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Acquisition time, radiation dose, subjective and objective image quality of dual-source CT scanners in acute pulmonary embolism: a comparative study

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Abstract

Objectives

To compare the scan acquisition time, radiation dose, subjective and objective image quality of two dual-source CT scanners (DSCT) for detection of acute pulmonary embolism.

Methods

Two hundred twenty-one scans performed on the 2nd-generation DSCT and 354 scans on the 3rd-generation DSCT were included in this large retrospective study. In a randomized blinded design, two radiologists independently reviewed the scans using a 5-point Likert scale. Radiation dose and objective image quality parameters were calculated.

Results

Mean acquisition time was significantly lower in the 3rd-generation DSCT (2.81 s ± 0.1 in comparison with 9.7 s ± 0.15 [mean ± SD] respectively; p < 0.0001) with the 3rd generation 3.4 times faster. The mean subjective image quality score was 4.33/5 and 4/5 for the 3rd- and 2nd-generation DSCT respectively (p < 0.0001) with strong interobserver reliability agreement. DLP, CTDIvol, and ED were significantly lower in the 3rd than the 2nd generation (175.6 ± 63.7 mGy cm; 5.3 ± 1.9 mGy and 2.8 ± 1.2 mSv in comparison with 266 ± 255 mGy.cm; 7.8 ± 2.2 mGy and 3.8 ± 4.3 mSv). Noise was significantly lower in the 3rd generation (p < 0.01). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM), a dose-insensitive index for CNR, were significantly higher in the 3rd-generation DSCT (33.5 ± 23.4; 29.0 ± 21.3 and 543.7 ± 1037 in comparison with 23.4 ± 17.7; 19.4 ± 16.0 and 170.5 ± 284.3).

Conclusion

Objective and subjective image quality are significantly higher on the 3rd-generation DSCT with significantly lower mean acquisition time and radiation dose.

Key Points

• The 3rd-generation DSCT scanner provides an improved image quality, less perceived artifacts, and lower radiation dose in comparison with the 2nd-generation DSCT, when operating in dual-energy (DE) mode.

• The 3.4-times-faster 3rd-generation DSCT scanner can be of particular value in patients with chronic lung diseases or breathing difficulties that prevent adequate breathhold.

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Abbreviations

ADMIRE:

Advanced Modeled Iterative Reconstruction

BMI:

Body mass index

CNR:

Contrast-to-noise ratio

CTPA:

Computed tomography pulmonary angiogram

DECT:

Dual-energy computed tomography

DSCT:

Dual-source computed tomography

ED:

Effective dose

FOM:

Figure of merit

FOV:

Field of view

ICOPER:

International Cooperative Pulmonary Embolism Registry

PE:

Pulmonary embolism

PEO:

Population-exposure-outcome

SAFIRE:

Sinogram-affirmed iterative reconstruction

SECT:

Single-energy computed tomography

SSCT:

Single-source computed tomography

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, University of British Columbia/ Vancouver General Hospital, 899 W 12th Ave, Vancouver, BC, V5Z 1M9, Canada

    Waleed Abdellatif, Jennifer Powell, Gordon Andrews & Savvas Nicolaou

  2. Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, V6T 1Z3, BC, Canada

    Eric Esslinger, Kevin Kobes & Amanda Wong

  3. Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Ismail Tawakol Ali

Authors
  1. Waleed Abdellatif
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  2. Eric Esslinger
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  3. Kevin Kobes
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  4. Amanda Wong
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  5. Jennifer Powell
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  6. Ismail Tawakol Ali
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  7. Gordon Andrews
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  8. Savvas Nicolaou
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Corresponding author

Correspondence to Waleed Abdellatif.

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Guarantor

The scientific guarantor of this publication is Savvas Nicolaou.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Dr. Savvas Nicolaou and the University of British Columbia have master research agreement with Siemens Healthcare.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because it is a retrospective imaging study.

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Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Cross-sectional study

• Performed at one institution

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Abdellatif, W., Esslinger, E., Kobes, K. et al. Acquisition time, radiation dose, subjective and objective image quality of dual-source CT scanners in acute pulmonary embolism: a comparative study. Eur Radiol 30, 2712–2721 (2020). https://doi.org/10.1007/s00330-019-06650-6

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