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Motion Artifact Reduction From High-Pitch Dual-Source Computed Tomography Pulmonary Angiography

Bunch, Paul M., MD*; Fulwadhva, Urvi P., MD*; Wortman, Jeremy R., MD*; Primak, Andrew N., PhD; Madan, Rachna, MD*; Steigner, Michael L., MD*; Sodickson, Aaron D., MD, PhD*

Journal of Computer Assisted Tomography: July/August 2018 - Volume 42 - Issue 4 - p 623–629
doi: 10.1097/RCT.0000000000000736
Cardiothoracic Imaging

Purpose The purpose of this study was to compare quantitative and qualitative measures of aortic, cardiac, and respiratory motion artifact between high-pitch dual-source (DS) and single-source (SS) computed tomography pulmonary angiography (CTPA) protocols.

Methods This institutional review board–approved, Health Insurance Portability and Accountability Act–compliant study retrospectively reviewed 80 non–electrocardiogram-gated CTPA examinations acquired with a second-generation DS system at 100 kVp following 50 mL iodinated contrast injection — 40 consecutive SS and 40 consecutive DS studies. Quantitative measures of aortic, left ventricular, and diaphragmatic motion were recorded as the maximal excursion of a structure's “double image,” and 3 independent readers performed qualitative motion assessments. Pulmonary arterial contrast enhancement, image noise, and radiation dose metrics were recorded. Statistical analyses were performed with 1-way analysis of variance and Fisher exact test.

Results Dual source outperformed SS technique in both quantitative and qualitative measures of motion. Mean distances between motion-artifact double images were reduced with DS protocol at each location (all P ≤ 0.004), and DS examinations were more likely to receive an assessment of no motion in all locations (all P < 0.0001). The DS protocol demonstrated increases in contrast enhancement, although increased image noise resulted in lower enhancement to noise ratio. Mean radiation dose was 60% lower using the DS protocol.

Conclusion High-pitch DS CTPA significantly reduces artifacts resulting from ascending aortic, cardiac, and diaphragmatic motion.

From the *Brigham and Women's Hospital, Department of Radiology, Boston, MA; and

Siemens Medical Solutions USA, Inc, Malvern, PA.

Received for publication September 28, 2017; accepted November 17, 2017.

Correspondence to: Jeremy R. Wortman, MD, Brigham and Women's Hospital, Department of Radiology, 75 Francis St, Boston, MA 02115 (e-mail:

P.M.B., U.P.F., and R.M. have nothing to disclose. A.N.P. is an employee of Siemens Healthcare. M.L.S. is a speaker of Toshiba (Vital Images). A.S. is a principal investigator on a Siemens research grant and consultant of Siemens, Bayer, and Bracco. J.R.W. is a coinvestigator on a Siemens research grant.

The authors declare no conflict of interest.

Institutional Review Board Statement: Our hospital's institutional review board approved the study represented in this article.

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