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Improving the Image Quality in Computed Tomographic Pulmonary Angiography With Dual-Energy Subtraction: A New Application of Spectral Computed Tomography

Bai, Aiguo MD; Sun, Yibo MD; Qi, Lin MD; Yang, Yanli MD; Hua, Yanqing MD

Journal of Computer Assisted Tomography: September/October 2013 - Volume 37 - Issue 5 - p 718–724
doi: 10.1097/RCT.0b013e3182a022be
Thoracic and Cardiovascular Imaging

Objectives The objectives of this study were to assess quantitative and subjective image quality in computed tomographic pulmonary angiography using dual-energy subtraction methods compared with those of the monochromatic images using optimal contrast-to-noise ratios and those of the routine polychromatic images and to select the best dual-energy subtraction method.

Materials and Methods A total of 1 routine polychromatic image, 3 sets of dual-energy subtraction images (DESIs), and 2 sets of monochromatic images with different optimal contrast-to-noise ratios from 30 patients were obtained. The signal intensity and noise were measured; signal-to-noise ratio and contrast-to-noise ratio (CNR) were calculated. The global subjective image quality was subjectively assessed.

Results The DESI 3 got the highest CNR and the DESI 1 got the second highest CNR. The DESI 1 got the highest global subjective image quality score. The 3 subtraction image sets got the highest score in visualization of the pulmonary artery branches.

Conclusions Computed tomographic pulmonary angiography with dual-energy subtraction technique is feasible. The DESI 1 afforded the best balance between the quantitative analysis and the subjective evaluation.

From the Department of Radiology, Hua Dong Hospital of Fu Dan University, Shanghai, China.

Received for publication April 13, 2013; accepted June 10, 2013.

Reprints: Yanqing Hua, MD, No. 221 W Yan’an Rd, Department of Radiology, Hua Dong Hospital of Fu Dan University, Shanghai 200040, China. (e-mail:;

Conflict of interest and source of funding statement:

We declare that all the parts of this article were uploaded, that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, and that there is no professional or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in or the review of this article.

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