative adversarial network. Comput Biol Med 2021; 135:104625. [PMID: 34246157 DOI: 10.1016/j.compbiomed.2021.104625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/26/2021] [Accepted: 06/28/2021] [Indexed: 12/01/2022]
Abstract
Low-dose computed tomography (LDCT) imaging can greatly reduce the radiation dose imposed on the patient. However, image noise and visual artifacts are inevitable when the radiation dose is low, which has serious impact on the clinical medical diagnosis. Hence, it is important to address the problem of LDCT denoising. Image denoising technology based on Generative Adversarial Network (GAN) has shown promising results in LDCT denoising. Unfortunately, the structures and the corresponding learning algorithms are becoming more and more complex and diverse, making it tricky to analyze the contributions of various network modules when developing new networks. In this paper, we propose a progressive Wasserstein generative adversarial network to remove the noise of LDCT images, providing a more feasible and effective way for CT denoising. Specifically, a recursive computation is designed to reduce the network parameters. Moreover, we introduce a novel hybrid loss function for achieving improved results. The hybrid loss function aims to reduce artifacts while better retaining the details in the denoising results. Therefore, we propose a novel LDCT denoising model called progressive Wasserstein generative adversarial network with the weighted structurally-sensitive hybrid loss function (PWGAN-WSHL), which provides a better and simpler baseline by considering network architecture and loss functions. Extensive experiments on a publicly available database show that our proposal achieves better performance than the state-of-the-art methods.
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Affiliation(s)
- Guan Wang
- School of Mathematics, Tianjin University, NO. 135, Yaguan Road, Jinnan District, Tianjin City, 300354, China.
| | - Xueli Hu
- School of Mathematics, Tianjin University, NO. 135, Yaguan Road, Jinnan District, Tianjin City, 300354, China
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Sinogram-Affirmed Iterative Reconstruction Negatively Impacts the Risk Category Based on Agatston Score: A Study Combining Coronary Calcium Score Measurement and Coronary CT Angiography. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6909130. [PMID: 32733949 PMCID: PMC7376420 DOI: 10.1155/2020/6909130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/13/2020] [Accepted: 05/19/2020] [Indexed: 11/23/2022]
Abstract
Purpose To assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on risk category for coronary artery disease by combining coronary calcium score measurement and coronary CT angiography (CCTA). Materials and Methods Eighty-nine patients (64.0% male) older than 18 years (64.4 ± 10.3 years) underwent coronary artery calcium scanning and prospectively ECG-triggered sequential CCTA examination. All raw data acquired in coronary artery calcium scanning were reconstructed by both filtered back projection (FBP) and SAFIRE algorithms with 5 different levels. Objective image quality and calcium quantification were evaluated and compared between FBP and all SAFIRE levels by the Sphericity Assumed test or Greenhouse-Geisser ε correction coefficient. Coronary artery stenosis was assessed in CCTA. Risk categories of all patients and of the patients with coronary artery stenosis in CCTA were compared between FBP and all SAFIRE levels by the Friedman test. Results The reconstruction protocol from traditional FBP to SAFIRE 5 was associated with a gradual reduction in CT value and image noise (P < 0.001) but associated with a gradual improvement in the signal-to-noise ratio (P < 0.001). There was a gradual reduction in coronary calcification quantification (Agatston score: from 73.5 in FBP to 38.1 in SAFIRE 5, P < 0.001) from traditional FBP to SAFIRE 5. There was a significant difference for the risk category between FBP and all levels of SAFIRE in all patients (from 3.5 in FBP to 3.2 in SAFIRE 5, P < 0.001) and in the patients with coronary artery stenosis in CCTA (from 4.0 in FBP to 3.6 in SAFIRE 5, P < 0.001). Conclusions SAFIRE significantly reduces coronary calcification quantification compared to FBP, resulting in the reduction of risk categories based on the Agatston score. The risk categories of the patients with coronary artery stenosis in CCTA may also decline. Thus, SAFIRE may lead risk categories to underestimate the existence of significant coronary artery stenosis.
