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70-kVp High-pitch Computed Tomography Pulmonary Angiography with 40 mL Contrast Agent: Initial Experience
Xie Li1, Qian Qian Ni2, U Joseph Schoepf3
1Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, No.305, ZhongShan East Road, Nanjing, Jiangsu 210002, China.
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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