ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Dual-energy computed tomography pulmonary angiography with ultra-low dose contrast administration: Comparison of image quality with standard computed tomography pulmonary angiography
Pınar Çeltikçi1, Koray Hekimoğlu2, Gökhan Kahraman2, Kemal Murat Haberal2, Dalokay Kılıç3
1Department of Radiology, Ankara City Hospital, Bilkent, Ankara, Türkiye
2Department of Radiology, Başkent University Faculty of Medicine, Ankara, Türkiye
3Department of Thoracic Surgery, Başkent University Faculty of Medicine, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2022.21976
Background: This study aims to compare quantitative and qualitative image quality between standard computed tomography pulmonary angiography and dual-energy computed tomography pulmonary angiography protocols.

Methods: Between September 2017 and August 2018, a total of 91 consecutive patients (34 males, 57 females; mean age: 65.9±15 years; range, 37 to 91 years) who were referred for computed tomography pulmonary angiography were randomly imaged with either a standard or dual-energy protocol. Standard protocol (n=49) was acquired with a 64-slice multidetector computed tomography scanner using 60 mL contrast media (18 g iodine). A third-generation dual-energy computed tomography scanner was utilized to acquire dual-energy computed tomography pulmonary angiography and simultaneous lung perfusion imaging (n=42), which required 40 mL contrast media (12 g iodine). Two radiologists reviewed images separately to determine interobserver variability. Attenuation and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio and contrast-to-noise ratio were calculated. A five-point scale was utilized to evaluate image quality and image noise qualitatively.

Results: The standard protocol required a significantly higher amount of iodine. Comparison of two groups employing quantitative measurements (attenuation value in five pulmonary arteries, mean attenuation value, mean background noise, signal-to-noise ratio, and contrast-to-noise ratio) and employing qualitative measurements (five-point scale scores of image quality and image noise) revealed no significant difference between dual-energy and standard groups (p>0.05). Qualitative and quantitative evaluations demonstrated low interobserver variability.

Conclusion: Dual-energy computed tomography pulmonary angiography protocol delivers image quality equal to standard protocol, while requiring less amount of iodinated contrast medium and providing simultaneous lung perfusion imaging to contribute the diagnosis of pulmonary embolism.

Keywords : Computed tomography angiography, contrast media, dual-energy computed tomography, lung perfusion, pulmonary artery
Viewed : 252
Downloaded : 101