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Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality.

Björkdahl, Peter and Nyman, Ulf LU (2010) In Acta Radiologica 51(3). p.260-270
Abstract
Background: Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations. Purpose: To compare radiation dose and image quality in a chest phantom and in patients for the diagnosis of pulmonary embolism (PE) at 100 and 120 peak kilovoltage (kVp) using 16-multichannel detector computed tomography (MDCT). Material and Methods: A 20-ml syringe containing 12 mg I/ml was scanned in a chest phantom at 100/120 kVp and 25 milliampere seconds (mAs). Consecutive patients underwent 100 kVp (n = 50) and 120 kVp (n = 50) 16-MDCT using a "quality reference" effective mAs of 100, 300 mg I/kg, and a 12-s injection duration. Attenuation (CT... (More)
Background: Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations. Purpose: To compare radiation dose and image quality in a chest phantom and in patients for the diagnosis of pulmonary embolism (PE) at 100 and 120 peak kilovoltage (kVp) using 16-multichannel detector computed tomography (MDCT). Material and Methods: A 20-ml syringe containing 12 mg I/ml was scanned in a chest phantom at 100/120 kVp and 25 milliampere seconds (mAs). Consecutive patients underwent 100 kVp (n = 50) and 120 kVp (n = 50) 16-MDCT using a "quality reference" effective mAs of 100, 300 mg I/kg, and a 12-s injection duration. Attenuation (CT number), image noise (1 standard deviation), and contrast-to-noise ratio (CNR; fresh clot = 70 HU) of the contrast medium syringe and pulmonary arteries were evaluated on 3-mm-thick slices. Subjective image quality was assessed. Computed tomography dose index (CTDI(vol)) and dose-length product (DLP) were presented by the CT software, and effective dose was estimated. Results: Mean values in the chest phantom and patients changed as follows when X-ray tube potential decreased from 120 to 100 kVp: attenuation +23% and +40%, noise +38% and +48%, CNR -6% and 0%, and CTDI(vol) -38% and -40%, respectively. Mean DLP and effective dose in the patients decreased by 42% and 45%, respectively. Subjective image quality was excellent or adequate in 49/48 patients at 100/120 kVp. No patient with a negative CT had any thromboembolism diagnosed during 3-month follow-up. Conclusion: By reducing X-ray tube potential from 120 to 100 kVp, while keeping all other scanning parameters unchanged, the radiation dose to the patient may be almost halved without deterioration of diagnostic quality, which may be of particular benefit in young individuals. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Radiologica
volume
51
issue
3
pages
260 - 270
publisher
John Wiley & Sons
external identifiers
  • wos:000275151700005
  • pmid:20121673
  • scopus:77749304526
ISSN
1600-0455
DOI
10.3109/02841850903505222
language
English
LU publication?
yes
id
7aae2786-3ef9-4f04-83bc-0b12f6b615b0 (old id 1553089)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20121673?dopt=Abstract
date added to LUP
2010-03-02 16:53:50
date last changed
2018-05-29 10:52:03
@article{7aae2786-3ef9-4f04-83bc-0b12f6b615b0,
  abstract     = {Background: Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations. Purpose: To compare radiation dose and image quality in a chest phantom and in patients for the diagnosis of pulmonary embolism (PE) at 100 and 120 peak kilovoltage (kVp) using 16-multichannel detector computed tomography (MDCT). Material and Methods: A 20-ml syringe containing 12 mg I/ml was scanned in a chest phantom at 100/120 kVp and 25 milliampere seconds (mAs). Consecutive patients underwent 100 kVp (n = 50) and 120 kVp (n = 50) 16-MDCT using a "quality reference" effective mAs of 100, 300 mg I/kg, and a 12-s injection duration. Attenuation (CT number), image noise (1 standard deviation), and contrast-to-noise ratio (CNR; fresh clot = 70 HU) of the contrast medium syringe and pulmonary arteries were evaluated on 3-mm-thick slices. Subjective image quality was assessed. Computed tomography dose index (CTDI(vol)) and dose-length product (DLP) were presented by the CT software, and effective dose was estimated. Results: Mean values in the chest phantom and patients changed as follows when X-ray tube potential decreased from 120 to 100 kVp: attenuation +23% and +40%, noise +38% and +48%, CNR -6% and 0%, and CTDI(vol) -38% and -40%, respectively. Mean DLP and effective dose in the patients decreased by 42% and 45%, respectively. Subjective image quality was excellent or adequate in 49/48 patients at 100/120 kVp. No patient with a negative CT had any thromboembolism diagnosed during 3-month follow-up. Conclusion: By reducing X-ray tube potential from 120 to 100 kVp, while keeping all other scanning parameters unchanged, the radiation dose to the patient may be almost halved without deterioration of diagnostic quality, which may be of particular benefit in young individuals.},
  author       = {Björkdahl, Peter and Nyman, Ulf},
  issn         = {1600-0455},
  language     = {eng},
  number       = {3},
  pages        = {260--270},
  publisher    = {John Wiley & Sons},
  series       = {Acta Radiologica},
  title        = {Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality.},
  url          = {http://dx.doi.org/10.3109/02841850903505222},
  volume       = {51},
  year         = {2010},
}