Volumetric assessment of solid pulmonary nodules on ultralow-dose CT: a phantom study.

Background: To reduce the radiation exposure from chest computed tomography (CT), ultralow-dose CT (ULDCT) protocols performed at sub-millisievert levels were previously tested for the evaluation of pulmonary nodules (PNs). The purpose of our study was to investigate the effect of ULDCT and iterative image reconstruction on volumetric measurements of solid PNs.

Methods: CT datasets of an anthropomorphic chest phantom containing solid microspheres were obtained with a third-generation dual-source CT at standard dose, 1/8th, 1/20th and 1/70th of standard dose [CT volume dose index (CTDI): 0.

Chest pain CT in the emergency department: Watch out for the myocardium.

Rationale And Objectives: To evaluate the frequency and relevance of hypodense myocardium (HM) encountered in patients undergoing chest-pain CT in the emergency department (ED).

Material And Methods: In this IRB-approved retrospective study, ECG-gated chest-pain CT examinations of 300 consecutive patients (mean age 60 ± 17 years) presenting with acute chest-pain to our ED were evaluated. Once ST-segment elevation infarction was excluded, chest-pain CT including the coronary arteries (rule-out acute coronary syndrome (ACS), pulmonary embolism (PE) and acute aortic syndrome (AAS): chest-pain CT, n = 121) or not including the coronary arteries was performed (rule-out PE and AAS: chest-pain CT, n = 179).

Diagnostic accuracy and added value of dual-energy subtraction radiography compared to standard conventional radiography using computed tomography as standard of reference.

Purpose: To retrospectively evaluate diagnostic performance of dual-energy subtraction radiography (DESR) for interpretation of chest radiographs compared to conventional radiography (CR) using computed tomography (CT) as standard of reference.

Material And Methods: A total of 199 patients (75 female, median age 67) were included in this institutional review board (IRB)-approved clinical trial. All patients were scanned in posteroanterior and lateral direction with dual-shot DE-technique.

Dose-Optimized Computed Tomography for Screening and Follow-Up of Solid Pulmonary Nodules in Obesity: A Phantom Study.

To determine the lowest CT radiation dose-level at maintained image-quality and high sensitivity for detection of pulmonary-nodules in obesity. Single-energy CT with tin-filtration was performed in a chest-phantom with solid pulmonary-nodules simulating over-weight and obesity. CTDI of the standard-protocol was 0.

Diagnostic Value of Bronchoalveolar Lavage for Diagnosis of Suspected Peripheral Lung Cancer.

Background: There is a paucity of data concerning the benefit of bronchoalveolar lavage (BAL) for the diagnosis of suspected peripheral lung cancer (PLC). The aim of this study was to investigate the diagnostic value of BAL for the diagnosis of suspected PLC.

Patients And Methods: All flexible bronchoscopies that included BAL among other modalities (brush, forceps, washing) for the diagnosis of a suspected PLC performed between 2009 and 2013 were analyzed in this retrospective study.

Ultralow-dose CT with tin filtration for detection of solid and sub solid pulmonary nodules: a phantom study.

Objectives: To investigate the diagnostic performance of advanced modelled iterative reconstruction (ADMIRE) to filtered back projection (FBP) when using an ultralow-dose protocol for the detection of solid and subsolid pulmonary nodules.

Methods: Single-energy CT was performed at 100 kVp with tin filtration in an anthropomorphic chest phantom with solid and subsolid pulmonary nodules (2-10 mm, attenuation, 20 to -800 HU at 120 kVp). The mean volume CT dose index (CTDIvol) of the standard chest protocol was 2.

Influence of Sinogram-Affirmed Iterative Reconstruction on Computed Tomography-Based Lung Volumetry and Quantification of Pulmonary Emphysema.

Objective: The purpose of this study was to evaluate the influence of sinogram-affirmed iterative reconstruction (SAFIRE) on quantification of lung volume and pulmonary emphysema in low-dose chest computed tomography compared with filtered back projection (FBP).

Methods: Enhanced or nonenhanced low-dose chest computed tomography was performed in 20 patients with chronic obstructive pulmonary disease (group A) and in 20 patients without lung disease (group B). Data sets were reconstructed with FBP and SAFIRE strength levels 3 to 5.

Screening for interstitial lung disease in systemic sclerosis: performance of high-resolution CT with limited number of slices: a prospective study.

