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"Triple low" free-breathing CTPA protocol for patients with dyspnoea
A Cantarinha1, C Bassil1, A Savignac1
1Service de Radiologie Générale Adulte, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Département Médico Universitaire Smart Imaging, Assistance Publique des Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
Clinical Radiology
|June 10, 2022
Summary
A new "triple-low" computed tomography pulmonary angiography (CTPA) protocol enables effective imaging of pulmonary arteries and parenchyma in dyspnoeic patients. This low-dose, free-breathing technique minimizes motion artifacts for clearer diagnostic evaluation.
Area of Science:
- Radiology
- Medical Imaging
- Pulmonary Medicine
Background:
- Computed tomography pulmonary angiography (CTPA) is crucial for diagnosing pulmonary embolism.
- Dyspnoeic patients often present challenges for standard CTPA due to motion artifacts.
- Low-dose protocols are desirable to reduce radiation exposure.
Purpose of the Study:
- To evaluate a "triple-low" (low dose, low contrast volume, free-breathing) CTPA protocol.
- To assess its performance in dyspnoeic patients with suspected pulmonary embolism.
- To discuss its clinical utility for pulmonary vasculature and parenchyma assessment.
Main Methods:
- A prospective study of 134 dyspnoeic patients undergoing "triple-low" CTPA.
- Protocol involved fast free-breathing acquisition and 35 ml contrast agent.
- Recorded radiodensity, dose-length product (DLP), and qualitative enhancement.
Main Results:
- Pulmonary artery enhancement consistently exceeded 250 HU.
- Mean DLP was comparable to low-dose chest CT (145 ± 73 mGy·cm).
- 90% of cases had optimal pulmonary parenchyma analysis; 69% showed homogeneous arterial enhancement.
Conclusions:
- The "triple-low" CTPA protocol is effective for imaging pulmonary arteries and parenchyma.
- It successfully overcomes respiratory motion artifacts in dyspnoeic patients.
- This protocol is suitable for routine clinical practice in this patient group.
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