Dual-Energy Computed Tomography Pulmonary Angiography: Comparison of Vessel Enhancement between Linear Blended and
Andrew Murphy1, Jeffrey Cheng2, Jit Pratap2
1Department of Medical Imaging, British Columbia Children's Hospital, Vancouver, Canada; Department of Medical Imaging, St Paul's Hospital, Vancouver, Canada; Faculty of Health Sciences, The University of Sydney, Discipline of Medical Radiation Sciences, Cumberland Campus, Lidcombe, Australia.
Introduction:
Optimal opacification of the pulmonary vasculature is a fundamental factor of a diagnostic quality computed tomography pulmonary angiogram (CTPA). This retrospective study examined the feasibility of utilising a noise-optimised monoenergetic reconstruction of the dual-energy computed tomography pulmonary angiogram (DE-CTPA) as an additional protocol to increase vessel opacification.
Method:
The study involved a retrospective analysis of 129 patients, 69 males (average age 58 years), 60 females (average age 56 years) who underwent a DE-CTPA at a tertiary referral hospital. Linear blended 120 kilovoltage (kV) images (LB120) dual-energy (DE) data sets (50% 100 kV and 50% 140 kV) were compared to noise-optimised virtual monoenergetic image reconstruction (VMI+) at 40 kiloelectron volts (VMI+40). The attenuation of the pulmonary trunk measured in Hounsfield units (HU) between the equivalent axial slices of the LB120 data set and the VMI+40 data set underwent statistical analysis via a Wilcoxon paired-sample test.
Results:
VMI+40 (1161.500 HU) yielded a statistically significant increase in median attenuation within the pulmonary trunk compared to the LB120 (304.400 HU), with a median difference between monoenergetic reconstruction and standard dual energy of data sets of 827.5 HU (P < .001).
Conclusions:
VMI+40 of the DE-CTPA scan demonstrates a statistically significant increase in vessel attenuation in all cases and may have utility in reducing the rates of indeterminate or repeated studies.
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