scholarly journals A practical biphasic contrast media injection protocol strongly enhances the aorta and pulmonary artery simultaneously using a single CT angiography scan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng-Chih Hsieh ◽  
An-Bang Zeng ◽  
Chia-Hung Chen ◽  
Zong-Yi Jhou ◽  
Chih-Hsin Wang ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Pulmonary Artery ◽  
Ct Angiography ◽  
Ct Scans ◽  
Clinical Trial Registry ◽  
Traditional Group ◽  
Lower Radiation Dose ◽  
Ct Protocol ◽  
Test Bolus ◽  
Injection Protocol

Abstract Background Enhancement profiles of the pulmonary artery (PA) and aorta differ when using computed tomography (CT) angiography. Our aim was to determine the optimal CT protocol for a one-time CT scan that assesses both blood vessels. Methods We prospectively enrolled 101 cases of CT angiography in patients with suspected pulmonary embolism or aortic dissection from our center between 2018 and 2020. We also retrospectively collected the data of 40 patients who underwent traditional two-time CT scans between 2015 and 2018. Patients were divided into four groups: test bolus (TB) I, TB II, bolus-tracking (BT) I, and BT II. The enhancement of the PA and aorta, and the radiation doses used in the four groups were collected. Those who underwent two-time scans were classified into the traditional PA or aorta scan groups. Data were compared between the BT and traditional groups. Results The aortic enhancement was highest in BT II (294.78 ± 64.48 HU) followed BT I (285.18 ± 64.99 HU), TB II (186.58 ± 57.53 HU), and TB I (173.62 ± 69.70 HU). The radiation dose used was lowest in BT I (11.85 ± 5.55 mSv) and BT II (9.07 ± 3.44 mSv) compared with that used in the traditional groups (20.07 ± 7.78 mSv) and accounted for half of the traditional group (45.17–59.02%). The aortic enhancement was also highest in BT II (294.78 ± 64.48 HU) followed by BT I (285.18 ± 64.99 HU) when compared with that in the traditional aorta scan group (234.95 ± 94.18 HU). Conclusion Our CT protocol with a BT technique allows for a lower radiation dose and better image quality of the PA and aorta than those obtained using traditional CT scans. Trial registration: NCT04832633, retrospectively registered in April 2021 to the clinical trial registry.

Triple rule-out CT angiography protocol with restricting field of view for detection of pulmonary thromboembolism and aortic dissection in emergency department patients: simulation of modified CT protocol for reducing radiation dose

2016 ◽  
Vol 58 (5) ◽  
pp. 521-527 ◽  
Author(s):  
Hyun Su Kim ◽  
Sung Mok Kim ◽  
Min Jae Cha ◽  
Yoo Na Kim ◽  
Hae Jin Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Radiation Dose ◽  
Aortic Dissection ◽  
Ct Angiography ◽  
Pulmonary Thromboembolism ◽  
Acute Chest Pain ◽  
Field Of View ◽  
Ct Protocol ◽  
Triple Rule Out ◽  
Rule Out

Background Triple rule-out computed tomography (TRO CT) is a CT protocol designed to simultaneously evaluate the coronary, aorta, and pulmonary arteries. Purpose To evaluate potential diagnostic performance of TRO CT with restricted volume coverage for detection of pulmonary thromboembolism (PTE) and aortic dissection (AD). Material and Methods This study included 1224 consecutive patients with acute chest pain who visited the emergency department and underwent TRO CT using a 128-slice dual-source CT. Image data were reconstructed according to the display field of view (DFOV) of coronary CT angiography (CCTA) and TRO CT protocols in each patient. The presence of PTE and AD was evaluated by independent observers in each DFOV. The radiation dose was calculated to evaluate the potential benefits by restricting z-axis coverage to cardiac scan range instead of the whole thorax. Results Among all patients, 22 cases with PTE (1.9%) and nine cases with AD (0.8%) were found. Except for one PTE case, all cases were detected on both DFOV of TRO CT and CCTA. Mean effective dose for evaluation of entire thorax and cardiac scan coverage were 5.9 ± 1.1 mSv and 3.5 ± 0.7 mSv, respectively. Conclusion Isolated PTE and AD outside the CCTA DFOV rarely occur. Therefore, modified TRO CT protocol using cardiac scan coverage can be adopted to detect PTE and AD with reduced radiation dose.

