Rahul D Renapurkar1, Andrew Primak2, Joseph Azok3, Jason Lempel3, Yasmeen Tandon4, Jennifer Bullen5, Frank Dong6, Wadih Karim3, Ruffin Graham3. 1. Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. renapur@ccf.org. 2. Siemens Medical Solutions, Malvern, PA, USA. 3. Thoracic Imaging, L10, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. 4. Department of Radiology, Case Western Reserve University-Metro Health Medical Center, Cleveland, OH, 44109, USA. 5. Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. 6. Section of Medical Physics, Cleveland Clinic, Cleveland, OH, USA.
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.
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.
Entities:
Keywords:
Attenuation; CARE kV; CT angiography; Dual energy CT; Pulmonary embolism
Authors: James V Spearman; U Joseph Schoepf; Marietta Rottenkolber; Ivo Driesser; Christian Canstein; Kolja M Thierfelder; Aleksander W Krazinski; Carlo N De Cecco; Felix G Meinel Journal: Radiology Date: 2015-10-16 Impact factor: 11.105
Authors: Priyanka Prakash; Mannudeep K Kalra; Avinash K Kambadakone; Homer Pien; Jiang Hsieh; Michael A Blake; Dushyant V Sahani Journal: Invest Radiol Date: 2010-04 Impact factor: 6.016
Authors: Achim Eller; Wolfgang Wuest; Michael Scharf; Michael Brand; Stephan Achenbach; Michael Uder; Michael M Lell Journal: Eur J Radiol Date: 2013-08-30 Impact factor: 3.528
Authors: Martin Beeres; Kimberly Williams; Ralf W Bauer; Jan Scholtz; Moritz Kaup; Tatjana Gruber-Rouh; Clara Lee; Julian L Wichmann; Claudia Frellesen; Nour-Eldin A Nour-Eldin; Thomas J Vogl; Josef Matthias Kerl; Boris Bodelle Journal: J Comput Assist Tomogr Date: 2015 Jul-Aug Impact factor: 1.826
Authors: Edward T D Hoey; Saeed Mirsadraee; Joanna Pepke-Zaba; David P Jenkins; Deepa Gopalan; Nicholas J Screaton Journal: AJR Am J Roentgenol Date: 2011-03 Impact factor: 3.959
Authors: Paul Apfaltrer; Valentin Bachmann; Mathias Meyer; Thomas Henzler; John M Barraza; Joachim Gruettner; Thomas Walter; U Joseph Schoepf; Stefan O Schoenberg; Christian Fink Journal: Eur J Radiol Date: 2012-04-09 Impact factor: 3.528
Authors: Fernando Uliana Kay; Marcelo A Beraldo; Maria A M Nakamura; Roberta De Santis Santiago; Vinicius Torsani; Susimeire Gomes; Rollin Roldan; Mauro R Tucci; Suhny Abbara; Marcelo B P Amato; Edson Amaro Journal: J Comput Assist Tomogr Date: 2018 Nov/Dec Impact factor: 1.826