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Mahmoudi G, Ay MR, Rahmim A, Ghadiri H. Computationally Efficient System Matrix Calculation Techniques in Computed Tomography Iterative Reconstruction. JOURNAL OF MEDICAL SIGNALS & SENSORS 2020; 10:1-11. [PMID: 32166072 PMCID: PMC7038747 DOI: 10.4103/jmss.jmss_29_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/27/2019] [Accepted: 09/04/2019] [Indexed: 11/29/2022]
Abstract
Background: Relative to classical methods in computed tomography, iterative reconstruction techniques enable significantly improved image qualities and/or lowered patient doses. However, the computational speed is a major concern for these iterative techniques. In the present study, we present a method for fast system matrix calculation based on the line integral model (LIM) to speed up the computations without compromising the image quality. In addition, we develop a hybrid line–area integral model (AIM) that highlights the advantages of both LIM and AIMs. Methods: The contributing detectors for a given pixel and a given projection view, and the length of corresponding intersection lines with pixels, are calculated using our proposed algorithm. For the hybrid method, the respective narrow-angle fan beam was modeled by multiple equally spaced lines. The computed system matrix was evaluated in the context of reconstruction using the simultaneous algebraic reconstruction technique (SART) as well as maximum likelihood expectation maximization (MLEM). Results: The proposed LIM offers a considerable reduction in calculation times compared to the standard Siddon algorithm: 2.9 times faster. Differences in root mean square error and peak signal-to-noise ratio were not significant between the proposed LIM and the Siddon algorithm for both SART and MLEM reconstruction methods (P > 0.05). Meanwhile, the proposed hybrid method resulted in significantly improved image qualities relative to LIM and the Siddon algorithm (P < 0.05), though computations were 4.9 times more intensive than the proposed LIM. Conclusion: We have proposed two fast algorithms to calculate the system matrix. The first is based on LIM and was faster than the Siddon algorithm, with matched image quality, whereas the second method is a hybrid LIM–AIM that achieves significantly improved images though with its computational requirements.
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Affiliation(s)
- Golshan Mahmoudi
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Ay
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Arman Rahmim
- Department of Radiology and Physics, University of British Columbia, Tehran, Iran.,Department of Integrative Oncology, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Hossein Ghadiri
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
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Rajiah P, Ciancibello L, Novak R, Sposato J, Landeras L, Gilkeson R. Ultra-low dose contrast CT pulmonary angiography in oncology patients using a high-pitch helical dual-source technology. ACTA ACUST UNITED AC 2020; 25:195-203. [PMID: 31063136 DOI: 10.5152/dir.2019.17498] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE We aimed to determine if the image quality and vascular enhancement are preserved in computed tomography pulmonary angiography (CTPA) studies performed with ultra-low contrast and optimized radiation dose using high-pitch helical mode of a second generation dual source scanner. METHODS We retrospectively evaluated oncology patients who had CTPA on a 128-slice dual-source scanner, with a high-pitch helical mode (3.0), following injection of 30 mL of Ioversal at 4 mL/s with body mass index (BMI) dependent tube potential (80-120 kVp) and current (130-150 mAs). Attenuation, noise, and signal-to-noise ratio (SNR) were measured in multiple pulmonary arteries. Three independent readers graded the images on a 5-point Likert scale for central vascular enhancement (CVE), peripheral vascular enhancement (PVE), and overall quality. RESULTS There were 50 males and 101 females in our study. BMI ranged from 13 to 38 kg/m2 (22.8±4.4 kg/m2). Pulmonary embolism was present in 29 patients (18.9%). Contrast enhancement and SNR were excellent in all the pulmonary arteries (395.3±131.1 and 18.3±5.7, respectively). Image quality was considered excellent by all the readers, with average reader scores near the highest possible score of 5.0 (CVE, 4.83±0.48; PVE, 4.68±0.65; noise/quality, 4.78±0.47). The average radiation dose length product (DLP) was 161±60 mGy.cm. CONCLUSION Using a helical high-pitch acquisition technique, CTPA images of excellent diagnostic quality, including visualization of peripheral segmental/sub-segmental branches can be obtained using an ultra-low dose of iodinated contrast and low radiation dose.
