Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Comparison of Image Quality of Low Voltage 64-slice Multidetector CT Angiography with the Standard Condition in Patients Suspected of Pulmonary Embolism

Document Type : Original Paper

Authors
1 MD, Department of Radiology, Ahvaz Jondishapur University of Medical Sciences, Khuzestan, Iran
2 MD, Ahvaz Jondishapur University of Medical Sciences, Khuzestan, Iran
3 MD, Nikan Health Researchers Institute, Tehran, Iran
4 MD, PhD, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Abstract
Introduction: Reduction of peak kilovoltage (kV) setting has been a useful approach to d creating radiation dose; however, it may have varied effects on noise and the accuracy of diagnosis. Thus, we compared image quality between low (80 kV) and standard kilovoltage (100 kV) protocols.
Material and Methods: This triple blind non-randomized parallel quasi-experimental study was conducted on 140 cases of questionable pulmonary embolism.
Results: Image quality was twice as high as the standard protocol in the 80-kV group (odds ratio=2.08). Main, segmental, and subsegmental arteries showed significantly higher vascular enhancement (P<0.001) in the 80-kV group. Similarly, the mean number of measurable segmental arteries was significantly greater in the 80-kV group relative to the standard group. On the other hand, the mean of image noise was significantly higher in the 80-kV group in comparison with the 100-kV group (mean: 68.4 vs. 43.1; P<0.001). Finally, the mean of radiation dose received in the 80-kV group was significantly lower than that in the 100-kV group (mean: 0.94 vs. 2.43 mSv; P<0.001).
Conclusion: Lower radiation dose received and higher image quality, but worse image noise, in the 80-kV group compared to the 100-kV group present acceptable evidence in support of reduction of voltage in cases with the suspicion of pulmonary embolism. In these patients, therefore, it is recommended as a good strategy to be adopted in computed tomography angiography.
Keywords
Subjects

  1. Alotaibi GS, Wu C, Senthilselvan A, McMurtry MS. Secular trends in incidence and mortality of acute venous thromboembolism: the AB-VTE population-based study. The American journal of medicine. 2016;129(8):879-e19.
  2. Nijkeuter M, Hovens MM, Davidson BL, Huisman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest. 2006 Jan 1;129(1):192-7.
  3. Kuriakose J, Patel S. Acute pulmonary embolism. Radiologic Clinics. 2010 ;48(1):31-50.
  4. Walsham AC, Roberts HC, Kashani HM, Mongiardi CN, Ng YL, Patsios DA. The use of computer-aided detection for the assessment of pulmonary arterial filling defects at computed tomographic angiography. Journal of computer assisted tomography. 2008; 32(6):913-8.
  5. Moores L, Bilello KL, Murin S. Sex and gender issues and venous thromboembolism1. Clinics in chest medicine. 2004;25(2):281-97.
  6. Karimizarchi H, Chaparian A. Estimating risk of exposure induced cancer death in patients undergoing computed tomography pulmonary angiography. Radioprotection. 2017; 52(2):81-6.
  7. Chaparian A, Zarchi HK. Assessment of radiation-induced cancer risk to patients undergoing computed tomography angiography scans. International Journal of Radiation Research. 2018;16(1):107-15.
  8. Heyer CM, Mohr PS, Lemburg SP, Peters SA, Nicolas V. Image quality and radiation exposure at pulmonary CT angiography with 100-or 120-kVp protocol: prospective randomized study. Radiology. 2007; 245(2):577-83.
  9. Szucs-Farkas Z, Schibler F, Cullmann J, Torrente JC, Patak MA, Raible S, et al. Diagnostic accuracy of pulmonary CT angiography at low tube voltage: intraindividual comparison of a normal-dose protocol at 120 kVp and a low-dose protocol at 80 kVp using reduced amount of contrast medium in a simulation study. American Journal of Roentgenology. 2011;197(5):852-9.
  10. Suess C, Chen X. Dose optimization in pediatric CT: current technology and future innovations. Pediatric radiology. 2002;32(10):729-34.
  11. Sigal-Cinqualbre AB, Hennequin R, Abada HT, Chen X, Paul JF. Low-kilovoltage multi–detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology. 2004; 231(1):169-74.
  12. LaBounty TM, Leipsic J, Poulter R, Wood D, Johnson M, Srichai MB, et al. Coronary CT angiography of patients with a normal body mass index using 80 kVp versus 100 kVp: a prospective, multicenter, multivendor randomized trial. American Journal of Roentgenology. 2011 Nov;197(5):W860-7.
  13. Schueller-Weidekamm C, Schaefer-Prokop CM, Weber M, Herold CJ, Prokop M. CT angiography of pulmonary arteries to detect pulmonary embolism: improvement of vascular enhancement with low kilovoltage settings. Radiology. 2006 ; 241(3):899-907.
  14. Albrecht MH, Bickford MW, Schoepf UJ, Tesche C, De Santis D, Eid M, et al. Beam-hardening in 70-kV Coronary CT angiography: Artifact reduction using an advanced post-processing algorithm. European journal of radiology. 2018; 101:111-7.
  15. Wintersperger B, Jakobs T, Herzog P, Schaller S, Nikolaou K, Suess C, et al. Aorto-iliac multidetector-row CT angiography with low kV settings: improved vessel enhancement and simultaneous reduction of radiation dose. European radiology. 2005; 15(2):334-41.
  16. Remy-Jardin M, Remy J, Artaud D, Deschildre F, Duhamel A. Peripheral pulmonary arteries: optimization of the spiral CT acquisition protocol. Radiology. 1997; 204(1):157-63.
  17. Engelke C, Manstein P, Rummeny EJ, Marten K. Suspected and incidental pulmonary embolism on multidetector-row CT: analysis of technical and morphological factors influencing the diagnosis in a cross-sectional cancer centre patient cohort. Clinical radiology. 2006; 61(1):71-80.;25: 102–13.

 

 

 

 

Volume 15, Issue 4 - Serial Number 4
Autumn 2018
Pages 237-242

  • Receive Date 16 December 2017
  • Revise Date 26 March 2018
  • Accept Date 27 March 2018