Attenuation-based kV pair selection in dual source dual energy computed tomography angiography of the chest: impact on radiation dose and image quality.

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.

• Authors: Rahul D Renapurkar, Andrew Primak, Joseph Azok, Jason Lempel, Yasmeen Tandon, Jennifer Bullen, Frank Dong, Wadih Karim, Ruffin Graham
• Journal: European radiology (Eur Radiol) Vol. 27 Issue 8 Pg. 3283-3289 (Aug 2017) ISSN: 1432-1084 [Electronic] Germany
• PMID: 28091793 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Body Weight
• Computed Tomography Angiography (methods, standards)
• Feasibility Studies
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Pulmonary Artery (diagnostic imaging)
• Pulmonary Embolism (diagnostic imaging)
• Radiation Dosage
• Radiography, Thoracic (methods, standards)