Lukas Lenga1, Franziska Trapp2, Moritz H Albrecht3, Julian L Wichmann3, Addison A Johnson4, Ibrahim Yel3, Tommaso D'Angelo3,5, Christian Booz3, Thomas J Vogl2, Simon S Martin3,4. 1. Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. lukas.lenga@gmail.com. 2. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany. 3. Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. 4. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA. 5. Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy.
Abstract
OBJECTIVES: To evaluate radiation exposure and image quality in matched patient cohorts for CT pulmonary angiography (CTPA) acquired in single- and dual-energy mode using second- and third-generation dual-source CT (DSCT) systems. METHODS: We retrospectively included 200 patients (mean age, 65.5 years ± 15.7 years) with suspected pulmonary embolism-equally divided into four study groups (n = 50) and matched by gender and body mass index. CTPA was performed with vendor-predefined second-generation (group A, 100-kV single-energy computed tomography (SECT); group B, 80/Sn140-kV dual-energy computed tomography (DECT)) or third-generation DSCT (group C, 100-kV SECT; group D, 90/Sn150-kV DECT) devices. Radiation metrics were assessed using a normalized scan range of 27.5 cm. For objective image quality evaluation, dose-independent figure-of-merit (FOM) contrast-to-noise ratios (CNRs) were calculated. Subjective image analysis included ratings for overall image quality, reader confidence, and image artifacts using five-point Likert scales. RESULTS: Calculations of the effective dose (ED) of radiation for a normalized scan range of 27.5 cm showed nonsignificant differences between SECT and DECT acquisitions for each scanner generation (p ≥ 0.253). The mean effective radiation dose was lower for third-generation groups C (1.5 mSv ± 0.8 mSv) and D (1.4 mSv ± 0.7 mSv) compared to second-generation groups A (2.5 mSv ± 0.9 mSv) and B (2.3 mSv ± 0.6 mSv) (both p ≤ 0.013). FOM-CNR measurements were highest for group D. Qualitative image parameters of overall image quality, reader confidence, and image artifacts showed nonsignificant differences among the four groups (p ≥ 0.162). CONCLUSIONS: Third-generation DSCT systems show lower radiation dose parameters for CTPA compared to second-generation DSCT. DECT can be performed with both scanner generations without radiation dose penalty or detrimental effects on image quality compared to SECT. KEY POINTS: • Radiation exposure showed nonsignificant differences between SECT and DECT for both DSCT scanner devices. • Dual-energy CTPA provides equivalent image quality compared to standard image acquisition. • Subjective image quality assessment was similar among the four study groups.
OBJECTIVES: To evaluate radiation exposure and image quality in matched patient cohorts for CT pulmonary angiography (CTPA) acquired in single- and dual-energy mode using second- and third-generation dual-source CT (DSCT) systems. METHODS: We retrospectively included 200 patients (mean age, 65.5 years ± 15.7 years) with suspected pulmonary embolism-equally divided into four study groups (n = 50) and matched by gender and body mass index. CTPA was performed with vendor-predefined second-generation (group A, 100-kV single-energy computed tomography (SECT); group B, 80/Sn140-kV dual-energy computed tomography (DECT)) or third-generation DSCT (group C, 100-kV SECT; group D, 90/Sn150-kV DECT) devices. Radiation metrics were assessed using a normalized scan range of 27.5 cm. For objective image quality evaluation, dose-independent figure-of-merit (FOM) contrast-to-noise ratios (CNRs) were calculated. Subjective image analysis included ratings for overall image quality, reader confidence, and image artifacts using five-point Likert scales. RESULTS: Calculations of the effective dose (ED) of radiation for a normalized scan range of 27.5 cm showed nonsignificant differences between SECT and DECT acquisitions for each scanner generation (p ≥ 0.253). The mean effective radiation dose was lower for third-generation groups C (1.5 mSv ± 0.8 mSv) and D (1.4 mSv ± 0.7 mSv) compared to second-generation groups A (2.5 mSv ± 0.9 mSv) and B (2.3 mSv ± 0.6 mSv) (both p ≤ 0.013). FOM-CNR measurements were highest for group D. Qualitative image parameters of overall image quality, reader confidence, and image artifacts showed nonsignificant differences among the four groups (p ≥ 0.162). CONCLUSIONS: Third-generation DSCT systems show lower radiation dose parameters for CTPA compared to second-generation DSCT. DECT can be performed with both scanner generations without radiation dose penalty or detrimental effects on image quality compared to SECT. KEY POINTS: • Radiation exposure showed nonsignificant differences between SECT and DECT for both DSCT scanner devices. • Dual-energy CTPA provides equivalent image quality compared to standard image acquisition. • Subjective image quality assessment was similar among the four study groups.
