title: Radiation Optimized Dual-source Dual-energy Computed Tomography Pulmonary Angiography: Intra-individual and Inter-individual Comparison.
abstract: This study aimed to intra-individually and inter-individually compare image quality, radiation dose, and diagnostic accuracy of dual-source dual-energy computed tomography pulmonary angiography (CTPA) protocols in patients with suspected pulmonary embolism (PE).
  
  
  
  Thirty-three patients with suspected PE underwent initial and follow-up dual-energy CTPA at 80/Sn140 kVp (group A) or 100/Sn140 kVp (group B), which were assigned based on tube voltages. Subjective and objective CTPA image quality and lung perfusion map image quality were evaluated. Diagnostic accuracies of CTPA and perfusion maps were assessed by two radiologists independently. Effective dose (ED) was calculated and compared.
  
  
  
  Mean computed tomography (CT) values of pulmonary arteries were higher in group A than group B (P = .006). There was no difference in signal-to-noise ratio and contrast-to-noise ratio between the two groups (both P > .05). Interobserver agreement for evaluating subjective image quality of CTPA and color-coded perfusion images was either good (κ = 0.784) or excellent (κ = 0.887). Perfusion defect scores and diagnostic accuracy of CTPA showed no difference between both groups (both P > .05). Effective dose of group A was reduced by 45.8% compared to group B (P < .001).
  
  
  
  Second-generation dual-source dual-energy CTPA with 80/Sn140 kVp allows for sufficient image quality and diagnostic accuracy for detecting PE while substantially reducing radiation dose.
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China.
authors: Xie
authors: X
authors: Li
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China.
authors: Guo Zhong
authors: GZ
authors: Chen
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China.
authors: Yan E
authors: YE
authors: Zhao
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina.
authors: U Joseph
authors: UJ
authors: Schoepf
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina.
authors: Moritz H
authors: MH
authors: Albrecht
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina.
authors: Matthew W
authors: MW
authors: Bickford
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China.
authors: Hai Feng
authors: HF
authors: Gu
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China. Electronic address: kevinzhlj@163.com.
authors: Long Jiang
authors: LJ
authors: Zhang
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, No. 305, Zhongshan East Road, Nanjing, Jiangsu, 210002, China. Electronic address: cjr.luguangming@vip.163.com.
authors: Guang Ming
authors: GM
authors: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003116:Color; D000072226:Computed Tomography Angiography / Q000379:methods* / Q000592:standards; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D059629:Signal-To-Noise Ratio; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Dual-energy CT; diagnostic accuracy; image quality; pulmonary embolism; radiation dose