Minimizing Contrast Media Dose in CT Pulmonary Angiography with Clinical Photon Counting Using High Pitch Technique.

To evaluate the potential to reduce the amount of iodinated contrast media (CM) for computer tomographic pulmonary angiography (CTPA) with a novel photon-counting-detector CT (PCCT). Overall, 105 patients referred for CTPA were retrospectively included in this study. CTPA was performed using bolus tracking and high-pitch dual-source scanning (FLASH mode) on a novel PCCT (Naeotom Alpha, Siemens Healthineers). CM (Accupaque 300, GE Healthcare) dose was lowered stepwise following the introduction of the new CT scanner. Thus, patients could be divided into 3 groups as follows: group 1, n = 29, 35 ml of CM; group 2, n = 62, 45 ml of CM and group 3, n = 14, 60 ml of CM. Four readers independently assessed the image quality (Likert-scale 1-5) and adequate assessment of the segmental pulmonary arteries. Additionally, the pulmonary arterial contrast opacification was measured. The subjective image quality was rated highest in group 1 with 4.6 compared to 4.5 (group 2) and 4.1 (group 3) with a significant difference between groups 1 and 3 (p < 0.001) and between groups 2 and 3 (p = 0.003). In all groups, almost all segmental pulmonary arteries could be assessed adequately without significant differences (18.5 vs. 18.7 vs. 18.4). Mean attenuation in the pulmonary trunk did not differ significantly between groups 321 ± 92 HU versus 345 ± 93 HU versus 347 ± 88 HU (p = 0.69). Significant CM dose reduction is possible without a reduction in image quality. PCCT enables diagnostic CTPA with 35 ml of CM.

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Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Saher Saeed: Nothing to disclose. Dr. med. Julius Henning Niehoff: Nothing to disclose. Jan Boriesosdick: Nothing to disclose. Dr. med. Arwed E Michael: Nothing to disclose. Matthias Michael Woeltjen: Nothing to disclose. Prof. Dr. Christoph Mönninghoff: Nothing to disclose. Univ. Prof. Dr. Alexey Surov: Nothing to disclose. Prof. Dr. Jan Borggrefe: Other: Jan Borggrefe received honoraria for scientific lectures from Philips Health care and Siemens Healthineers. The radiology department at the university hospital Minden has a research collaboration with Siemens Healthineers. Dr. med. Jan Robert Kröger: Other: Jan Robert Kroeger received research support from Philips Health care, support for attending meetings and/or travel from Veryan, honoraria for scientific lectures from GE Health care and honoraria for clinical advisory board membership from Siemens Healthineers.