Clinical evaluation of automatic tube voltage selection in chest CT angiography |
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Authors: | Tilo Niemann Simon Henry Jean-Baptiste Faivre Kanna Yasunaga Sofiane Bendaoud Ariana Simeone Jacques Remy Alain Duhamel Thomas Flohr Martine Remy-Jardin |
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Institution: | 1. Department of Thoracic Imaging, Hospital Calmette (EA 2694), University Lille Nord de France, 59000, Lille, France 2. Department of Medical Statistics (EA 2694), University Lille Nord de France, 59000, Lille, France 3. Department of Research and Development, Siemens Medical Systems, Forchheim, Germany 4. Department of Thoracic Imaging, Hospital Calmette, Boulevard Jules Leclercq, 59037, Lille cedex, France
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Abstract: | Objective To evaluate the clinical impact of automatic tube voltage selection on chest CT angiography (CTA). Methods Ninety-three patients were prospectively evaluated with a CT protocol aimed at comparing two successive CTAs acquired under similar technical conditions except for the kV selection: (1) the initial CTA was systematically obtained at 120 kVp and 90 ref mAs; (2) the follow-up CTA was obtained with an automatic selection of the kilovoltage (Care KV; Siemens Healthcare) for optimised CTA. Results At follow-up, 90 patients (97 %) underwent CTA with reduced tube voltage, 100 kV (n?=?26; 28 %) and 80 kV (n?=?64; 69 %), resulting in a significant dose-length-product reduction (follow-up: 87.27; initial: 141.88 mGy.cm; P?<?0.0001; mean dose reduction: 38.5 %) and a significant increase in the CNR at follow-up (follow-up: 11.5?±?3.5 HU; initial: 10.9?±?3.7 HU; P?=?0.03). The increase in objective image noise at follow-up (follow-up: 23.2?±?6.7 HU vs. 17.8?±?5.1 HU; P?<?0.0001) did not alter the diagnostic value of images. Conclusion Automatic tube voltage selection reduced the radiation dose delivered during chest CT angiograms by 38.5 % while improving the contrast-to-noise ratio of the examinations. Key Points ? As low a dose as possible must be used for CT angiography. ? Automatic tube voltage selection permits reduced patient exposure. ? Lowering the kVp enables increased intravascular attenuation. ? Automatic tube voltage selection does not compromise the overall image quality. |
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