A comparison of bolus track and test bolus computed tomography pulmonary angiography and the implications on pulmonary and aortic vessel enhancement, effective dose and suboptimal scan rate

Introduction Bolus track and test bolus are the most commonly used contrast timing protocols to undertake computed tomography pulmonary angiography (CTPA). The aim of this study was to compare test bolus and bolus track contrast enhancement protocols in terms of enhancement of the pulmonary vessels...

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Bibliographic Details
Published in:Journal of medical radiation sciences 2024-03, Vol.71 (1), p.44-50
Main Authors: Murphy, Aoife, White, Helen
Format: Article
Language:English
Subjects:
Blood clots
bolus track
computed tomography
computed tomography pulmonary angiography
Contrast agents
Coronary vessels
Coronaviruses
COVID-19
Medical imaging
Mortality
Patients
Pulmonary arteries
pulmonary embolism
Radiation
Software
test bolus
Tomography
Veins & arteries
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Summary:Introduction Bolus track and test bolus are the most commonly used contrast timing protocols to undertake computed tomography pulmonary angiography (CTPA). The aim of this study was to compare test bolus and bolus track contrast enhancement protocols in terms of enhancement of the pulmonary vessels and aorta, radiation dose and suboptimal scan rate to determine the optimal technique for CTPA. Methods A total of 200 CTPA examinations (100 using each protocol) performed between January and February 2021 were assessed retrospectively. All scans were performed on a 2x128 Dual Source Siemens Drive Scanner. CT attenuation was measured in Hounsfield Units (HU), with measurements taken from the main pulmonary trunk, right pulmonary artery and left pulmonary artery, ascending and descending aorta. The mean effective dose was calculated from the dose‐length product (DLP). The suboptimal scan rate was calculated as the percentage of examinations below 210HU. Results The average HU of the pulmonary arteries was 358 HU ± SD 129.2 in the test bolus group and increased to 394 HU ± SD 133.9 in the bolus track group with a P value of ≤0.05. The average HU of the aorta was 235 HU ± SD 82.8 in the test bolus group and increased to 319 HU ± SD 91.8 in the bolus track group with a P value of  0.05). Fewer suboptimal scans were performed with the bolus track protocol (5 scans
ISSN:2051-3895
2051-3909
DOI:10.1002/jmrs.724