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Affiliation(s)
- Prabhakar Rajiah
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA;Department of Radiology, Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Leslie Ciancibello
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ronald Novak
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA;Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, Ohio, USA
| | - Jennifer Sposato
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Luis Landeras
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA;Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Robert Gilkeson
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Lu F, Gao Y, Kong Q, Qiao P, Shao M, Xie M. Application of 640-slice CT wide-detector volume scan in low-dose CT pulmonary angiography. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2019; 27:197-205. [PMID: 30584179 DOI: 10.3233/xst-180427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Computed tomography (CT) pulmonary angiography (CTPA) examination has been frequently applied in detecting suspected pulmonary embolism (PE). How to reduce radiation dose to patients is also of concern. OBJECTIVE To assess the value of using 640-slice CT wide-detector volume scan with adaptive statistical iterative reconstruction (ASIR) algorithm in low-dose CTPA. METHODS Fifty-eight patients who performed with CTPA were divided into two groups randomly. In the first experimental group (n = 30), ASIR combined with volume scan were performed on the patients, while in the second conventional group (n = 28), patients received ASIR combined with conventional spiral scan. General data including age and body mass index, image quality, pulmonary arterial phase, and radiation dose were analyzed by t test in the two groups. RESULTS In both groups, all images revealed the 5-order or higher pulmonary arterial branches and fully met the needs for clinical diagnosis. There was no statistical difference in general data between the two groups. In terms of pulmonary phase accuracy, compared with the conventional group, images at pulmonary arterial phase could be captured more accurately in the experimental group. CTDI in the experimental group decreased by 30% compared with that in the conventional group. The actual radiation dose in the experimental group was 1.5 mSv, which is reduced by 53% compared to that in the conventional group. CONCLUSIONS Compared with the conventional spiral scan, using 640-slice CT volume scan with ASIR in CTPA is more accurate in scanning phase and has lower radiation dose. There is no significant difference in image quality between the two groups.
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Affiliation(s)
- Fengqi Lu
- Department of Radiology, Nanjing Medical University Affiliated Wuxi the Second Hospital, Wuxi City, China
| | - Yu Gao
- Department of Radiology, Nanjing Medical University Affiliated Wuxi the Second Hospital, Wuxi City, China
| | - Que Kong
- Department of Radiology, Nanjing Medical University Affiliated Wuxi the Second Hospital, Wuxi City, China
| | - Peng Qiao
- Department of Radiology, Nanjing Medical University Affiliated Wuxi the Second Hospital, Wuxi City, China
| | - Min Shao
- Department of Radiology, Nanjing Medical University Affiliated Wuxi the Second Hospital, Wuxi City, China
| | - Min Xie
- Department of Radiology, Nanjing Medical University Affiliated Wuxi the Second Hospital, Wuxi City, China
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Leithner D, Gruber-Rouh T, Beeres M, Wichmann JL, Mahmoudi S, Martin SS, Lenga L, Albrecht MH, Booz C, Vogl TJ, Scholtz JE. 90-kVp low-tube-voltage CT pulmonary angiography in combination with advanced modeled iterative reconstruction algorithm: effects on radiation dose, image quality and diagnostic accuracy for the detection of pulmonary embolism. Br J Radiol 2018; 91:20180269. [PMID: 29792729 DOI: 10.1259/bjr.20180269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate low-tube-voltage 90-kVp CT pulmonary angiography (CTPA) with advanced modeled iterative reconstruction algorithm (Admire) compared to 120-kVp equivalent dual-energy (DE) acquisition with regards to radiation exposure, image quality and diagnostic accuracy for pulmonary embolism (PE) assessment. METHODS CTPA studies of 40 patients with suspected PE (56.7 ± 16.3 years) performed on a third-generation 192-slice dual-source CT scanner were retrospectively included. 120-kVp equivalent linearly-blended (60% 90-kVp, 40% 150-kVp) and 90-kVp images were reconstructed. Attenuation and noise of the pulmonary trunk were measured to calculate contrast-to-noise ratios (CNR). Three radiologists assessed the presence of central and segmental PE and diagnostic confidence. Interobserver agreement was calculated using intraclass correlation coefficient (ICC). Radiation exposure was assessed as effective dose (ED). RESULTS Pulmonary trunk CNR values were significantly increased in 90-kVp compared to linearly-blended series (15.4 ± 6.3 vs 11.3 ± 4.6, p < 0.001). Diagnostic accuracy for PE assessment was similar in both series with excellent interobserver agreement (p = 0.48; ICC, 0.83; p = 0.48). Overall confidence for PE assessment was rated excellent for both series with a significant advantage for linearly-blended series (p < 0.001; 4.1 vs 3.8). ED was reduced by 37.2% with 90-kVp compared to 120-kVp equivalent image series (1.1 ± 0.6 vs 1.7 ± 0.7 mSv, p < 0.001). CONCLUSION 90-kVp CTPA with Admire provided increased quantitative image quality with similar diagnostic accuracy and confidence for PE assessment compared to 120-kVp equivalent acquisition, while radiation dose was reduced by 37.2%. Advances in knowledge: 90-kVp CTPA with an advanced iterative reconstruction algorithm results in excellent image quality and reduction of radiation exposure without limiting diagnostic performance.
