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

Autor: Renapurkar RD; Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. renapur@ccf.org., Primak A; Siemens Medical Solutions, Malvern, PA, USA., Azok J; Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA., Lempel J; Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA., Tandon Y; Department of Radiology, Case Western Reserve University-Metro Health Medical Center, Cleveland, OH, 44109, USA., Bullen J; Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA., Dong F; Section of Medical Physics, Cleveland Clinic, Cleveland, OH, USA., Karim W; Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA., Graham R; Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2017 Aug; Vol. 27 (8), pp. 3283-3289. Date of Electronic Publication: 2017 Jan 13.
DOI: 10.1007/s00330-016-4714-7
Abstrakt: 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.
Databáze: MEDLINE
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