Authors: Jan C Schenzle; Wieland H Sommer; Klement Neumaier; Gisela Michalski; Ursula Lechel; Konstantin Nikolaou; Christoph R Becker; Maximilian F Reiser; Thorsten R C Johnson Journal: Invest Radiol Date: 2010-06 Impact factor: 6.016
Authors: Sebastian T Schindera; Rendon C Nelson; Srinivasan Mukundan; Erik K Paulson; Tracy A Jaffe; Chad M Miller; David M DeLong; Keigo Kawaji; Terry T Yoshizumi; Ehsan Samei Journal: Radiology Date: 2008-01 Impact factor: 11.105
Authors: Paul D Stein; Sarah E Fowler; Lawrence R Goodman; Alexander Gottschalk; Charles A Hales; Russell D Hull; Kenneth V Leeper; John Popovich; Deborah A Quinn; Thomas A Sos; H Dirk Sostman; Victor F Tapson; Thomas W Wakefield; John G Weg; Pamela K Woodard Journal: N Engl J Med Date: 2006-06-01 Impact factor: 91.245
Authors: Andrew N Primak; Juan Carlos Ramirez Giraldo; Christian D Eusemann; Bernhard Schmidt; Birgit Kantor; Joel G Fletcher; Cynthia H McCollough Journal: AJR Am J Roentgenol Date: 2010-11 Impact factor: 3.959
Authors: Conrad Wittram; Michael M Maher; Albert J Yoo; Mannudeep K Kalra; Jo-Anne O Shepard; Theresa C McLoud Journal: Radiographics Date: 2004 Sep-Oct Impact factor: 5.333
Authors: Anno Graser; Thorsten R C Johnson; Elizabeth M Hecht; Christoph R Becker; Christianne Leidecker; Michael Staehler; Christian G Stief; Henriette Hildebrandt; Myrna C B Godoy; Myra E Finn; Flora Stepansky; Maximilian F Reiser; Michael Macari Journal: Radiology Date: 2009-06-01 Impact factor: 11.105
Authors: Lukas Lenga; Marvin Lange; Simon S Martin; Moritz H Albrecht; Christian Booz; Ibrahim Yel; Christophe T Arendt; Thomas J Vogl; Doris Leithner Journal: Br J Radiol Date: 2021-04-29 Impact factor: 3.039
Authors: Tommaso D'Angelo; Moritz H Albrecht; Danilo Caudo; Silvio Mazziotti; Thomas J Vogl; Julian L Wichmann; Simon Martin; Ibrahim Yel; Giorgio Ascenti; Vitali Koch; Giuseppe Cicero; Alfredo Blandino; Christian Booz Journal: Eur Radiol Exp Date: 2021-09-03
Authors: Aleksander Kosmala; Philipp Gruschwitz; Simon Veldhoen; Andreas Max Weng; Bernhard Krauss; Thorsten Alexander Bley; Bernhard Petritsch Journal: Int J Cardiovasc Imaging Date: 2020-06-06 Impact factor: 2.357