Objectives: Early diagnosis of interstitial lung disease (ILD), currently the main cause of death in systemic sclerosis (SSc), is needed. The gold standard is high-resolution CT (HRCT) of the chest, but regular screening faces the risk of increased radiation exposure. We performed a prospective validation of a dedicated, 9-slice HRCT protocol with reduced radiation dose for the detection of ILD in patients with SSc.

Bicuspid aortic valves: diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT.

Objectives: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves.

Materials And Methods: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analyzed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analyzed the appearance of the valve cusps.

Ultralow-dose chest computed tomography for pulmonary nodule detection: first performance evaluation of single energy scanning with spectral shaping.

Purpose: The purpose of this study was to evaluate the image quality and sensitivity of ultralow radiation dose single-energy computed tomography (CT) with tin filtration for spectral shaping and iterative reconstructions for the detection of pulmonary nodules in a phantom setting.

Methods: Single-energy CT was performed using third-generation dual-source CT (SOMATOM Force; 2 × 192 slices) at 70 kVp, 100 kVp with tin filtration (100Sn kVp), and 150Sn kV with tube current-time product adjustments resulting in standard dose (CT volume dose index, 3.1 mGy/effective dose, 1.

Diagnostic performance of a non-contrast-enhanced magnetic resonance imaging protocol for potential living related kidney donors.

Rationale And Objectives: The objective of the study was to evaluate the performance of a non-contrast-enhanced magnetic resonance (MR) imaging protocol for preoperative screening of living related kidney donors.

Materials And Methods: Forty consecutive subjects (mean age 52.2 ± 11.

Automated attenuation-based kilovoltage selection: preliminary observations in patients after endovascular aneurysm repair of the abdominal aorta.

Objective: The objective of our study was to assess prospectively the impact of automated attenuation-based kilovoltage selection on image quality and radiation dose in patients undergoing body CT angiography (CTA) after endovascular aneurysm repair (EVAR) of the abdominal aorta.

Subjects And Methods: Thirty-five patients (five women, 30 men; mean age ± SD, 69 ± 13 years; mean body mass index ± SD, 27.3 ± 4.

Low-dose CT of the lung: potential value of iterative reconstructions.

Objectives: To prospectively assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on image quality of nonenhanced low-dose lung CT as compared to filtered back projection (FBP).

Methods: Nonenhanced low-dose chest CT (tube current-time product: 30 mAs) was performed on 30 patients at 100 kVp and on 30 patients at 80 kVp. Images were reconstructed with FBP and SAFIRE.

Performance of unenhanced respiratory-gated 3D SSFP MRA to depict hepatic and visceral artery anatomy and variants.

Objectives: To prospectively evaluate the performance of unenhanced respiratory-gated magnetization-prepared 3D-SSFP inversion recovery MRA (unenhanced-MRA) to depict hepatic and visceral artery anatomy and variants in comparison to contrast-enhanced dynamic gradient-echo MRI (CE-MRI) and to digital subtraction angiography (DSA).

Methods: Eighty-four patients (55.6±12.

Thoraco-abdominal high-pitch dual-source CT angiography: experimental evaluation of injection protocols with an anatomical human vascular phantom.

Objective: To experimentally evaluate three different contrast injection protocols at thoraco-abdominal high-pitch dual-source computed tomography angiography (CTA), with regard to level and homogeneity of vascular enhancement at different cardiac outputs.

Materials And Methods: A uniphasic, a biphasic as well as an individually tailored contrast protocol were tested using a human vascular phantom. Each protocol was scanned at 5 different cardiac outputs (3-5L/min, steps of 0.

Automated attenuation-based tube potential selection for thoracoabdominal computed tomography angiography: improved dose effectiveness.

Purpose: To introduce a novel algorithm of automated attenuation-based tube potential selection and to assess its impact on image quality and radiation dose of body computed tomography angiography (CTA).

Materials And Methods: In all, 40 patients (mean age 71±11.8 years, body mass index (BMI) 25.

Computed tomography of the lung in the high-pitch mode: is breath holding still required?

Objectives: To prospectively investigate whether the high-pitch mode (HPM) for computed tomography (CT) enables the diagnostic visualization of the lung parenchyma without suspended respiration.

Materials And Methods: A total of 40 consecutive patients (age, 67 ± 11 years) underwent 128-slice dual-source CT of the chest including nonenhanced, arterial, and venous phase of contrast. CT was performed in the HPM with a pitch of 3.

