Abstract
Objectives
To assess the impact of ASIR (adaptive statistical iterative reconstruction) and lower tube potential on dose reduction and image quality in chest computed tomography angiographies (CTAs) of patients with pulmonary embolism.
Materials and methods
CT data from 44 patients with pulmonary embolism were acquired using different protocols—Group A: 120 kV, filtered back projection, n = 12; Group B: 120 kV, 40 % ASIR, n = 12; Group C: 100 kV, 40 % ASIR, n = 12 and Group D: 80 kV, 40 % ASIR, n = 8. Normalised effective dose was calculated; image quality was assessed quantitatively and qualitatively.
Results
Normalised effective dose in Group B was 33.8 % lower than in Group A (p = 0.014) and 54.4 % lower in Group C than in Group A (p < 0.001). Group A, B and C did not show significant differences in qualitative or quantitative analysis of image quality. Group D showed significantly higher noise levels in qualitative and quantitative analysis, significantly more artefacts and decreased overall diagnosability. Best results, considering dose reduction and image quality, were achieved in Group C.
Conclusions
The combination of ASIR and lower tube potential is an option to reduce radiation without significant worsening of image quality in the diagnosis of pulmonary embolism.
Key Points
• Iterative algorithms and lowering of tube potential reduce radiation without compromising interpretability
• 40 % ASIR and 100 kV tube potential led to a 54.4 % dose reduction
• 40 % ASIR and 80 kV tube potential led to significantly worse image quality
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Acknowledgments
We would like to thank Dr. Laura Wilk from Lund University for proofreading and discussing the manuscript.
The scientific guarantor of this publication is PD. Florian Streitparth. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise.
Institutional Review Board approval was obtained, but the informed consent requirement was waived, since patients were not exposed to additional radiation and data were stored anonymously. Methodology: prospective, experimental, performed at one institution.
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Kaul, D., Grupp, U., Kahn, J. et al. Reducing radiation dose in the diagnosis of pulmonary embolism using adaptive statistical iterative reconstruction and lower tube potential in computed tomography. Eur Radiol 24, 2685–2691 (2014). https://doi.org/10.1007/s00330-014-3290-y
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DOI: https://doi.org/10.1007/s00330-014-3290-y