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Affiliation(s)
- Doris Leithner
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.,2 Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center , New York, NY , USA
| | - Tatjana Gruber-Rouh
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Martin Beeres
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Julian L Wichmann
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Scherwin Mahmoudi
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Simon S Martin
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Lukas Lenga
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Moritz H Albrecht
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Christian Booz
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Thomas J Vogl
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Jan-Erik Scholtz
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.,3 Department of Radiology, Massachusetts General Hospital, Cardiac MR PET CT Program, Harvard Medical School , Boston, MA , USA
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Moore AJE, Wachsmann J, Chamarthy MR, Panjikaran L, Tanabe Y, Rajiah P. Imaging of acute pulmonary embolism: an update. Cardiovasc Diagn Ther 2018; 8:225-243. [PMID: 30057872 DOI: 10.21037/cdt.2017.12.01] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Imaging plays an important role in the evaluation and management of acute pulmonary embolism (PE). Computed tomography (CT) pulmonary angiography (CTPA) is the current standard of care and provides accurate diagnosis with rapid turnaround time. CT also provides information on other potential causes of acute chest pain. With dual-energy CT, lung perfusion abnormalities can also be detected and quantified. Chest radiograph has limited utility, occasionally showing findings of PE or infarction, but is useful in evaluating other potential causes of chest pain. Ventilation-perfusion (VQ) scan demonstrates ventilation-perfusion mismatches in these patients, with several classification schemes, typically ranging from normal to high. Magnetic resonance imaging (MRI) also provides accurate diagnosis, but is available in only specialized centers and requires higher levels of expertise. Catheter pulmonary angiography is no longer used for diagnosis and is used only for interventional management. Echocardiography is used for risk stratification of these patients. In this article, we review the role of imaging in the evaluation of acute PE.
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Affiliation(s)
- Alastair J E Moore
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jason Wachsmann
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Murthy R Chamarthy
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Lloyd Panjikaran
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Yuki Tanabe
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Prabhakar Rajiah
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
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Li H, Kang L, Sun Y. Clinical value of cardiac color ultrasound and cardiac troponin T combined with dynamic electrocardiogram in treatment of acute pulmonary embolism. Exp Ther Med 2018; 15:2044-2048. [PMID: 29434803 PMCID: PMC5776628 DOI: 10.3892/etm.2017.5658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/12/2017] [Indexed: 11/25/2022] Open
Abstract
The clinical value of cardiac color ultrasound and cardiac troponin T (cTnT) combined with dynamic electrocardiogram in evaluating the treatment effect on acute pulmonary embolism (APE) was investigated. Ninety-eight patients with APE treated in Jinan Zhangqiu District Hospital of TCM from March 2016 to February 2017 were selected, and they were examined via the cardiac color ultrasound, cTnT and dynamic electrocardiogram to evaluate the clinical value in the treatment of pulmonary embolism. Electrocardiogram showed that there was no significant difference in the poor prognosis rate between right ventricular strain group and non-right ventricular strain group (P>0.05); the poor prognosis rate in cTnT positive group was significantly higher than that in cTnT negative group (P<0.05). Moreover, the ultrasonic cardiogram revealed that the poor prognosis rate in right ventricular dysfunction group was significantly higher than that in non-right ventricular dysfunction group (P<0.05). It was found in the receiver operating characteristic (ROC) curve analysis that the areas under the curve (AUC) of ROC detected via cardiac color ultrasound and cTnT were >0.9, while that detected via dynamic electrocardiogram was <0.7. Besides, logistic regression analysis showed that cTnT and right ventricular dysfunction were the risk factors affecting the poor prognosis of patients with APE (P<0.05). In conclusion, cardiac color ultrasound can predict the prognosis of patients with APE through monitoring the right ventricular function; cTnT can also evaluate the prognosis of APE; but the electrocardiogram has little significance in evaluating the prognosis of APE.