Maximum diameter measurements of aortic aneurysms on axial CT images after endovascular aneurysm repair: sufficient for follow-up?

Purpose: To assess the accuracy of maximum diameter measurements of aortic aneurysms after endovascular aneurysm repair (EVAR) on axial computed tomographic (CT) images in comparison to maximum diameter measurements perpendicular to the intravascular centerline for follow-up by using three-dimensional (3D) volume measurements as the reference standard.

Materials And Methods: Forty-nine consecutive patients (73 ± 7.5 years, range 51-88 years), who underwent EVAR of an infrarenal aortic aneurysm were retrospectively included.

Cardiac CT for the differentiation of bicuspid and tricuspid aortic valves: comparison with echocardiography and surgery.

Objective: The purpose of this study is to evaluate the diagnostic performance of CT, compared with that of echocardiography and surgery, for differentiating between bicuspid and tricuspid aortic valves.

Materials And Methods: Forty-seven patients with bicuspid valve and 47 patients with tricuspid aortic valve underwent retrospectively ECG-gated dual-source CT and echocardiography. Thirty-four (72%) of the 47 patients with bicuspid aortic valve underwent valve surgery.

High-pitch 128-slice dual-source CT for the assessment of coronary stents in a phantom model.

Rationale And Objectives: To evaluate the quality of stent lumen delineation using dual-source computed tomography (DSCT) in the standard-pitch mode (SP) as compared to the high-pitch mode (HP) in a phantom study.

Materials And Methods: Forty different coronary stents placed in plastic tubes filled with contrast agent were imaged with a second generation DSCT system in a SP (pitch 0.23) and HP (pitch 3.

High-pitch dual-source CT coronary angiography: systolic data acquisition at high heart rates.

Objective: To assess the effect of systolic data acquisition for electrocardiography (ECG)-triggered high-pitch computed tomography (CT) on motion artefacts of coronary arteries in patients with high heart rates (HRs).

Methods: Eighty consecutive patients (15 women, age 67 ± 14 years) with HR ≥ 70 bpm underwent CT angiography of the thoracic aorta (CTA) on 128-slice dual-source CT in ECG-triggered high-pitch acquisition mode (pitch = 3.2) set at 60% (group A, n = 40) or 30% (group B, n = 40) of the RR interval.

Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode.

Objective: To compare the diagnostic accuracy and radiation doses of two low-dose protocols for coronary artery imaging with second-generation, dual-source CT in comparison with catheter angiography (CA).

Design, Setting And Patients: Prospective, single-centre study conducted in a referral centre enrolling 100 patients with low-to-intermediate risk and suspicion of coronary artery disease. All patients underwent contrast-enhanced, 128-slice, dual-source CT coronary angiography and CA.

Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note.

Purpose: To describe prospective ECG-triggered dual-source CT dual-step pulsing (pECG(dual_step)) for evaluation of coronary arteries and cardiac function.

Methods: Fifty-one consecutive patients pre- or post-cardiovascular surgery were examined with adaptive sequential tube current modulated (pECG(dual-step)) 128-slice dual-source CT without heart rate control (main padding window: 40% RR interval >65 bpm/70% RR interval <65 bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated.

Image fusion of coronary CT angiography and cardiac perfusion MRI: a pilot study.

Objective: To develop a tool for the image fusion of computed tomography coronary angiography (CTCA) and cardiac magnetic resonance imaging (CMR).

Methods: Surface representations and volume-rendered images from fused CTCA/CMR data of five patients with significant coronary artery disease (CAD) on CTCA and perfusion deficits on CMR were generated using a newly developed software prototype. The spatial relationship of significant coronary artery stenosis at CTCA and myocardial defects at CMR was evaluated.

Scan length adjustment of CT coronary angiography using the calcium scoring scan: effect on radiation dose.

Objective: The objective of our study was to prospectively investigate the effect of adjusting the scan length of CT coronary angiography using the calcium scoring images instead of the scout view with regard to radiation dose.

Subjects And Methods: One hundred twenty-five consecutive patients (mean age +/- SD, 62 +/- 10 years) undergoing both calcium scoring and CT coronary angiography were included in our study. The scan length of calcium scoring was planned on the scout view; the scan length of CT coronary angiography was planned on the axial images of the calcium scoring by identifying the origin of the left main artery and cardiac apex and adding 1 cm cranially and caudally.