title: High-pitch computed tomography pulmonary angiography with iterative reconstruction at 80 kVp and 20 mL contrast agent volume.
abstract: OBJECTIVE
  To evaluate the image quality, radiation dose and diagnostic accuracy of 80kVp, high-pitch CT pulmonary angiography (CTPA) with iterative reconstruction using 20 ml of contrast agent.
  
  
  METHODS
  One hundred patients with suspected pulmonary embolism (PE) were randomly divided into two groups (n = 50 each; group A, 100 kVp, 1.2 pitch, 60 ml of contrast medium and filtered back projection algorithm; group B, 80 kVp, 2.2 pitch, 20 ml of contrast medium and sinogram affirmed iterative reconstruction). Image quality, diagnostic accuracy and radiation dose were evaluated and compared.
  
  
  RESULTS
  Mean CT numbers of pulmonary arteries in group B were higher than those in group A (all P < 0.001). Contrast-to-noise ratio and signal-to-noise ratio of group B were higher than those of group A (both P < 0.001). There was no significant difference in subjective image quality scores between two groups (P = 0.807). The interobserver agreement was excellent (k = 0.836). There was no significant difference in diagnostic accuracy between the two groups (P > 0.05). Compared with group A, radiation dose of group B was reduced by 50.3% (P < 0.001).
  
  
  CONCLUSIONS
  High-pitch CTPA at 80 kVp can obtain sufficient image quality in normal-weight individuals with 20 ml of contrast agent and half the radiation dose of a conventional CTPA protocol.
  
  
  CONCLUSIONS
  CTPA is feasible at 80 kVp using only 20 ml of contrast agent. High-pitch CTPA at 80 kVp has an effective dose under 1 mSv. This CTPA protocol can obtain sufficient image quality in normal-weight individuals.
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China, cjr.luguangming@vip.163.com.
authors.forename: Guang Ming
authors.initials: GM
authors.lastname: Lu
authors.forename: Song
authors.initials: S
authors.lastname: Luo
authors.forename: Felix G
authors.initials: FG
authors.lastname: Meinel
authors.forename: Andrew D
authors.initials: AD
authors.lastname: McQuiston
authors.forename: Chang Sheng
authors.initials: CS
authors.lastname: Zhou
authors.forename: Xiang
authors.initials: X
authors.lastname: Kong
authors.forename: Yan E
authors.initials: YE
authors.lastname: Zhao
authors.forename: Ling
authors.initials: L
authors.lastname: Zheng
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
mesh_terms: D000792:Angiography / Q000379:methods*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012372:ROC Curve; D011829:Radiation Dosage; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
references.citation: J Comput Assist Tomogr. 2013 Mar-Apr;37(2):301-5
references.pmid: 23493224
references.citation: Eur J Radiol. 2012 Oct;81(10):2887-91
references.pmid: 22019597
references.citation: Invest Radiol. 2008 Dec;43(12):871-6
references.pmid: 19002059
references.citation: AJR Am J Roentgenol. 2007 May;188(5):1255-61
references.pmid: 17449768
references.citation: Radiol Clin North Am. 2009 Jan;47(1):27-40
references.pmid: 19195532
references.citation: Eur Radiol. 2010 May;20(5):1188-96
references.pmid: 19890644
references.citation: AJR Am J Roentgenol. 2013 Dec;201(6):1283-90
references.pmid: 24261368
references.citation: Acta Radiol. 2009 Mar;50(2):181-93
references.pmid: 19169917
references.citation: Clin Radiol. 2012 Sep;67(9):833-9
references.pmid: 22683247
references.citation: JAMA. 2013 Feb 20;309(7):647-8
references.pmid: 23423394
references.citation: Invest Radiol. 2009 Dec;44(12):793-9
references.pmid: 19884825
references.citation: Radiology. 2013 Apr;267(1):4-8
references.pmid: 23525714
references.citation: Acta Radiol. 2012 Nov 1;53(9):1004-13
references.pmid: 22940858
references.citation: Radiology. 2006 Dec;241(3):899-907
references.pmid: 17114631
references.citation: AJR Am J Roentgenol. 2012 Dec;199(6):1220-5
references.pmid: 23169711
references.citation: Eur J Radiol. 2013 Oct;82(10):1793-8
references.pmid: 23743054
references.citation: Eur Radiol. 2013 Mar;23(3):597-606
references.pmid: 22983283
references.citation: Clin Radiol. 2014 Jan;69(1):36-40
references.pmid: 24070908
references.citation: AJR Am J Roentgenol. 2013 Nov;201(5):971-6
references.pmid: 24147466
references.citation: Clin Radiol. 2012 Nov;67(11):1053-60
references.pmid: 22520034
references.citation: Emerg Radiol. 2012 Oct;19(5):437-45
references.pmid: 22527361
references.citation: Radiol Clin North Am. 2012 Jan;50(1):1-14
references.pmid: 22099484
references.citation: Clin Radiol. 2013 May;68(5):e249-53
references.pmid: 23428340
references.citation: Eur Radiol. 2012 Dec;22(12):2597-606
references.pmid: 22699873
references.citation: Eur Radiol. 2012 Feb;22(2):279-86
references.pmid: 21874569
references.citation: Radiology. 2013 May;267(2):609-18
references.pmid: 23297336
references.citation: Eur Radiol. 1999;9(8):1602-13
references.pmid: 10525875
references.citation: AJR Am J Roentgenol. 2010 Aug;195(2):W118-24
references.pmid: 20651170
references.citation: Eur J Radiol. 2013 Sep;82(9):1571-6
references.pmid: 23777744
references.citation: AJR Am J Roentgenol. 2012 Dec;199(6):1247-51
references.pmid: 23169715
references.citation: AJR Am J Roentgenol. 2013 Mar;200(3):522-8
references.pmid: 23436840