Abstract
The purpose of this study is to investigate the feasibility of double low-dose (low radiation and low contrast medium doses) computed tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary embolism. This retrospective study involved analysis of 59 patients undergoing 64- and 128-slice CTPA examinations which were scanned with a pitch of 0.9 and 100 and 120 kVp, respectively, while flash mode of CTPA was done with a pitch of 3.2 and 120 kVp. There were no significant differences in image quality assessment between the low kVp and standard kVp or high-pitch CTPA protocols (p=0.181-0.186). The mean effective dose for the 100 kVp protocol was significantly lower than that for the120 kVp and the flash mode protocols (p < 0.001). The contrast medium was between 35-45 ml for the 100 and 120 kVp protocols, and 20-30 ml for the 120 kVp flash mode protocol. Double low-dose CT pulmonary angiography is feasible for detection of pulmonary embolism with acquisition of diagnostic images.
Highlights
Computed tomography pulmonary angiography (CTPA) is the first line imaging modality in the diagnosis of patients with suspected pulmonary embolism (PE) owing to its high sensitivity and specificity [1, 2]
The purpose of this study is to investigate the feasibility of double low-dose computed tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary embolism
This study further confirms the usefulness of low kVp for radiation dose reduction in CTPA examinations
Summary
Computed tomography pulmonary angiography (CTPA) is the first line imaging modality in the diagnosis of patients with suspected pulmonary embolism (PE) owing to its high sensitivity and specificity [1, 2]. Despite high diagnostic yield of CTPA in PE, appropriate use of CTPA needs to be medically justified due to its associated high radiation dose and widespread use of CTPA in clinical practice [3,4,5]. Technological developments in CT scanners have allowed the CTPA to be performed widely in many clinical centres with significant reduction of radiation dose which used to be a major concern of CT imaging. Significant progress has been achieved in reducing radiation dose associated with CTPA. Another concern related to CTPA is the risk of using contrast medium during contrast-enhanced CT scans since contrast medium has potential risk of contrast-induced nephropathy (CIN). In patients with cardiovascular disease such as coronary artery disease and pulmonary embolism, reducing the risk of CIN is necessary since these patients are often associated with chronic kidney disease or with diabetes mellitus
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