Xie Li1, Qian Qian Ni2, U Joseph Schoepf3, Julian L Wichmann4, Lloyd M Felmly5, Li Qi2, Xiang Kong2, Chang Sheng Zhou2, Song Luo2, Long Jiang Zhang6, Guang Ming Lu7. 1. Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, No.305, ZhongShan East Road, Nanjing, Jiangsu 210002, China. 2. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. 3. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA. 4. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany. 5. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA. 6. Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, No.305, ZhongShan East Road, Nanjing, Jiangsu 210002, China; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: kevinzhlj@163.com. 7. Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, No.305, ZhongShan East Road, Nanjing, Jiangsu 210002, China; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: cjr.luguangming@vip.163.com.
Abstract
RATIONALE AND OBJECTIVES: To assess image quality, radiation dose, and diagnostic accuracy of 70-kVp high-pitch computed tomography pulmonary angiography (CTPA) using 40 mL contrast agent and sinogram affirmed iterative reconstruction (SAFIRE) compared to 100-kVp CTPA using 60 mL contrast agent and filtered back projection. MATERIALS AND METHODS: Eighty patients underwent CTPA at either 70 kVp (group A, n = 40; 3.2 pitch, 40 mL contrast medium, and SAFIRE) or 100 kVp (group B, n = 40; 1.2 pitch, 60 mL contrast medium, and filtered back projection). Signal-to-noise ratio and contrast-to-noise ratio were calculated. Subjective image quality was evaluated using a five-grade scale, and diagnostic accuracy was assessed. Radiation doses were compared. RESULTS: Computed tomography values, signal-to-noise ratio, and contrast-to-noise ratio of pulmonary arteries were higher in group A compared to group B (all P < 0.001). Subjective image quality showed no difference between the two groups (P = 0.559) with good interobserver agreement (κ = 0.647). No difference was found regarding diagnostic accuracy between the two groups (P > 0.05). The effective dose for group A was lower by 80% compared to group B (P < 0.001). CONCLUSIONS: 70-kVp high-pitch CTPA with reduced contrast media and SAFIRE provides comparable image quality and substantial radiation dose savings compared to a routine CTPA protocol.
RATIONALE AND OBJECTIVES: To assess image quality, radiation dose, and diagnostic accuracy of 70-kVp high-pitch computed tomography pulmonary angiography (CTPA) using 40 mL contrast agent and sinogram affirmed iterative reconstruction (SAFIRE) compared to 100-kVp CTPA using 60 mL contrast agent and filtered back projection. MATERIALS AND METHODS: Eighty patients underwent CTPA at either 70 kVp (group A, n = 40; 3.2 pitch, 40 mL contrast medium, and SAFIRE) or 100 kVp (group B, n = 40; 1.2 pitch, 60 mL contrast medium, and filtered back projection). Signal-to-noise ratio and contrast-to-noise ratio were calculated. Subjective image quality was evaluated using a five-grade scale, and diagnostic accuracy was assessed. Radiation doses were compared. RESULTS: Computed tomography values, signal-to-noise ratio, and contrast-to-noise ratio of pulmonary arteries were higher in group A compared to group B (all P < 0.001). Subjective image quality showed no difference between the two groups (P = 0.559) with good interobserver agreement (κ = 0.647). No difference was found regarding diagnostic accuracy between the two groups (P > 0.05). The effective dose for group A was lower by 80% compared to group B (P < 0.001). CONCLUSIONS: 70-kVp high-pitch CTPA with reduced contrast media and SAFIRE provides comparable image quality and substantial radiation dose savings compared to a routine CTPA protocol.
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