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  • Title: 70-kVp High-pitch Computed Tomography Pulmonary Angiography with 40 mL Contrast Agent: Initial Experience.
    Author: Li X, Ni QQ, Schoepf UJ, Wichmann JL, Felmly LM, Qi L, Kong X, Zhou CS, Luo S, Zhang LJ, Lu GM.
    Journal: Acad Radiol; 2015 Dec; 22(12):1562-70. PubMed ID: 26432073.
    Abstract:
    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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