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Erschienen in: European Radiology 8/2014

01.08.2014 | Chest

Prospective randomised comparison of diagnostic confidence and image quality with normal-dose and low-dose CT pulmonary angiography at various body weights

verfasst von: Zsolt Szucs-Farkas, Boglarka Megyeri, Andreas Christe, Peter Vock, Johannes T. Heverhagen, Sebastian T. Schindera

Erschienen in: European Radiology | Ausgabe 8/2014

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Abstract

Objectives

To find a threshold body weight (BW) below 100 kg above which computed tomography pulmonary angiography (CTPA) using reduced radiation and a reduced contrast material (CM) dose provides significantly impaired quality and diagnostic confidence compared with standard-dose CTPA.

Methods

In this prospectively randomised study of 501 patients with suspected pulmonary embolism and BW <100 kg, 246 were allocated into the low-dose group (80 kVp, 75 ml CM) and 255 into the normal-dose group (100 kVp, 100 ml CM). Contrast-to-noise ratio (CNR) in the pulmonary trunk was calculated. Two blinded chest radiologists independently evaluated subjective image quality and diagnostic confidence. Data were compared between the normal-dose and low-dose groups in five BW subgroups.

Results

Vessel attenuation did not differ between the normal-dose and low-dose groups within each BW subgroup (P = 1.0). The CNR was higher with the normal-dose compared with the low-dose protocol (P < 0.006) in all BW subgroups except for the 90-99 kg subgroup (P = 0.812). Subjective image quality and diagnostic confidence did not differ between CT protocols in all subgroups (P between 0.960 and 1.0).

Conclusions

Subjective image quality and diagnostic confidence with 80 kVp CTPA is not different from normal-dose protocol in any BW group up to 100 kg.

Key Points

80 kVp CTPA is safe in patients weighing <100 kg
Reduced radiation and iodine dose still provide high vessel attenuation
Image quality and diagnostic confidence with low-dose CTPA is good
Diagnostic confidence does not deteriorate in obese patients weighing <100 kg
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Metadaten
Titel
Prospective randomised comparison of diagnostic confidence and image quality with normal-dose and low-dose CT pulmonary angiography at various body weights
verfasst von
Zsolt Szucs-Farkas
Boglarka Megyeri
Andreas Christe
Peter Vock
Johannes T. Heverhagen
Sebastian T. Schindera
Publikationsdatum
01.08.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 8/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3208-8

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