CT Pulmonary Angiogram with Reduced Radiation Exposure at Low Tube Kilovoltage

Ahmed Abdullahi Hashi


This study's primary goal is to assess the image quality and radiation dose of the low-dose 80kV computed tomography pulmonary angiogram (CTPA) protocol compared to the standard 100kV CTPA protocol for the assessment of pulmonary embolism (PE). The study consisted of 100 patients who had clinically suspected pulmonary embolism and required a CTPA. Patients underwent imaging with a 320-row multi-detector Toshiba Aquilion One Genesis Edition in the absence of the proprietary radiation reduction software known as forward projected model-based Iterative Reconstruction Solution (commercial acronym 'FIRST'). Participants were divided into two groups: A and B.  Group A was composed of 50 patients who were allocated to standard CT protocol using a 100 kV exposure setting and all other settings set as a standard by the manufacturer.  Group B was composed of 50 patients who were allocated to a CTPA with a low-dose 80kV protocol, standard deviation level 8, an effective mAs of 258, reconstruction algorithm-kernel FC 51 within the lung window, and tube current modulation. A considerable decrease in radiation dose was observed with the low-dose CTPA protocol. The mean radiation dose was also decreased by 66% while using the 80kV protocol than when utilising a standard 100kV technique; this was achieved without compromising this study's diagnostic value. Furthermore, the contrast enhancement was considerably more significant, up to 40% higher when using 80kV. The study found that a low tube voltage of 80kV CTPA protocol resulted in a considerable decrease in radiation dose and improved contrast enhancement without sacrificing the examinations' diagnostic utility.


Low do and image quality of 80kV; CT pulmonary angiogram; Low tube voltage; 80kV CTPA protocol; 100kV versus 80kV; Image quality and contrast enhancement assessment of 80V

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[1] Carroll BJ, Beyer SE, Mehegan T, Dicks A, Pribish A, Locke A, et al. Changes in Care for Acute Pulmonary Embolism with a Multidisciplinary Pulmonary Embolism Response Team: PE Response Team. The American Journal of Medicine. 2020.

[2] Ishaaya E, Tapson VF. Advances in the diagnosis of acute pulmonary embolism. F1000Research. 2020;9.

[3] Aissaoui N, Konstantinides S, Meyer G. What’s new in severe pulmonary embolism? Intensive care medicine. 2019;45(1):75-7.

[4] Stulz P, Schliipfer R, Feer R, Habicht J, Griidel E. Decision making in the surgical treatment of massive pulmonary embolism. shock. 1994;19(15):79.

[5] Romans L. Computed Tomography for Technologists: A comprehensive text: Lippincott Williams & Wilkins; 2018.

[6] Wittram C, Maher MM, Halpern EF, Shepard J-AO. Attenuation of acute and chronic pulmonary emboli. Radiology. 2005;235(3):1050-4.

[7] Bongartz G, Golding S, Jurik, A, et al. European Union Quality Creteria Computed tomography. European Union website Established by the European Commission's Study Group on Development of Quality Criteria for CT scan. 1998.

[8] Szucs-Farkas Z, Kurmann L, Strautz T, Patak MA, Vock P, Schindera ST. Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100-and 80-kVp protocols. Investigative radiology. 2008;43(12):871-6.

[9] Rajiah P, Ciancibello L, Novak R, Sposato J, Landeras L, Gilkeson R. Ultra-low dose contrast CT pulmonary angiography in oncology patients using a high-pitch helical dual-source technology. Diagn Interv Radiol. 2019;25(3):195-203.

[10] Rusandu A, Ødegård A, Engh G, Olerud HM. The use of 80 kV versus 100 kV in pulmonary CT angiography: an evaluation of the impact on radiation dose and image quality on two CT scanners. Radiography. 2019;25(1):58-64.

[11] Aldosari S, Sun Z. A Systematic Review of Double Low-dose CT Pulmonary Angiography in Pulmonary Embolism. Current Medical Imaging Reviews. 2019;15(5):453-60.

[12] Mustafa K, Kayan M, Cetinkaya G, Turkoglu S, Kayan F. Investigating the use and optimization of low dose KV and contrast media in CT Pulmonary angiography examination. Iranian Journal of Radiology. 2018;15(3).

DOI: http://dx.doi.org/10.33533/jpm.v14i2.2197

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