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Prospective randomised comparison of diagnostic confidence and image quality with normal-dose and low-dose CT pulmonary angiography at various body weights
Ist Teil von
European radiology, 2014-08, Vol.24 (8), p.1868-1877
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2014
Link zum Volltext
Quelle
SpringerLink (Online service)
Beschreibungen/Notizen
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