Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study (original) (raw)
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Reducing computed tomography radiation dose in diagnosing pulmonary embolism
Pakistan Journal of Medical Sciences, 2016
Background and Objective: Computed tomography angiography plays a major role in the diagnosis of pulmonary embolism. Radiation dose associated with it is a major concern; therefore it is important to optimize protocols and techniques to ensure minimum radiation dose. Methods: The study compares two protocols i.e. Conventional Timing Bolus CT protocol and Delayed Timing Bolus protocol used to assist suspected pulmonary embolism patients. Results: A significant reduction in the average effective dose (39%) was noticed when using the delayed timing bolus protocol. Conclusion: Delayed timing bolus protocol has a good impact on radiation dose without affecting the value of the computed tomography angiography study.
Risk-Benefit Analysis of Pulmonary CT Angiography in Patients With Suspected Pulmonary Embolus
American Journal of Roentgenology, 2012
T examinations are the largest source of medical radiation exposure, accounting for 49% of collective effective medical radiation dose in 2006 [1]. In comparison with radiography, CT examinations are intrinsically high dose [2] and the increased x-ray power of MDCT scanners is associated with an increased average dose per examination [3], making it likely that an even higher radiation dose is currently delivered in centers with limited radiation dose awareness. CT dose reduction efforts have two components: The first is optimizing acquisition and reconstruction parameters to ensure that dose is as low as reasonably achievable and the second is ensuring that CT examinations are appropriately requested with adequate clinical justification. Clinical justification requires that the outcome
Image Quality and Radiation Dose of Pulmonary CT Angiography Performed Using 100 and 120 kVp
American Journal of Roentgenology, 2012
P ulmonary CT angiography (CTA) performed with MDCT facilitates rapid and accurate diagnosis of pulmonary embolism (PE) [1]. The technique is widely accessible, is quick to perform, and has a high sensitivity (94-100%) and specificity (89-100%) for the diagnosis of acute PE [1, 2]. In addition, pulmonary CTA may show additional thoracic abnormalities in patients referred for exclusion of PE [1, 3]. Therefore, pulmonary CTA is widely accepted as the primary imaging modality for the investigation of patients with suspected PE. However, because PE is diagnosed in fewer than 10% of all pulmonary CTA examinations [1, 4, 5], there is increasing concern regarding the riskbenefit ratio for this examination particularly in younger patients and in women who are at higher risk of carcinogenesis from diagnostic
European Radiology, 2007
This study was an analysis of the correlation between pulmonary embolism (PE) and patient survival. Among 694 consecutive patients referred to our institution with clinical suspicion of acute PE who underwent CT pulmonary angiography, 188 patients comprised the study group: 87 women (46.3%, median age: 60.7; age range: 19-88 years) and 101 men (53.7%, median age: 66.9; age range: 21-97 years). PE was assessed by two radiologist who were blinded to the results from the follow-up. A PE index was derived for each set of images on the basis of the embolus size and location. Results were analyzed using logistic regression, and correlation with risk factors and patient outcome (survival or death) was calculated. We observed no significant correlation between the CTPE index and patient outcome (p=0.703). The test of lo-gistic regression with the sum of heart and liver disease or presence of cancer was significantly (p<0.05) correlated with PE and overall patient outcome. Interobserver agreement showed a significant correlation rate for the assessment of the PE index (0.993; p<0.001). In our study the CT PE index did not translate into patient outcome. Prospective larger scale studies are needed to confirm the predictive value of the index and refine the index criteria.
European Heart Journal - Quality of Care and Clinical Outcomes, 2021
Aims The use of computed tomography pulmonary angiography (CTPA) in the detection of pulmonary embolism (PE) has considerably increased due developing technology and better availability of imaging. The underuse of pre-test probability scores and overuse of CTPA has been previously reported. We sought to investigate the indications for CTPA at a University Hospital emergency clinic and seek for factors eliciting the potential overuse of CTPA. Methods and results Altogether 1001 patients were retrospectively collected and analysed from the medical records using a structured case report form. PE was diagnosed in 222/1001 (22.2%) of patients. Patients with PE had more often prior PE/deep vein thrombosis, bleeding/thrombotic diathesis and less often asthma, chronic obstructive pulmonary disease, coronary artery disease, or decompensated heart failure. Patients were divided into three groups based on Wells PE risk-stratification score and two groups based on the revised Geneva score. A to...
Canadian Association of Radiologists Journal
Acute pulmonary embolism (APE) is a well-recognized cause of circulatory system compromise and even demise which can frequently present a diagnostic challenge for the physician. The diagnostic challenge is primarily due to the frequency of indeterminate presentations as well as several other conditions which can have a similar clinical presentation. This often obliges the physician to establish a firm diagnosis due to the potentially serious outcomes related to this disease. Computed tomography pulmonary angiography (CTPA) has increasingly cemented its role as the primary investigation tool in this clinical context and is widely accepted as the standard of care due to several desired attributes which include great accuracy, accessibility, rapid turn-around time and the ability to suggest an alternate diagnosis when APE is not the culprit. In Part 1 of this guidance document, a series of up-to-date recommendations are provided to the reader pertaining to CTPA protocol optimization (i...