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Affiliation(s)
- Hongjun Li
- Electrocardiograph Room, Jinan Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan, Shandong 250200, P.R. China
| | - Lixin Kang
- Physical Examination Center, Jinan Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan, Shandong 250200, P.R. China
| | - Yongqiang Sun
- Department of Orthopedics, Jinan Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan, Shandong 250200, P.R. China
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Scharf M, Brendel S, Melzer K, Hentschke C, May M, Uder M, Lell MM. Image quality, diagnostic accuracy, and potential for radiation dose reduction in thoracoabdominal CT, using Sinogram Affirmed Iterative Reconstruction (SAFIRE) technique in a longitudinal study. PLoS One 2017; 12:e0180302. [PMID: 28678818 PMCID: PMC5498038 DOI: 10.1371/journal.pone.0180302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 06/13/2017] [Indexed: 12/15/2022] Open
Abstract
Objective To step-wise evaluate image quality of sinogram-affirmed iterative reconstruction (SAFIRE) in reduced-dose (RD) thoracoabdominal computed tomography (CT) compared to full-dose (FD) and RD filtered back projection (FBP) in a longitudinal study. Materials and methods 122 patients were included in this prospective study. 49 patients (14 men: mean age ± SD, 56±0.4 years; 35 women: 58±1.3 years) completed FD, RD1 (80%-dose) and RD2 (60%-dose) thoracoabdominal CT. Each CT dataset was reconstructed with FBP and SAFIRE. For quantitative image analysis image noise was measured in defined tissue regions. Qualitative image evaluation was performed according to the European Guidelines on Quality criteria for CT. Additionally artifacts, lesion conspicuity, and edge sharpness were assessed. Results Compared to FD-FBP noise in soft tissue increased by 12% in RD1-FBP and 27% in RD2-FBP reconstructions, whereas SAFIRE lead to a decrease of 28% (RD1) and 17% (RD2), respectively (all p <0.001). Visually sharp reproduction, lesion conspicuity, edge sharpness of pathologic findings, and overall image quality did not differ statistically significant between FD-FBP and RD-SAFIRE datasets. Image quality decreased in RD1- and RD2-FBP compared to FD-FBP, reaching statistically significance in RD2 datasets (p <0.001). In RD1- and RD2-FBP (p <0.001) streak artifacts were noted. Conclusion Using SAFIRE the reference mAs in thoracoabdominal CT can be reduced by at least 30% in clinical routine without loss of image quality or diagnostic information.
