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MDCT for suspected pulmonary embolism: multi-institutional survey of 16-MDCT data acquisition protocols
Pamela T Johnson1, David Naidich, Elliot K Fishman
1The Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins School of Medicine, 601 N. Caroline Street, Room 3251, Baltimore, MD 21287, USA.
Abstract:
The purpose of this study was to determine the extent to which a consensus exists on multidetector row computed tomography (MDCT) protocol parameters for suspected pulmonary embolism (PE). In August of 2004, a questionnaire addressing a number of body MDCT protocols was mailed to 99 fellows of the Society of Computed Body Tomography, representing a total of 46 institutions. In May 2005, this was followed up with a second mailing. The survey requested details pertaining to protocols for the most advanced MDCT scanner in the department. The overall survey response rate of 37% (17/46) yielded 15 protocols for 16-MDCT imaging of suspected PE. This data was tabulated and revealed a consensus for the use of bolus tracking, rapid contrast infusion, caudo-cranial scanning, the narrowest detector row collimation, and thin (<2 mm) reconstruction sections. However, contrast infusion timing, contrast concentration, and implementation of radiation dose modulation were variable. This compilation of protocols reflects recently published studies advocating the use of narrow acquisition collimation and reconstruction sections for MDCT of suspected PE. Future studies are necessary to elucidate the optimal intravenous contrast infusion parameters and further assess the efficacy of reduced radiation dose protocols.
Insights
Consensus exists for multidetector row computed tomography (MDCT) protocols in diagnosing pulmonary embolism (PE), particularly regarding bolus tracking and thin reconstruction sections. However, contrast timing and radiation dose modulation remain variable.
Area of Science:
- Radiology
- Medical Imaging
- Diagnostic Procedures
Background:
- Pulmonary embolism (PE) diagnosis relies heavily on medical imaging.
- Multidetector row computed tomography (MDCT) is a primary imaging modality for suspected PE.
- Standardization of MDCT protocols is crucial for consistent diagnostic accuracy.
Purpose of the Study:
- To assess the level of consensus on multidetector row computed tomography (MDCT) protocol parameters for diagnosing pulmonary embolism (PE).
- To identify areas of agreement and variability in MDCT protocols used for PE detection.
Main Methods:
- A survey questionnaire was distributed to radiologists at multiple institutions to gather data on MDCT protocols for suspected PE.
- Data was collected on parameters including contrast administration, scanning direction, collimation, and reconstruction.
- A response rate of 37% yielded 15 protocols for 16-MDCT imaging.
Main Results:
- A consensus was observed for specific MDCT parameters: bolus tracking, rapid contrast infusion, caudo-cranial scanning, narrowest detector row collimation, and thin reconstruction sections (<2 mm).
- Significant variability was found in contrast infusion timing, contrast concentration, and the implementation of radiation dose modulation techniques.
- The compiled protocols align with recent literature advocating for narrow acquisition and reconstruction parameters in MDCT for PE.
Conclusions:
- While consensus exists on several key MDCT parameters for PE diagnosis, significant variability persists in others.
- Further research is needed to optimize intravenous contrast administration and evaluate reduced radiation dose protocols for MDCT in PE.
- Standardization efforts should focus on areas of current variability to enhance diagnostic consistency and patient safety.
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