| Du Changyu,Liu Yijun,Wei Wei,et al.Application value of auto-prescription technique combined with iterative reconstruction algorithm in low-dose CT pulmonary angiography[J].Chinese Journal of Radiological Medicine and Protection,2025,45(7):685-691 |
| Application value of auto-prescription technique combined with iterative reconstruction algorithm in low-dose CT pulmonary angiography |
| Received:July 25, 2024 |
| DOI：10.3760/cma.j.cn112271-20240725-00280 |
| KeyWords:Pulmonary CT angiography Pulmonary embolism Low dose Auto-prescription |
| FundProject: |
| Author Name | Affiliation | E-mail | | Du Changyu | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | | | Liu Yijun | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | yijunliu1965@126.com | | Wei Wei | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | | | Hu Mengting | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | | | Zhang Jingyi | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | | | Cheng Qiye | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | | | He Jian | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | | | Chen Anliang | Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China | |
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| Abstract:: |
| Objective To explore the application value of the double-low technique of auto-prescription technique combined with iterative reconstruction algorithm in CT pulmonary angiography (CTPA). Methods A total of 86 patients who were clinically suspected of having pulmonary embolism and underwent CTPA examination in the First Affiliated Hospital of Dalian Medical University were prospectively collected and randomly assigned to a control group (n = 45) and an observation group (n = 41) according to the random number table method. In the control group, a tube voltage of 120 kVp was used with a standard iodine contrast agent dose of 60 ml, and images were reconstructed using the 40% adaptive statistical iterative reconstruction algorithm (ASIR-V). In the observation group, the tube voltage was set by auto-prescription technique, and 0.4 ml/kg of personalized low iodine contrast agent was used. Images were reconstructed with 40%, 60%, and 80% ASIR-V, respectively, and designated as observation 1, observation 2, and observation 3 respectively. The volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose (E) were recorded and compared among the four groups. The CT values and standard deviation (SD) of the main pulmonary artery, left and right pulmonary arteries, as well as the left and right pulmonary lobe arteries were measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of these arteries were calculated. Additionally, the SD value at the contrast medium concentration in the superior vena cava was measured, and the artifact index (AI) was subsequently calculated. Two observers independently assessed the visibility of the pulmonary arteries, image noise, and sclerosis artifacts in the superior vena cava using a blinded method. Results The E in the observation group was 3.28 (2.08, 3.93) mSv, which was significantly lower than that in the control group [5.03 (4.86, 5.20)] mSv, and the difference was statistically significant (Z = 174.00, P < 0.05). The contrast agent dosage in the observation group was 28 (25, 30) ml, which was lower than that in the control group (60 ml), and the difference was statistically significant (Z = 0, P < 0.05). The CT values for the main pulmonary artery and the left and right pulmonary lobe arteries in the observation group were higher than those in the control group, and the differences were all statistically significant (t = -3.65 to -3.89, P < 0.05). The SNR and CNR of the observation groups 2 and 3 were greater than those of the control group (t = -9.20 to -2.98, P < 0.05). The consistency of subjective evaluations between the two observers was good (Kappa = 0.729 - 0.879, P < 0.05). There was no statistically significant difference in the subjective score of pulmonary artery visibility between the control and observation group (P > 0.05). The subjective scores for image noise in observation group 2 and group 3 were higher than those in the control group (U =598.50, 654.00, P < 0.05). The presence of artifacts due to sclerosis in the superior vena cava was significantly lower in the observation group compared to the control group (χ2 = 46.09, P < 0.001). Conclusions The combination of auto-prescription technique with ASIR-V reconstruction algorithm and low contrast agent imaging protocol can reduce the radiation dose and contrast agent dose without compromising image quality, and enable personalized double low CTPA imaging.Clinical trial registration Chinese Clinical Trial Registry, YJ-KY-2022-57 |
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