Optimization of image quality in pulmonary CT angiography with low dose of contrast material

• Autorzy: Assi A. A. N. , Arra A. A.

Identyfikatory

DOI

10.1515/pjmpe-2017-0008

• Języki publikacji: EN

Abstrakty

EN

Aim: The aim of this study was to compare objective image quality data for patient pulmonary embolism between a conventional pulmonary CTA protocol with respect to a novel acquisition protocol performed with optimize radiation dose and less amount of iodinated contrast medium injected to the patients during PE scanning. Materials and Methods: Sixty- four patients with Pulmonary Embolism (PE) possibility, were examined using angio-CT protocol. Patients were randomly assigned to two groups: A (16 women and 16 men, with age ranging from 19-89 years) mean age, 62 years with standard deviation 16; range, 19-89 years) - injected contrast agent: 35-40 ml. B (16 women and 16 men, with age ranging from 28-86 years) - injected contrast agent: 70-80 ml. Other scanning parameters were kept constant. Pulmonary vessel enhancement and image noise were quantified; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective vessel contrast was assessed by two radiologists in consensus. Result: A total of 14 cases of PE (22 %) were found in the evaluated of subjects (nine in group A, and five in group B). All PE cases were detected by the two readers. There was no significant difference in the size or location of the PEs between the two groups, the average image noise was 14 HU for group A and 19 HU for group B. The difference was not statistically significant (p = 0.09). Overall, the SNR and CNR were slightly higher on group B (24.4 and 22.5 respectively) compared with group A (19.4 and 16.4 respectively), but those differences were not statistically significant (p = 0.71 and p = 0.35, respectively). Conclusion and Discussion: Both groups that had been evaluated by pulmonary CTA protocol allow similar image quality to be achieved as compared with each other's, with optimize care dose for both protocol and contrast volume were reduced by 50 % in new protocol comparing to the conventional protocol.

Słowa kluczowe

EN

pulmonary embolism; signal to noise ratio; contrast to noise ratio; contrast volume; image quality

• Wydawca: Polskie Towarzystwo Fizyki Medycznej ; De Gruyter
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2017
• Tom: Vol. 23, Iss. 2
• Strony: 43--46
• Opis fizyczny: Bibliogr. 26 poz., rys., tab.

Twórcy

autor

Assi A. A. N.

• Department of medical imaging , Arab American University, Jenin, Palestine
• Department of medical imaging, An-Najah University, Nablus, Palestine

autor

Arra A. A.

• Department of medical imaging, An-Najah University, Nablus, Palestine

Bibliografia

• [1] Remy-Jardin M, Pistolesi M, Goodman LR, et al. Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology. 2007;245(2):315-329.
• [2] Perrier A, Roy PM, Sanchez O, et al. Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med. 2005;352:1760-1788.
• [3] Righini M, Le Gal G, Aujesky D, et al. Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial. Lancet. 2008;371(9621):1343-1352.
• [4] Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006; 354:2317-2327.
• [5] Horlander KT, Mannino DM, Leeper KV. Pulmonary embolism mortality in the United States, 1979-1998: an analysis using multiple-cause mortality data. Arch Intern Med. 2003;163(14):1711-1717.
• [6] Blachere H, Latrabe V, Montaudon M, et al. Pulmonary embolism revealed on helical CT angiography: comparison with ventilation-perfusion radionuclide lung scanning. AJR Am J Roentgenol. 2000;174(4):1041-1047.
• [7] Coche E, Verschuren F, Keyeux A, et al. Diagnosis of acute pulmonary embolism in outpatients: comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy. Radiology. 2003;229(3):757-765.
• [8] Mayo JR, Remy-Jardin M, Muller NL, et al. Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology. 1997;205(2):447-452.
• [9] Remy-Jardin M, Remy J, Baghaie F, et al. Clinical value of thin collimation in the diagnostic workup of pulmonary embolism. AJR Am J Roentgenol. 2000;175(2):407-411.
• [10] O’Neill J, Murchison JT, Wright L, et al. Effect of the introduction of helical CT on radiation dose in the investigation of pulmonary embolism. Br J Radiol. 2005;78(925):46-50.
• [11] O’Neill JM, Wright L, Murchison JT. Helical CTPA in the investigation of pulmonary embolism: a 6-year review. Clin Radiol. 2004;9(9):819-825.
• [12] Holmquist F, Hansson K, Pasquariello F, et al. Minimizing contrast medium doses to diagnose pulmonary embolism with 80-kVp multidetector computed tomography in azotemic patients. Acta Radiol. 2009;50(2):181-193.
• [13] Holmquist F, Nyman U. Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients. Eur Radiol. 2006;16(5):1165-1176.
• [14] Szucs-Farkas Z, Kurmann L, Strautz T, et al. Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100- and 80-kVp protocols. Invest Radiol. 2008;43(12):871-876.
• [15] Bae KT. Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology. 2003;227(3):809-816.
• [16] Han JK, Kim AY, Lee KY, et al.. Factors influencing vascular and hepatic enhancement at CT: experimental study on injection protocol using a canine model. J Comput Assist Tomogr, 2000;24(3):400-406.
• [17] Schoellnast H, Deutschmann HA, Berghold A, et al. MDCT angiography of the pulmonary arteries: influence of body weight, body mass index, and scan length on arterial enhancement at different iodine flow rates. AJR Am J Roentgenol. 2006;187(4):1074-1078.
• [18] Dean PB, Violante MR, Mahoney JA. Hepatic CT contrast enhancement: effect of dose, duration of infusion, and time elapsed following infusion. Invest Radiol. 1980;15(2):158-161.
• [19] Heiken JP, Brink JA, McClennan BL, et al. Dynamic contrast-enhanced CT of the liver: comparison of contrast medium injection rates and uniphasic and biphasic injection protocols. Radiology. 1993;187(2):327-331.
• [20] Chambers TP, Baron RL, Lush RM. Hepatic CT enhancement. I. Alterations in the volume of contrast material within the same patients. Radiology. 1994;193(2):513-517.
• [21] Kopka L, Rodenwaldt J, Fischer U, et al. Dual-phase helical CT of the liver: effects of bolus tracking and different volumes of contrast material. Radiology. 1996;201(2):321-326.
• [22] Awai K, Hiraishi K, Hori S. Effect of contrast material injection duration and rate on aortic peak time and peak enhancement at dynamic CT involving injection protocol with dose tailored to patient weight. Radiology. 2004;230(1):142-150.
• [23] Bae KT, Heiken JP. Scan and contrast administration principles of MDCT. Eur Radiol. 2005;15(suppl 5):E46-E59.
• [24] Erturk SM, Ichikawa T, Sou H, et al. Effect of duration of contrast material injection on peak enhancement times and values of the aorta, main portal vein, and liver at dynamic MDCT with the dose of contrast medium tailored to patient weight. Clin Radiol. 2008;63(3):263-271.
• [25] Dorio PJ, Lee Jr FT, Henseler KP, et al. Using a saline chaser to decrease contrast media in abdominal CT. AJR Am J Roentgenol. 2003;180:929-934.
• [26] Haage P, Schmitz-Rode T, Hübner D, et al. Reduction of contrast material dose and artifacts by a saline flush using a double power injector in helical CT of the thorax. AJR Am J Roentgenol. 2000;174:1049-1053.