Comparison of image quality and radiation doses between rapid kV-switching and dual-source DECT techniques in the chest

• Published in: European journal of radiology 2019-10, Vol.119, p.108639-108639, Article 108639
• Main Authors: Singh, Ramandeep, Sharma, Amita, McDermott, Shaunagh, Homayounieh, Fatemeh, Rastogi, Shivam, Flores, Efren J., Shepard, Jo Anne O., Gilman, Matthew D., Digumarthy, Subba R.
• Format: Article
• Language: English
• Subjects: Chest; Contrast Media; Dual energy; Female; Humans; Image Processing, Computer-Assisted - methods; Image Processing, Computer-Assisted - standards; Iodine; Male; Middle Aged; Multidetector computed tomography; Multidetector Computed Tomography - methods; Multidetector Computed Tomography - standards; Radiation Dosage; Radiography, Thoracic - methods; Radiography, Thoracic - standards; Retrospective Studies
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2019.08.008

•Radiation doses and monoenergetic images from SS-DECT and DS-DECT are similar.•Material decomposition images from SS-DECT and DS-DECT are substantially different.•Suboptimal material decomposition on SS-DECT generates artifactual heterogeneity.•Artifactual heterogeneity on SS-DECT confounds evaluation of perfusion defects.•Radiologists need to be aware of this limitation when reporting SS-DECT MDI images. To compare image quality and radiation doses for chest DECT acquired with dual-source and rapid-kV switching techniques. Our institutional Review Board approved retrospective study included 97 patients (54 men, 43 women; 63 ± 14 years) who underwent contrast-enhanced chest DECT with both single source, rapid kV-switching (SS-DECT) and dual source (DS-DECT) techniques per standard of care departmental protocols. Reconstructed images from both scanners had identical section thickness and section interval for virtual monoenergetic and material decomposition iodine (MDI) images. Two thoracic radiologists independently evaluated all DECT for findings, quality of images, perfusion defects (MDI), and presence of artifacts. Radiation dose descriptor, size-specific dose estimates (SSDE), was recorded. Data were analyzed with Wilcoxon Signed Rank and Cohen’s Kappa tests. There were no significant differences in patient weight or SSDE for the two DECT techniques (p > 0.06). Both radiologists reported no difference in lesion and artifact evaluation on the virtual monoenergetic images from either technique (p > 0.05). However, SS-DECT (in 63–71/97 patients) had substantial artifactual heterogeneity in pulmonary perfusion on MDI images compared to none on DS-DECT (p