The use of 80 kV versus 100 kV in pulmonary CT angiography: An evaluation of the impact on radiation dose and image quality on two CT scanners

Rusandu, Albertina; Ødegård, Asbjørn; Engh, Gabriele; Olerud, Hilde Merete

doi:10.1016/j.radi.2018.10.004

Cited by 17 publications

(8 citation statements)

References 30 publications

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“…Image quality was not detrimentally impacted by the presence of breast shields. Noise levels within the pulmonary vasculature for our low-dose protocol, regardless of the shielding status, were higher than the 22 HU threshold proposed as acceptable by some authors29; however, are comparable to published values for low-dose CTPA; for example, averaged pulmonary vessel noise ranging from 32±9 to 42±1630 and MPA noise of 43±29 for 80 kVp CTPAs 31. Our SNRs (10.7±2.5 with shield, 11.3±3.5 without) are generally comparable to other low-dose 80 kV protocols (14.8±11.3) 31.…”

Section: Discussionsupporting

confidence: 77%

Breast Shielding Combined With an Optimized Computed Tomography Pulmonary Angiography Pregnancy Protocol

Gillespie¹,

Yates²,

Murphy³

et al. 2022

Journal of Thoracic Imaging

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Objectives: To determine the impact of breast shields on breast dose and image quality when combined with a low-dose computed tomography pulmonary angiography (CTPA) protocol for pregnancy. Methods: A low-dose CTPA protocol, with and without breast shields, was evaluated by anthropomorphic phantom and 20 prospectively recruited pregnant participants from January to October 2019. Thermoluminescent dosimeters measured surface and absorbed breast dose in the phantom and surface breast dose in participants. The Monte-Carlo method estimated the absorbed breast dose in participants. Image quality was assessed quantitatively by regions of interest analysis and subjectively by the Likert scale. Doses and image quality for CTPA alone were compared with CTPA with breast shields. Results: Mean surface and absorbed breast dose for CTPA alone were 1.3±0.4 and 2.8±1.5 mGy in participants, and 1.5±0.7 and 1.6±0.6 mGy in the phantom. Shielding reduced surface breast dose to 0.5±0.3 and 0.7±0.2 mGy in the phantom (66%) and study participants (48%), respectively. Absorbed breast dose reduced to 0.9±0.5 mGy (46%) in the phantom. Noise increased with breast shields at lower kV settings (80 to 100 kV) in the phantom; however, in study participants there was no significant difference between shield and no-shield groups for main pulmonary artery noise (no-shield: 34±9.8, shield: 36.3±7.2, P=0.56), SNR (no-shield: 11.2±3.7, shield: 10.8±2.6, P=0.74) or contrast-to-noise ratio (no-shield: 10.0±3.3, shield: 9.3±2.4, P=0.6). Median subjective image quality scores were comparable (no-shield: 4.0, interquartile range: 3.5 to 4.4, shield: 4.3, interquartile range: 4.0 to 4.5). Conclusion: Combining low-dose CTPA with breast shields confers additional breast-dose savings without impacting image quality and yields breast doses approaching those of low-dose scintigraphy, suggesting breast shields play a role in protocol optimization for select groups.

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Section: Discussionsupporting

confidence: 77%

Breast Shielding Combined With an Optimized Computed Tomography Pulmonary Angiography Pregnancy Protocol

Gillespie¹,

Yates²,

Murphy³

et al. 2022

Journal of Thoracic Imaging

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“…pregestational weight as a criterion for choosing the protocol might be a better alternative. 35 The lack of systematic routines for protocol reviewing and optimizing in half of the hospitals indicates a need for practice improvement because regular reviewing is essential to ensure a correct balance between the radiation dose and image quality. [25][26][27][42][43][44][45][46] Even in hospitals with systematic protocol-reviewing routines in the present study, the reviewing frequency was lower than the recommended yearly frequency.…”

Section: Discussionmentioning

confidence: 99%

“…The use of a lower tube potential was the most commonly used approach, with almost all hospitals using a tube potential of 100 kVp or even lower, probably because of the high number of studies confirming the effectiveness of this method in dose reduction without compromising image quality. 23,[35][36][37][38] The choice of the CT scanner was actively used as a radiation dose-reduction strategy by scanning radiation-sensitive patients such as pregnant and pediatric patients with the newest CT scanner, which usually has radiation dose-reducing features such as iterative reconstruction, dual energy, and automatic kVp selection.…”