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Affiliation(s)
- Michael Scharf
- Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
- * E-mail:
| | - Stephanie Brendel
- Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Katja Melzer
- Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Christian Hentschke
- Institute of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias May
- Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael M. Lell
- Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Siegel Y, Kuker R, Banks J, Danton G. CT pulmonary angiogram quality comparison between early and later pregnancy. Emerg Radiol 2017; 24:635-640. [DOI: 10.1007/s10140-017-1506-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
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Kaup M, Gruber-Rouh T, Scholtz JE, Albrecht MH, Bucher A, Frellesen C, Vogl TJ, Beeres M. Low-dose CT pulmonary angiography on a 15-year-old CT scanner: a feasibility study. Acta Radiol Open 2017; 5:2058460116684371. [PMID: 28286671 PMCID: PMC5330415 DOI: 10.1177/2058460116684371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 11/22/2016] [Indexed: 11/16/2022] Open
Abstract
Background Computed tomography (CT) low-dose (LD) imaging is used to lower radiation exposure, especially in vascular imaging; in current literature, this is mostly on latest generation high-end CT systems. Purpose To evaluate the effects of reduced tube current on objective and subjective image quality of a 15-year-old 16-slice CT system for pulmonary angiography (CTPA). Material and Methods CTPA scans from 60 prospectively randomized patients (28 men, 32 women) were examined in this study on a 15-year-old 16-slice CT scanner system. Standard CT (SD) settings were 100 kV and 150 mAs, LD settings were 100 kV and 50 mAs. Attenuation of the pulmonary trunk, various anatomic landmarks, and image noise were quantitatively measured; contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR) were calculated. Three independent blinded radiologists subjectively rated each image series using a 5-point grading scale. Results CT dose index (CTDI) in the LD series was 66.46% lower compared to the SD settings (2.49 ± 0.55 mGy versus 7.42 ± 1.17 mGy). Attenuation of the pulmonary trunk showed similar results for both series (SD 409.55 ± 91.04 HU; LD 380.43 HU ± 93.11 HU; P = 0.768). Subjective image analysis showed no significant differences between SD and LD settings regarding the suitability for detection of central and peripheral PE (central SD/LD, 4.88; intra-class correlation coefficients [ICC], 0.894/4.83; ICC, 0.745; peripheral SD/LD, 4.70; ICC, 0.943/4.57; ICC, 0.919; all P > 0.4). Conclusion The LD protocol, on a 15-year-old CT scanner system without current high-end hardware or post-processing tools, led to a dose reduction of approximately 67% with similar subjective image quality and delineation of central and peripheral pulmonary arteries.
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Affiliation(s)
- Moritz Kaup
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Tatjana Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Jan E Scholtz
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Andreas Bucher
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Claudia Frellesen
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
| | - Martin Beeres
- Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany
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14
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Renapurkar RD, Primak A, Azok J, Lempel J, Tandon Y, Bullen J, Dong F, Karim W, Graham R. Attenuation-based kV pair selection in dual source dual energy computed tomography angiography of the chest: impact on radiation dose and image quality. Eur Radiol 2017; 27:3283-3289. [PMID: 28091793 DOI: 10.1007/s00330-016-4714-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/09/2016] [Accepted: 12/15/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the impact of attenuation-based kilovoltage (kV) pair selection in dual source dual energy (DSDE)-pulmonary embolism (PE) protocol examinations on radiation dose savings and image quality. METHODS A prospective study was carried out on 118 patients with suspected PE. In patients in whom attenuation-based kV pair selection selected the 80/140Sn kV pair, the pre-scan 100/140Sn CTDIvol (computed tomography dose index volume) values were compared with the pre-scan 80/140Sn CTDIvol values. Subjective and objective image quality parameters were assessed. RESULTS Attenuation-based kV pair selection switched to the 80/140Sn kV pair ("switched" cohort) in 63 out of 118 patients (53%). The mean 100/140Sn pre-scan CTDIvol was 8.8 mGy, while the mean 80/140Sn pre-scan CTDIvol was 7.5 mGy. The average estimated dose reduction for the "switched" cohort was 1.3 mGy (95% CI 1.2, 1.4; p < 0.001), representing a 15% reduction in dose. After adjusting for patient weight, mean attenuation was significantly higher in the "switched" vs. "non-switched" cohorts in all five pulmonary arteries and in all lobes on iodine maps. CONCLUSIONS This study demonstrates that attenuation-based kV pair selection in DSDE examination is feasible and can offer radiation dose reduction without compromising image quality. KEY POINTS • Attenuation-based kV pair selection in dual energy examination is feasible. • It can offer radiation dose reduction to approximately 50% of patients. • Approximate 15% reduction in radiation dose was achieved using this technique. • The image quality is not compromised by use of attenuation-based kV pair selection.
