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Evaluation of a High Iodine Delivery Rate in Combination With Low Tube Current for Dose Reduction in Pulmonary Computed Tomography Angiography

Heusch, Philipp MD*; Lanzman, Rotem S. MD*; Aissa, Joel MD*; Schimmöller, Lars MD*; Antoch, Gerald MD*; Krix, Martin MD, PhD; Kröpil, Patric MD*

doi: 10.1097/RTI.0000000000000099
Original Articles

Purpose: The present study evaluates the combination of a high iodine delivery rate with a low tube current-time product for pulmonary computed tomography angiography (CTA).

Materials and Methods: One-hundred nineteen consecutive patients undergoing pulmonary CTA for suspected pulmonary embolism were included and imaged on a 128-row computed tomography scanner at 100 kVp using highly concentrated contrast material (85 mL Iomeprol; 400 mg iodine/mL). The protocol entailed a flow rate of 5 mL/s and 90 mAs for group A, 3.5 mL/s and 135 mAs for group B, 5 mL/s and 135 mAs for group C, and 3.5 mL/s and 90 mAs for group D. Signal-to-noise ratio and contrast-to-noise ratio (CNR) were determined for the pulmonary artery. Subjective image quality (IQ) was rated on a 5-point scale (1=nondiagnostic IQ to 5=excellent IQ).

Results: CNR did not differ significantly between groups A (43.7±27.7), B (34.5±17.9), and C (38.9±13.8), as well as between groups B and D (29.9±11.2). CNR was higher in groups A and C than in group D (P<0.02). Subjective IQ was higher in group A than in groups B and D (P<0.05). Subjective IQ was significantly higher in group A compared with group D (P=0.026) and in group C compared with group D (P=0.007).

Conclusions: A high iodine delivery rate permits dose reduction in pulmonary CTA and can be recommended in patients with suspected pulmonary embolism.

*Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Duesseldorf

Bracco Imaging, Global Medical & Regulatory Affairs, Konstanz, Germany

Supported financially by Bracco Imaging.

Martin Krix is an employee of Bracco Imaging. The remaining authors declare no conflicts of interest.

Correspondence to: Rotem S. Lanzman, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, D-40225 Duesseldorf, Germany (e-mail:

© 2014 by Lippincott Williams & Wilkins