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Evaluation of image quality and radiation dose saving comparing knowledge model-based iterative reconstruction on 80-kV CT pulmonary angiography (CTPA) with hybrid iterative reconstruction on 100-kV CT.
Ippolito, Davide; De Vito, Andrea; Franzesi, Cammillo Talei; Riva, Luca; Pecorelli, Anna; Corso, Rocco; Crespi, Andrea; Sironi, Sandro.
Affiliation
  • Ippolito D; Department of Diagnostic Radiology, "San Gerardo" Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy. davide.atena@tiscalinet.it.
  • De Vito A; School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy. davide.atena@tiscalinet.it.
  • Franzesi CT; Department of Diagnostic Radiology, "San Gerardo" Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.
  • Riva L; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy.
  • Pecorelli A; Department of Diagnostic Radiology, "San Gerardo" Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.
  • Corso R; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy.
  • Crespi A; Department of Diagnostic Radiology, "San Gerardo" Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.
  • Sironi S; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy.
Emerg Radiol ; 26(2): 145-153, 2019 Apr.
Article in En | MEDLINE | ID: mdl-30415416
OBJECTIVES: To evaluate dose reduction and image quality of 80-kV CT pulmonary angiography (CTPA) reconstructed with knowledge model-based iterative reconstruction (IMR), and compared with 100-kV CTPA with hybrid iterative reconstruction (iDose4). MATERIALS AND METHODS: One hundred and fifty-one patients were prospectively investigated for pulmonary embolism; a study group of 76 patients underwent low-kV setting (80 kV, automated mAs) CTPA study, while a control group of 75 patients underwent standard CTPA protocol (100 kV; automated mAs); all patients were examined on 256 MDCT scanner (Philips iCTelite). Study group images were reconstructed using IMR while the control group ones with iDose4. CTDIvol, DLP, and ED were evaluated. Region of interests placed in the main pulmonary vessels evaluated vascular enhancement (HU); signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. RESULTS: Compared to iDose4-CTPA, low-kV IMR-CTPA presented lower CTDIvol (6.41 ± 0.84 vs 9.68 ± 3.5 mGy) and DLP (248.24 ± 3.2 vs 352.4 ± 3.59 mGy × cm), with ED of 3.48 ± 1.2 vs 4.93 ± 1.8 mSv. Moreover, IMR-CTPA showed higher values of attenuation (670.91 ± 9.09 HU vs 292.61 ± 15.5 HU) and a significantly higher SNR (p < 0.0001) and CNR (p < 0.0001).The subjective image quality of low-kV IMR-CTPA was also higher compared with iDose4-CTPA (p < 0.0001). CONCLUSIONS: Low-dose CTPA (80 kV and automated mAs modulation) reconstructed with IMR represents a feasible protocol for the diagnosis of pulmonary embolism in the emergency setting, achieving high image quality with low noise, and a significant dose reduction within adequate reconstruction times(≤ 120 s).
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pulmonary Embolism / Radiographic Image Interpretation, Computer-Assisted / Computed Tomography Angiography Type of study: Guideline / Observational_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Emerg Radiol Year: 2019 Document type: Article Affiliation country: Italy Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pulmonary Embolism / Radiographic Image Interpretation, Computer-Assisted / Computed Tomography Angiography Type of study: Guideline / Observational_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Emerg Radiol Year: 2019 Document type: Article Affiliation country: Italy Country of publication: United States