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Affiliation(s)
- Rahul D Renapurkar
- Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
| | | | - Joseph Azok
- Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Jason Lempel
- Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Yasmeen Tandon
- Department of Radiology, Case Western Reserve University-Metro Health Medical Center, Cleveland, OH, 44109, USA
| | - Jennifer Bullen
- Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Frank Dong
- Section of Medical Physics, Cleveland Clinic, Cleveland, OH, USA
| | - Wadih Karim
- Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Ruffin Graham
- Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
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15
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Laqmani A, Avanesov M, Butscheidt S, Kurfürst M, Sehner S, Schmidt-Holtz J, Derlin T, Behzadi C, Nagel HD, Adam G, Regier M. Comparison of image quality and visibility of normal and abnormal findings at submillisievert chest CT using filtered back projection, iterative model reconstruction (IMR) and iDose 4™. Eur J Radiol 2016; 85:1971-1979. [PMID: 27776648 DOI: 10.1016/j.ejrad.2016.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/31/2016] [Accepted: 09/04/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare both image quality and visibility of normal and abnormal findings at submillisievert chest CT (smSv-CT) using filtered back projection (FBP) and the two different iterative reconstruction (IR) techniques iterative model reconstruction (IMR) and iDose4™. MATERIALS AND METHODS This institutional review board approved study was based on retrospective interpretation of clinically indicated acquired data. The requirement to obtain informed consent was waived. 81 patients with suspected pneumonia underwent smSv-CT (Brilliance iCT, Philips Healthcare; mean effective dose: 0.86±0.2mSv). Data were reconstructed using FBP and two different IR techniques iDose4™ and IMR (Philips Healthcare) at various iteration levels. Objective image noise (OIN) was measured. Two experienced readers independently assessed all images for image noise, image appearance and visibility of normal anatomic and abnormal findings. A random intercept model was used for statistical analysis. RESULTS Compared to FBP and iDose4™, IMR reduced OIN up to 88% and 72%, respectively (p<0.001). A mild blotchy image appearance was seen in IMR images, affecting diagnostic confidence. iDose4™ images provided satisfactory to good image quality for visibility of normal and abnormal findings and were superior to FBP (p<0.001). IMR images were significantly inferior for visibility of normal structures compared to iDose4™, while being superior for visibility of abnormal findings except for reticular pattern (p<0.001). CONCLUSION IMR results for visibility of normal and abnormal lung findings are heterogeneous, indicating that IMR may not represent a priority technique for clinical routine. iDose4™ represents a suitable method for evaluation of lung tissue at submillisievert chest CT.
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Affiliation(s)
- Azien Laqmani
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Maxim Avanesov
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Sebastian Butscheidt
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Maximilian Kurfürst
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Susanne Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Jakob Schmidt-Holtz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Thorsten Derlin
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Cyrus Behzadi
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Hans D Nagel
- Science & Technology for Radiology, Fritz-Reuter-Weg 5f, 21244 Buchholz, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Marc Regier
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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16
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Stein PD, Matta F, Hughes PG, Hourmouzis ZN, Hourmouzis NP, Schweiss RE, Bach JA, Kazan VM, Kakish EJ, Keyes DC, Hughes MJ. Follow-up CT pulmonary angiograms in patients with acute pulmonary embolism. Emerg Radiol 2016; 23:463-7. [PMID: 27405309 DOI: 10.1007/s10140-016-1422-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/04/2016] [Indexed: 11/29/2022]
Abstract
Computed tomographic (CT) angiography is associated with a non-negligible lifetime attributable risk of cancer. The risk is considerably greater for women and younger patients. Recognizing that there are risks from radiation, the purpose of this investigation was to assess the frequency of follow-up CT angiograms in patients with acute pulmonary embolism. This was a retrospective cohort study of patients aged ≥18 years with acute pulmonary embolism seen in three emergency departments from January 2013 to December 2014. Records of all patients were reviewed for at least 14 months. Pulmonary embolism was diagnosed by CT angiography in 600 patients. At least one follow-up CT angiogram in 1 year was obtained in 141 of 600 (23.5 %). Two follow-ups in 1 year were obtained in 40 patients (6.7 %), 3 follow-ups were obtained in 15 patients (2.5 %), and 4 follow-ups were obtained in 3 patients (0.5 %). Among young women (aged ≤29 years) with pulmonary embolism, 10 of 21 (47.6 %) had at least 1 follow-up and 4 of 21 (19.0 %) had 2 or more follow-ups in 1 year. Among all patients, recurrent pulmonary embolism was diagnosed in 15 of 141 (10.6 %) on the first follow-up CT angiogram and in 6 of 40 (15.0 %) on the second follow-up. Follow-up CT angiograms were obtained in a significant proportion of patients with pulmonary embolism, including young women, the group with the highest risk. Alternative options might be considered to reduce the hazard of radiation-induced cancer, particularly in young women.
