Journal ArticleDOI
Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism
Long Jiang Zhang,Chang Sheng Zhou,U. Joseph Schoepf,Hui Xue Sheng,Shengyong Wu,Aleksander W. Krazinski,Justin R. Silverman,Felix G. Meinel,Yan E. Zhao,Zong Jun Zhang,Guangming Lu +10 more
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TLDR
DECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/ perfusion match or mismatch in patients with suspected pulmonary embolism.Abstract:
To evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE). This study was institutional review board-approved and written informed consent was obtained from each patient. Thirty-two subjects (aged 11–61 years) underwent combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT. Ventilation, perfusion and morphological information were visually interpreted. Ventilation/perfusion information was classified as mismatch (differing patterns) or match (concordant patterns). Adverse reactions and radiation doses were recorded for each subject. Of 32 patients undergoing xenon-enhanced DECT, six patients reported adverse reactions (shortness of breath, n = 2; mild dizziness, n = 3; limb numbness, n = 1). Twenty-eight of 32 patients could be included into the data analysis. PE was detected in 10/28 patients. PE-related ventilation/perfusion mismatch was found in 17 lung lobes in 8/10 patients and matched ventilation/perfusion was detected in 2 patients. Eighteen patients had no PE. In this group, there was no case of a ventilation/perfusion mismatch. Matched ventilation/perfusion impairment was seen in one patient. The overall radiation dose from two DECT acquisitions was 4.8 ± 1.4 mSv (range 2.7-7.5 mSv). DECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/perfusion match or mismatch in patients with suspected PE. • Combined dual-energy CT lung ventilation/perfusion imaging is feasible. • Combined dual-energy CT ventilation/perfusion imaging provides lung morphological and functional information. • Dual-energy CT can demonstrate ventilation/perfusion mismatch in patients with pulmonary embolism.read more
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Journal ArticleDOI
Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications
TL;DR: The underlying motivation and physical principles of dual- or multi-energy CT are reviewed, the current and evolving clinical applications are introduced and each of the current technical approaches is described.
Journal ArticleDOI
Dual-Energy CT of the Lung
TL;DR: DECT can provide both anatomic and functional information about the lungs in a variety of pulmonary disease states based on a single contrast-enhanced CT examination and has been shown to improve the diagnosis of acute and chronic PEs, other vascular disorders, lung malignancies, and parenchymal diseases.
Journal ArticleDOI
Evolution in Computed Tomography: The Battle for Speed and Dose.
TL;DR: Technical advancements of scanner hardware and image reconstruction techniques are reviewed and discussed in their clinical context and have led to a steady increase of CT examinations in all age groups for a number of reasons.
Journal ArticleDOI
State-of-the-Art Pulmonary CT Angiography for Acute Pulmonary Embolism
Moritz H. Albrecht,Matthew W. Bickford,John W. Nance,Longjiang Zhang,Carlo N. De Cecco,Julian L. Wichmann,Thomas J. Vogl,U. Joseph Schoepf,U. Joseph Schoepf +8 more
TL;DR: Pulmonary CTA is well established as a fast and reliable means of excluding or diagnosing PE and advances in risk stratification and prognostication from pulmonary CTA examinations should further refine its clinical value while minimizing the potential harm from overutilization and overdiagnosis.
Journal ArticleDOI
Spectral and dual-energy X-ray imaging for medical applications
TL;DR: Spectral imaging is an umbrella term for energy-resolved X-ray imaging in medicine as mentioned in this paper, which makes use of the energy dependence of Xray attenuation to either increase the contrast-to-noise ratio, or to provide quantitative image data and reduce image artefacts by so-called material decomposition.
References
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Journal ArticleDOI
Computed Tomography — An Increasing Source of Radiation Exposure
David J. Brenner,Eric J. Hall +1 more
TL;DR: The facts are summarized about CT scans, which involve much higher doses of radiation than plain films, and the implications for public health are summarized.
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Estimating Risk of Cancer Associated With Radiation Exposure From 64-Slice Computed Tomography Coronary Angiography
TL;DR: Estimates derived from simulation models suggest that use of 64-slice CTCA is associated with a nonnegligible LAR of cancer, which varies markedly and is considerably greater for women, younger patients, and for combined cardiac and aortic scans.
Journal ArticleDOI
Strategies for reducing radiation dose in CT.
Cynthia H. McCollough,Andrew N. Primak,Natalie N. Braun,James M. Kofler,Lifeng Yu,Jodie A. Christner +5 more
TL;DR: The dose reduction strategies described in this article must be well understood and properly used to satisfy the ALARA principle and the use of CT must also be justified for the specific diagnostic task.
Journal ArticleDOI
Management of Suspected Acute Pulmonary Embolism in the Era of CT Angiography: A Statement from the Fleischner Society
Martine Remy-Jardin,Massimo Pistolesi,Lawrence R. Goodman,Warren B. Gefter,Alexander Gottschalk,John R. Mayo,H. Dirk Sostman +6 more
TL;DR: A consensus update on the role of CT angiography in the diagnostic approach to PE is proposed, with the aim of reducing the number of unnecessary CT pulmonary angiograms being obtained in patients who are unlikely to have PE.