ArticleThe British journal of radiology2018
90-kVp low-tube-voltage CT pulmonary angiography in combination with advanced modeled iterative reconstruction algorithm: effects on radiation dose, image quality and diagnostic accuracy for the detection of pulmonary embolism.
Article in The British journal of radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Computed tomography pulmonary angiography in around-the-clock clinical care with individualised scan protocols: a 5-year observational study on incidence and causes of repeat scanning.European radiology · 2026Observational
- Trends in CT pulmonary angiography utilization and recurrent imaging in sickle cell disease: a longitudinal study.International journal of emergency medicine · 2025Article
- High-pitch CT pulmonary angiography (CTPA) with ultra-low contrast medium volume for the detection of pulmonary embolism: a comparison with standard CTPA.European radiology · 2024Article
- Positive rate and quality assessment of CT pulmonary angiography in sickle cell disease: a case‒control study.Emergency radiology · 2023Article
- Venous Thromboembolism During Pregnancy and the Postpartum Period: Risk Factors, Diagnostic Testing, and Treatment.Obstetrical & gynecological survey · 2022Review
- Salvaging low contrast abdominal CT studies using noise-optimised virtual monoenergetic image reconstruction.BJR open · 2022Article
- Dual-energy CT in pulmonary vascular disease.The British journal of radiology · 2022Review
- Feasibility of bronchial wall quantification in low- and ultralow-dose third-generation dual-source CT: An ex vivo lung study.Journal of applied clinical medical physics · 2020Article
- Additive value of split-bolus single-phase CT scan protocol for preoperative assessment of lung cancer patients referred for video-assisted thoracic surgery.Radiological physics and technology · 2019Article
- Computed tomography pulmonary angiography using high-pitch dual-source scanner technology.Saudi medical journal · 2019Article
- Patient-specific 3D printed pulmonary artery model with simulation of peripheral pulmonary embolism for developing optimal computed tomography pulmonary angiography protocols.Quantitative imaging in medicine and surgery · 2019Article
- Optimizing the diagnosis and assessment of chronic thromboembolic pulmonary hypertension with advancing imaging modalities.Pulmonary circulationReview
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Authors and funding
11 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveTo evaluate low-tube-voltage 90-kVp CT pulmonary angiography (CTPA) with advanced modeled iterative reconstruction algorithm (Admire) compared to 120-kVp equivalent dual-energy (DE) acquisition with regards to radiation exposure, image quality and diagnostic accuracy for pulmonary embolism (PE) assessment.
methodsCTPA studies of 40 patients with suspected PE (56.7 ± 16.3 years) performed on a third-generation 192-slice dual-source CT scanner were retrospectively included. 120-kVp equivalent linearly-blended (60% 90-kVp, 40% 150-kVp) and 90-kVp images were reconstructed. Attenuation and noise of the pulmonary trunk were measured to calculate contrast-to-noise ratios (CNR). Three radiologists assessed the presence of central and segmental PE and diagnostic confidence. Interobserver agreement was calculated using intraclass correlation coefficient (ICC). Radiation exposure was assessed as effective dose (ED).
resultsPulmonary trunk CNR values were significantly increased in 90-kVp compared to linearly-blended series (15.4 ± 6.3 vs 11.3 ± 4.6, p < 0.001). Diagnostic accuracy for PE assessment was similar in both series with excellent interobserver agreement (p = 0.48; ICC, 0.83; p = 0.48). Overall confidence for PE assessment was rated excellent for both series with a significant advantage for linearly-blended series (p < 0.001; 4.1 vs 3.8). ED was reduced by 37.2% with 90-kVp compared to 120-kVp equivalent image series (1.1 ± 0.6 vs 1.7 ± 0.7 mSv, p < 0.001).
conclusion90-kVp CTPA with Admire provided increased quantitative image quality with similar diagnostic accuracy and confidence for PE assessment compared to 120-kVp equivalent acquisition, while radiation dose was reduced by 37.2%. Advances in knowledge: 90-kVp CTPA with an advanced iterative reconstruction algorithm results in excellent image quality and reduction of radiation exposure without limiting diagnostic performance.
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