Attenuation-based kV pair selection in dual source dual energy computed tomography angiography of the chest: impact on radiation dose and image quality

作者：Renapurkar Rahul D; Primak Andrew; Azok Joseph; Lempel Jason; Tandon Yasmeen; Bullen Jennifer; Dong Frank; Karim Wadih; Graham Ruffin

来源：European Radiology, 2017, 27(8): 3283-3289.

DOI：10.1007/s00330-016-4714-7

• Dual energy CT
• CT angiography
• Pulmonary embolism
• CARE kV
• Attenuation

The purpose of this study was to evaluate the impact of attenuation-based kilovoltage (kV) pair selection in dual source dual energy (DSDE)-pulmonary embolism (PE) protocol examinations on radiation dose savings and image quality.
A prospective study was carried out on 118 patients with suspected PE. In patients in whom attenuation-based kV pair selection selected the 80/140Sn kV pair, the pre-scan 100/140Sn CTDIvol (computed tomography dose index volume) values were compared with the pre-scan 80/140Sn CTDIvol values. Subjective and objective image quality parameters were assessed.
Attenuation-based kV pair selection switched to the 80/140Sn kV pair ("switched" cohort) in 63 out of 118 patients (53%). The mean 100/140Sn pre-scan CTDIvol was 8.8 mGy, while the mean 80/140Sn pre-scan CTDIvol was 7.5 mGy. The average estimated dose reduction for the "switched" cohort was 1.3 mGy (95% CI 1.2, 1.4; p < 0.001), representing a 15% reduction in dose. After adjusting for patient weight, mean attenuation was significantly higher in the "switched" vs. "non-switched" cohorts in all five pulmonary arteries and in all lobes on iodine maps.
This study demonstrates that attenuation-based kV pair selection in DSDE examination is feasible and can offer radiation dose reduction without compromising image quality.
aEuro cent Attenuation-based kV pair selection in dual energy examination is feasible.
aEuro cent It can offer radiation dose reduction to approximately 50% of patients.
aEuro cent Approximate 15% reduction in radiation dose was achieved using this technique.
aEuro cent The image quality is not compromised by use of attenuation-based kV pair selection.

• 出版日期2017-8