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.
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.
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.
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: firstname.lastname@example.org).
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.