Diagnostic performance of a low dose triple rule-out CT angiography using SAFIRE in emergency department
2017; Elsevier BV; Volume: 98; Issue: 12 Linguagem: Inglês
10.1016/j.diii.2017.09.006
ISSN2211-5684
AutoresSalim Si‐Mohamed, Joël Greffier, Xavier Bobbia, A. Larbi, Julien Delicque, Elina Khasanova, Jean-Paul Bérégi, Francesco Macrì,
Tópico(s)Advanced X-ray and CT Imaging
ResumoTo compare the diagnostic performance of “triple rule out” CT angiography (TRO-CTA) at 100 kVp using sinogram affirmed iterative reconstruction (SAFIRE) with TRO-CTA at 120 kVp using filtered back projection (FBP) in patients with acute chest pain. Consecutive non-prepared patients from a single radiological emergency department, referred for acute chest pain evaluation with TRO-CTA, were randomly assigned to two different TRO-CTA protocols. Fifty patients (66% men; mean age, 66.6 ± 19.0 [SD] years [range: 24–97 years]) had TRO-CTA at 120 kVp with FBP and 97 patients (67% men; mean age, 62.8 ± 17.9 [SD] years [range: 24–93 years]) had TRO-CTA at 100 kVp with SAFIRE. Two radiologists reviewed the TRO-CTA images for pathologic findings and degree of diagnostic confidence. Image noise, vessel attenuation value, signal-to-noise and contrast-to-noise ratios in five main thoracic arteries were measured for objective and subjective analysis. A total of 147 patients (98 men, 49 women; mean age, 64.7 ± 18.4 [SD] [range, 24–97 years) were included with good diagnostic confidence and equivalent pathological findings between the two TRO-CTA protocols. Objective and subjective analysis were identical between protocols and radiologists, except for vessel attenuation in the ascending aorta (P = 0.02) and image noise in the pulmonary trunk (P = 0.04). The effective radiation dose decreased significantly by 34% in the low dose TRO-CTA using SAFIRE protocol (5.7 ± 2.7 vs 8.6 ± 6.1 mSv; P = 4.7 × 10–6). Low dose TRO-CTA protocol using SAFIRE allows a high confidence diagnostic level with the benefit of a 34% radiation dose decrease compared with a standard TRO-CTA protocol using FBP.
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