Abstract
Pulmonary CT angiography (CTPA) is regarded as the preferred imaging method in diagnosing pulmonary embolism (PE). Considering the harm of radiation exposure and the side effect of iodinated contrast agent, CTPA protocol with low tube voltage and low dose of contrast agent became research hotspot in last decade. The present study evaluates the image quality, radiation dose, positive rate of PE and the location of PE with a CTPA protocol using low tube voltage (80 kVp) and low-iodine-concentration contrast agent (270 mg I/ml) in patients suspected of PE compared to a conventional CTPA protocol (120 kVp, 350 mg I/ml). The results showed that 80 kVp CTPA protocol with 40 ml 270 mg I/ml achieved equally subjective image quality and a positive rate for diagnosing PE, though the quantitative image quality was reduced compared to the 120 kVp CTPA protocol with 40 ml 350 mg I/ml administered, with a 63.6% decrease in radiation dose and a 22.9% reduction in iodine content of contrast agent. Our results document that CTPA protocol with low tube voltage and low iodine concentration of contrast agent is satisfied to the clinical application.
Highlights
Pulmonary CT angiography (CTPA) is regarded as the preferred imaging method in diagnosing pulmonary embolism (PE)
The inter-observer agreement for the subjective image was assessed using Kappa analysis. Both the mean CT value in the pulmonary arteries and the background noise were significantly higher in group A than in group B, whereas the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were lower in group A than group B (Table 3)
The radiation exposure in group A was reduced by nearly 63.6% compared to that in group B, and the iodine content administered in group A was decreased by 22.9% relative to group B
Summary
Pulmonary CT angiography (CTPA) is regarded as the preferred imaging method in diagnosing pulmonary embolism (PE). Recent studies[10,13,14] have shown that CT angiography protocol with low tube voltage, low iodine and ASIR results in an effective reduction in the radiation dose and iodine content of contrast agent whilst maintaining image quality. To acquire high iodine concentrations in pulmonary arteries as well as good image quality, the current CTPA protocols mainly adopt high concentrations and large doses of iodine contrast agent[15,16]. It was previously shown[17] that the incidence of contrast-induced nephropathy increased as the contrast agent’s dose increased. Correspondence and requests for materials should be addressed toY.S. (email: yqshen@ hust.edu.cn) www.nature.com/scientificreports/
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