Effects of radiation dose reduction on diagnostic performance of 3rd generation Dual Source CT pulmonary angiography.
Eur J Radiol
; 134: 109426, 2021 Jan.
Article
em En
| MEDLINE
| ID: mdl-33254062
ABSTRACT
PURPOSE:
To evaluate the effects of radiation dose reduction on diagnostic accuracy and image quality of pulmonary angiography CT (CTPA) in adults with suspected pulmonary embolism (PE). MATERIAL &METHODS:
52 consecutive patients received CTPA for suspected PE. Realistic low-Dose CT simulations were generated using an offline software (ReconCT, Siemens Healthineers, Forchheim, Germany), as either filter back projections (FBP) or iterative reconstruction as ADMIRE (strength 3 or 5) with 25 %, 50 % and 75 % of the original dose. To assess image quality (overall image quality, noise, artifacts, and sharpness) and diagnostic confidence, a five-point scale was used. Patient-based and segment-based diagnostic accuracy was calculated for Low-dose computed tomography (LDCT)-reconstruction with original dose CTPA as a standard of reference. Furthermore, effective radiation doses were calculated using a commercially available dose management platform (Radimetrics, Bayer HealthCare, Leverkusen, Germany).RESULTS:
Among 52 patients, a total of 15 patients (28.8 %) had acute pulmonary artery embolism. The median dose-length product and effective dose for all 52 scans were 291.1⯱â¯210.1â¯mGyâ cm and 5.8⯱â¯3.4 mSv. Overall subjective image quality was highest for ADMIRE 5 with 75 % and lowest for FBP with 25 % of the original dose (median [interquartile range]5 [5] vs. 3 [2-3], pâ¯<â¯0.001. Patient-based diagnostic accuracy was perfect for all iteratively reconstructed data sets (ADMIRE 3 and 5) (sensitivity 100 %, negative predictive value [NPV] 100 %). LDCT data sets with FBP had perfect diagnostic accuracy at 50 % and 75 % of the original dose, which however decreased at 25 % of the original dose (sensitivity 93 %; [NPV] 97 %). Segment-based diagnostic accuracy was high for ADMIRE 3 and 5 down to 25 % dose reduction (sensitivity 90.4 % specificity 99.5 %) and lowest for FBP with 25 % dose reduction (sensitivity 84.6 %, specificity 98.9 %). Inter-class correlation regarding the detection of PE was almost perfect at all doses and recons (ICC 96.1-1.0). Thus, accurate diagnosis for PE was possible for ADMIRE 3 and 5 datasets with 25 % of the original dose (1.45 mSv) and for FBP with 50 % of the original dose (2.9 mSv).CONCLUSION:
Our findings indicate that radiation dose reduction down to 25 % (1.45 mSv) of the original data via iterative reconstruction algorithms on a 3rd generation Dual Source CT (DSCT) scanner maintained the diagnostic accuracy and image quality for the assessment of PE in CTPA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Angiografia
/
Redução da Medicação
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Adult
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2021
Tipo de documento:
Article