Article Dans Une Revue Diagnostic and Interventional Imaging Année : 2017

Diagnostic performance of a low dose triple rule-out CT angiography using SAFIRE in emergency department

Résumé

OBJECTIVES: To compare the diagnostic performance of "triple rule out" CT angiography (TRO-CTA) at 100kVp using sinogram affirmed iterative reconstruction (SAFIRE) with TRO-CTA at 120kVp using filtered back projection (FBP) in patients with acute chest pain. METHODS: Consecutive non-prepared patients from a single radiological emergency department, referred for acute chest pain evaluation with TRO-CTA, were randomly assigned to two different TRO-CTA protocols. Fifty patients (66% men; mean age, 66.6\textpm19.0 [SD] years [range: 24-97years]) had TRO-CTA at 120kVp with FBP and 97 patients (67% men; mean age, 62.8\textpm17.9 [SD] years [range: 24-93years]) had TRO-CTA at 100kVp with SAFIRE. Two radiologists reviewed the TRO-CTA images for pathologic findings and degree of diagnostic confidence. Image noise, vessel attenuation value, signal-to-noise and contrast-to-noise ratios in five main thoracic arteries were measured for objective and subjective analysis. RESULTS: A total of 147 patients (98 men, 49 women; mean age, 64.7\textpm18.4 [SD] [range, 24-97years) were included with good diagnostic confidence and equivalent pathological findings between the two TRO-CTA protocols. Objective and subjective analysis were identical between protocols and radiologists, except for vessel attenuation in the ascending aorta (P=0.02) and image noise in the pulmonary trunk (P=0.04). The effective radiation dose decreased significantly by 34% in the low dose TRO-CTA using SAFIRE protocol (5.7\textpm2.7 vs 8.6\textpm6.1mSv; P=4.7\texttimes10-6). CONCLUSIONS: Low dose TRO-CTA protocol using SAFIRE allows a high confidence diagnostic level with the benefit of a 34% radiation dose decrease compared with a standard TRO-CTA protocol using FBP.

Dates et versions

hal-01743306 , version 1 (26-03-2018)

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S. Si-Mohamed, J. Greffier, X. Bobbia, A. Larbi, J. Delicque, et al.. Diagnostic performance of a low dose triple rule-out CT angiography using SAFIRE in emergency department. Diagnostic and Interventional Imaging, 2017, 98 (12), pp.881--891. ⟨10.1016/j.diii.2017.09.006⟩. ⟨hal-01743306⟩
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