Section: Discussionmentioning

confidence: 99%

“…19,23,[30][31][32][33] Previous studies have shown the feasibility of reducing the tube potential to 80 kVp. [35][36][37][38] Reducing the tube potential also provides the possibility of lowering the amount of iodinated contrast agent. 31,38 Automatic kilovoltage peak selection in relation to patient size is an available function on newer CT scanners and has been shown to reduce the radiation dose.…”

Section: Introductionmentioning

confidence: 99%

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Individualization of computed tomography protocols for suspected pulmonary embolism: a national investigation of routines

et al. 2020

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Objective: Given the extensive use of computed tomography (CT) in radiation-sensitive patients such as pregnant and pediatric patients, and considering the importance of tailoring CT protocols to patient characteristics for both the radiation dose and image quality, this study was performed to investigate the extent to which individualization of CT protocols is practiced across Norway. Methods: This cross-sectional study involved collection of CT protocols and administration of a mini-questionnaire to obtain additional information about how CT examinations are individualized. All public hospitals performing CT to detect pulmonary embolism were invited, and 41% participated. Results: Tailoring a standard protocol to different patient groups was more common than using dedicated protocols. Most of the available radiation dose-reduction approaches were used. However, implementation of these strategies was not systematic. Children and pregnant patients were examined without using dedicated CT protocols or by using protocol adjustments focusing on radiation dose reduction in 30% and 39% of the hospitals, respectively. Conclusion: Practice optimization is needed, especially the development of dedicated CT protocols or guidelines that tailor the existing protocol to pediatric and pregnant patients. Practice might benefit from a more systematic approach to individualization of CT examinations, such as inserting tailoring instructions into CT protocols.

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“…Dette argumentet er ikke like gjeldende i dag, da oppdatert teknologi og kunnskap bidrar til lavere stråledoser. Man kan for eksempel redusere stråledose og forbedre bildekvalitet på CTA ved å benytte lav rørspenning 40 eller Dual-energy 41 . Litteraturen påpeker at yngre pasienter ofte prioriteres til MR, med hensyn til stråledose 19,29,35 spesielt ved gjentatte kontroller der strålebelastningen totalt sett blir større.…”

Section: Diskusjonunclassified

Valg av modalitet ved karundersøkelser: CTA vs. MRA

Skalmerås

Ellingbø

Rusandu

2021

RadOpen

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Keywords: MRA, CTA, Modality choice, Angiographic imaging, Mixed method Sammendrag Hensikt Hensikten med denne studien var å undersøke hva som legges til grunn for radiologens valg av modalitet ved karundersøkelser. Dette med hensyn til at radiografen, med ansvar for berettigelse og selvstendig utførelse på CTA og MRA, bør kjenne til begrunnelsen for valgt modalitet. Metode Denne mixed method-studien bestod av en spørreundersøkelse med et nasjonalt perspektiv og et litteratursøk med et globalt perspektiv. Spørreundersøkelsen ble sendt til radiologer på offentlige sykehus i Norge. Litteratursøk ble gjennomført i databasene PubMed, Web of Science og Scopus, med søkeordene “MRA and CTA”, “MRA vs CTA” og “MRA and CTA and decision”. Resultat 38 respondenter deltok i undersøkelsen, og 21 studier ble inkludert fra litteratursøket. I resultatet kom det frem flere viktige faktorer som påvirker valg av modalitet, blant annet tilgjengelighet, pasientens situasjon, bildekvalitet og diagnostisk verdi. Noen viktig funn er at modalitetsvalg avhenger av patologi og dens lokalisasjon, samt at det i stor grad tas hensyn til ønske fra den som henviser. Konklusjon Valg av modalitet er hovedsakelig basert på klinisk problemstilling og pasientrelaterte faktorer. Faktorer knyttet til selve modaliteten som strålingsbelastning, undersøkelseshastighet, tilgjengelighet, er også tatt i betraktning, men foretrukken modalitet vil endres i takt med teknologiutvikling. Det kan sess et behov for retningslinjer for å øke radiografens kompetanse.

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The use of 80 kV versus 100 kV in pulmonary CT angiography: An evaluation of the impact on radiation dose and image quality on two CT scanners

Cited by 17 publications

References 30 publications

Breast Shielding Combined With an Optimized Computed Tomography Pulmonary Angiography Pregnancy Protocol

Breast Shielding Combined With an Optimized Computed Tomography Pulmonary Angiography Pregnancy Protocol

Individualization of computed tomography protocols for suspected pulmonary embolism: a national investigation of routines

Valg av modalitet ved karundersøkelser: CTA vs. MRA

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