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High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females
INTRODUCTION: Computed tomography pulmonary angiography (CTPA) is the gold standard test to investigate pulmonary embolism (PE). This technique carries significant radiation risk in young females because of radiosensitive breast and thyroid tissues. A high-pitched CT technique offers significant rad...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10248322/ https://www.ncbi.nlm.nih.gov/pubmed/37289287 http://dx.doi.org/10.1007/s10140-023-02142-9 |
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author | Rehan, Saad Kutschera, Peter Paul, Eldho Lau, Theodore Lau, Kenneth K. |
author_facet | Rehan, Saad Kutschera, Peter Paul, Eldho Lau, Theodore Lau, Kenneth K. |
author_sort | Rehan, Saad |
collection | PubMed |
description | INTRODUCTION: Computed tomography pulmonary angiography (CTPA) is the gold standard test to investigate pulmonary embolism (PE). This technique carries significant radiation risk in young females because of radiosensitive breast and thyroid tissues. A high-pitched CT technique offers significant radiation dose reduction (RDR) and minimises breathing artefact. The addition of CT tube tin-filtration may offer further RDR. The aim of this retrospective study was to assess RDR and image quality (IQ) of high-pitch tin-filtered (HPTF)-CTPA against conventional-CTPA. METHODS: Retrospective review of consecutive adult females age < 50 years undergoing high pitch tin filtration (HPTF) and standard pitch no tin filtration (SPNF) during a 3-year period beginning in November 2017. CTs in both groups were compared for radiation dose, pulmonary arteries contrast density (Hounsfield units (HU)) and movement artefact. Findings of both groups were compared with the Student’s T-test and Mann–Whitney U test, where p < 0.05 being considered significant. Diagnostic quality was also recorded. RESULTS: Ten female patients (mean age 33, 6/10 pregnant) in HPTF group and 10 female patients (mean age 36, 1/10 pregnant) in SPNF group were included. The HPTF group achieved 93% RDR (dose length product: 25.15 mGy.cm vs 337.10 mGy.cm, p < 0.01). There was significant contrast density difference between the two groups in the main, left or right pulmonary arteries (322.72 HU, 311.85 HU and 319.41 HU in HPTF group vs 418.60 HU, 405.10 HU and 415.96 HU in SPNF group respectively, p = 0.03, p = 0.03 and p = 0.04). 8/10 HPTF group and 10/10 in the control group were > 250 HU in all three vessels; the remaining 2 HPTF CTPA were > 210HU. All CT scans in both groups were of diagnostic quality and none exhibited movement artefact. CONCLUSION: This study was the first to demonstrate significant RDR with the HPTF technique whilst maintaining IQ in patients undergoing chest CTPA. This technique is particularly beneficial in young females and pregnant females with suspected PE. |
format | Online Article Text |
id | pubmed-10248322 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-102483222023-06-12 High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females Rehan, Saad Kutschera, Peter Paul, Eldho Lau, Theodore Lau, Kenneth K. Emerg Radiol Original Article INTRODUCTION: Computed tomography pulmonary angiography (CTPA) is the gold standard test to investigate pulmonary embolism (PE). This technique carries significant radiation risk in young females because of radiosensitive breast and thyroid tissues. A high-pitched CT technique offers significant radiation dose reduction (RDR) and minimises breathing artefact. The addition of CT tube tin-filtration may offer further RDR. The aim of this retrospective study was to assess RDR and image quality (IQ) of high-pitch tin-filtered (HPTF)-CTPA against conventional-CTPA. METHODS: Retrospective review of consecutive adult females age < 50 years undergoing high pitch tin filtration (HPTF) and standard pitch no tin filtration (SPNF) during a 3-year period beginning in November 2017. CTs in both groups were compared for radiation dose, pulmonary arteries contrast density (Hounsfield units (HU)) and movement artefact. Findings of both groups were compared with the Student’s T-test and Mann–Whitney U test, where p < 0.05 being considered significant. Diagnostic quality was also recorded. RESULTS: Ten female patients (mean age 33, 6/10 pregnant) in HPTF group and 10 female patients (mean age 36, 1/10 pregnant) in SPNF group were included. The HPTF group achieved 93% RDR (dose length product: 25.15 mGy.cm vs 337.10 mGy.cm, p < 0.01). There was significant contrast density difference between the two groups in the main, left or right pulmonary arteries (322.72 HU, 311.85 HU and 319.41 HU in HPTF group vs 418.60 HU, 405.10 HU and 415.96 HU in SPNF group respectively, p = 0.03, p = 0.03 and p = 0.04). 8/10 HPTF group and 10/10 in the control group were > 250 HU in all three vessels; the remaining 2 HPTF CTPA were > 210HU. All CT scans in both groups were of diagnostic quality and none exhibited movement artefact. CONCLUSION: This study was the first to demonstrate significant RDR with the HPTF technique whilst maintaining IQ in patients undergoing chest CTPA. This technique is particularly beneficial in young females and pregnant females with suspected PE. Springer International Publishing 2023-06-08 /pmc/articles/PMC10248322/ /pubmed/37289287 http://dx.doi.org/10.1007/s10140-023-02142-9 Text en © The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Original Article Rehan, Saad Kutschera, Peter Paul, Eldho Lau, Theodore Lau, Kenneth K. High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
title | High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
title_full | High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
title_fullStr | High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
title_full_unstemmed | High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
title_short | High-pitched tin-filtered CT pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
title_sort | high-pitched tin-filtered ct pulmonary angiography in radiation dose reduction for pulmonary embolism investigations in young females |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10248322/ https://www.ncbi.nlm.nih.gov/pubmed/37289287 http://dx.doi.org/10.1007/s10140-023-02142-9 |
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