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Affiliation(s)
- Paul D Stein
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, 909 Fee Road, East Lansing, MI, 48824, USA.
| | - Fadi Matta
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, 909 Fee Road, East Lansing, MI, 48824, USA
| | - Patrick G Hughes
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, 909 Fee Road, East Lansing, MI, 48824, USA.,Department of Medical Education, Summa Akron City Hospital, Akron, OH, USA
| | - Zak N Hourmouzis
- Department of Medical Education, Summa Akron City Hospital, Akron, OH, USA
| | - Nina P Hourmouzis
- Department of Medical Education, Summa Akron City Hospital, Akron, OH, USA
| | - Robert E Schweiss
- Department of Emergency Medicine, St. Mary Mercy Hospital, Livonia, MI, USA
| | - Jennifer A Bach
- Department of Emergency Medicine, St. Mary Mercy Hospital, Livonia, MI, USA
| | - Viviane M Kazan
- Department of Emergency Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - Edward J Kakish
- Department of Emergency Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - Daniel C Keyes
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, 909 Fee Road, East Lansing, MI, 48824, USA.,Department of Emergency Medicine, St. Mary Mercy Hospital, Livonia, MI, USA
| | - Mary J Hughes
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, 909 Fee Road, East Lansing, MI, 48824, USA
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17
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Boos J, Kröpil P, Lanzman RS, Aissa J, Schleich C, Heusch P, Sawicki LM, Antoch G, Thomas C. CT pulmonary angiography: simultaneous low-pitch dual-source acquisition mode with 70 kVp and 40 ml of contrast medium and comparison with high-pitch spiral dual-source acquisition with automated tube potential selection. Br J Radiol 2016; 89:20151059. [PMID: 27007972 DOI: 10.1259/bjr.20151059] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the feasibility of a 70-kVp CT pulmonary angiography (CTPA) protocol using simultaneous dual-source (SimDS) acquisition mode with 40 ml of contrast medium (CM) and comparison with a high-pitch spiral dual-source (SpiralDS) acquisition protocol with automated tube potential selection (ATPS). METHODS Following the introduction of a new 70-kVp/40-ml SimDS-CTPA protocol in December 2014 for all patients with a body mass index (BMI) below 35 kg m(-2), the first 35 patients were retrospectively included in this study and assigned to Group A (BMI: 27 ± 4 kg m(-2), age: 66 ± 15 years). The last 35 patients with a BMI below 35 kg m(-2) who had received SpiralDS-CTPA with ATPS were included for comparison (Group B) (70 ml CM; BMI: 27 ± 4 kg m(-2), age: 68 ± 16 years). Subjective image quality (image quality) was assessed by two radiologists (from 1, non-diagnostic, to 4, excellent). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), volumetric CT dose index (CTDIvol), dose-length product (DLP) and effective dose were assessed. RESULTS All examinations were of diagnostic image quality. Subjective image quality, SNR and CNR were comparable between Groups A and B (3.7 ± 0.6 vs 3.7 ± 0.5, 14.6 ± 6.0 vs 13.9 ± 3.7 and 12.4 ± 5.7 vs 11.6 ± 3.3, respectively; p > 0.05). CTDIvol, DLP and effective dose were significantly lower in Group A than in Group B (4.5 ± 1.6 vs 7.5 ± 2.1 mGy, 143.3 ± 44.8 vs 278.3 ± 79.44 mGy cm and 2.0 ± 0.6 vs 3.9 ± 1.1 mSv, respectively; p < 0.05). CONCLUSION 70-kVp SimDS-CTPA with 40 ml of CM is feasible and provides diagnostic image quality, while radiation dose and CM can be reduced by almost 50% and 40%, respectively, compared with a SpiralDS-CTPA protocol with ATPS. ADVANCES IN KNOWLEDGE 70-kVp SimDS-CTPA with 40 ml of CM is feasible in patients with a BMI up to 35 kg m(-2) and can help reduce radiation exposure and CM in these patients.
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Affiliation(s)
- Johannes Boos
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Patric Kröpil
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Rotem S Lanzman
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Joel Aissa
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Christoph Schleich
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Philipp Heusch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Lino M Sawicki
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Christoph Thomas
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
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