Improved assessment of mediastinal and pulmonary pathologies in combined staging CT examinations using a fast-speed acquisition dual-source CT protocol

Eur Radiol. 2017 Dec;27(12):4931-4940. doi: 10.1007/s00330-017-4888-7. Epub 2017 Jul 4.

Abstract

Objectives: To demonstrate the feasibility of fast Dual-Source CT (DSCT) and to evaluate the clinical utility in chest/abdomen/pelvis staging CT studies.

Methods: 45 cancer patients with two follow-up combined chest/abdomen/pelvis staging CT examinations (maximally ±10 kV difference in tube potential) were included. The first scan had to be performed with our standard protocol (fixed pitch 0.6), the second one using a novel fast-speed DSCT protocol (fixed pitch 1.55). Effective doses (ED) were calculated, noise measurements performed. Scan times were compared, motion artefacts and the diagnostic confidence rated in consensus reading.

Results: ED for the standard and fast-speed scans was 9.1 (7.0-11.1) mSv and 9.2 (7.4-12.8) mSv, respectively (P = 0.075). Image noise was comparable (abdomen; all P > 0.05) or reduced for fast-speed CTs (trachea, P = 0.001; ascending aorta, P < 0.001). Motion artefacts of the heart/the ascending aorta (all P < 0.001) and breathing artefacts (P < 0.031) were reduced in fast DSCT. The diagnostic confidence for the evaluation of mediastinal (P < 0.001) and pulmonary (P = 0.008) pathologies was improved for fast DSCT.

Conclusions: Fast DSCT for chest/abdomen/pelvis staging CT examinations is performed within 2 seconds scan time and eliminates relevant intrathoracic motion/breathing artefacts. Mediastinal/pulmonary pathologies can thus be assessed with high diagnostic confidence. Abdominal image quality remains excellent.

Key points: • Fast dual-source CT provides chest/abdomen/pelvis staging examinations within 2 seconds scan time. • The sevenfold scan time reduction eliminates relevant intrathoracic motion/breathing artefacts. • Mediastinal/pulmonary pathologies can now be assessed with high diagnostic confidence. • The coverage of the peripheral soft tissues is comparable to single-source CT. • Fast and large-volume oncologic DSCT can be performed with 9 mSv effective dose.

Keywords: Abdomen; Dual-source computed tomography; Oncology; Pelvis; Thorax.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Cytarabine
  • Feasibility Studies
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Male
  • Mediastinum / diagnostic imaging*
  • Middle Aged
  • Neoplasms / diagnostic imaging*
  • Pelvis / diagnostic imaging
  • Radiation Dosage
  • Radiography, Abdominal / methods*
  • Radiography, Thoracic / methods*
  • Retrospective Studies
  • Thioguanine
  • Thoracic Neoplasms / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*

Substances

  • Cytarabine
  • Thioguanine

Supplementary concepts

  • CT protocol