Abstract 1637: Radiation Dose Measurements on Subjects Undergoing Combined CT Perfusion and CT Angiography Imaging with a Prototype 256-row MDCT Scanner

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Richard George ◽  
Joao Lima ◽  
Mahadevappa Mahesh
Keyword(s):  
Radiation Dose ◽  
Effective Dose ◽  
Ct Angiography ◽  
Rotation Speed ◽  
Ct Perfusion ◽  
Current Configuration ◽  
Test Bolus ◽  
Mdct Coronary Angiography ◽  
Dose Measurements ◽  
Mdct Scanner

Introduction: The purpose of this study was to directly measure the radiation dose on subjects undergoing combined CT Perfusion (CTP) and CT Angiography (CTA) imaging on a 256-row MDCT scanner. Methods: Fifteen patients underwent combined CTP and CTA imaging on a prototype 256 row MDCT scanner (Toshiba, Nasu, Japan). The prototype 256-row MDCT scanner consists of 256 rows of 0.5 mm size detectors with the capability to scan 12.8 cm length in the axial plane per CT gantry rotation in 0.5 secs. The protocol included a scout scan and test bolus scan followed by adenosine stress CTP (120 kVp, 200 mA, gantry rotation speed of 0.5 secs for 3 rotations, 128x1.0 mm) and rest CTA (120 kVp, 350 mA, gantry rotation speed of 0.5 secs for 3 rotations, 256x0.5 mm) in an axial scan mode. Direct dose measurements were performed using a custom vest worn by the patient fitted with 15–25 thermoluminiscent dosimeters (TLDs) (Landauer, IL) placed in AP and lateral locations. An anthropomorphic phantom was also scanned with the same protocol with TLDs positioned on the surface and inside the phantom at various organ locations. Effective doses were estimated based on the maximum surface dose according to previously validated methodology. Results: The effective dose from TLD measurements ranged from 22 to 32 mSv for the entire protocol. This is based on direct dose measured on subjects and not based on dose derived from phantom measurements as done routinely. Conclusions: The doses reported in this study are comparable to similarly measured doses from 64-slice MDCT coronary angiography alone. This prototype scanner uses 3 gantry rotations and a 1.5 second exposure time in it current configuration. Since, 256-row MDCT can cover the entire heart in a single rotation, it eliminates the need for tissue overlap from low pitch values. Efforts are currently underway to develop a prospective ECG-gated protocol that can limit radiation exposure to a single rotation for both stress and rest CTA scans. With a single rotation, the effective dose can be reduced to nearly one-third of the dose measured with this prototype, or approximately 7–11 mSv for a combined CTP and CTA imaging.

Lowering radiation dose for integrated assessment of coronary morphology and physiology: First experience with step-and-shoot CT angiography in a rubidium 82 PET-CT protocol

2008 ◽  
Vol 15 (6) ◽  
pp. 783-790 ◽  
Author(s):  
Mehrbod Javadi ◽  
Mahadevappa Mahesh ◽  
Gerald McBride ◽  
Corina Voicu ◽  
William Epley ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ct Angiography ◽  
Integrated Assessment ◽  
Pet Ct ◽  
Ct Protocol ◽  
Step And Shoot ◽  
Rubidium 82

An Optimized Test Bolus Contrast Injection Protocol for Consistent Coronary Artery Luminal Enhancement for Coronary CT Angiography

2020 ◽  
Vol 27 (3) ◽  
pp. 371-380 ◽  
Author(s):  
Veit Sandfort ◽  
Younhee Choi ◽  
Rolf Symons ◽  
Marcus Y. Chen ◽  
David A. Bluemke
Keyword(s):  
Coronary Artery ◽  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Contrast Injection ◽  
Coronary Ct ◽  
Test Bolus ◽  
Injection Protocol

PD37-11 EFFECTIVE ULTRA LOW DOSE CT PROTOCOL WITH LOWER RADIATION DOSE THAN ABDOMINAL X-RAY

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Kymora Scotland ◽  
Jean Buckley ◽  
James Nugent ◽  
Savvas Nicolaou ◽  
Charles Zwirewich ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Low Dose ◽  
X Ray ◽  
Low Dose Ct ◽  
Lower Radiation Dose ◽  
Ct Protocol
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