Prospective respiratory-triggered 64-slice CT pulmonary angiography for detection of pulmonary embolism—a feasibility study in a porcine model

• Published in: Emergency radiology 2010-11, Vol.17 (6), p.465-471
• Main Authors: Henes, Frank Oliver G., Groth, Michael, Regier, Marc, Bley, Thorsten, Nagel, Hans-Dieter, Adam, Gerhard, Begemann, Philipp G. C.
• Format: Article
• Language: English
• Subjects: Angiography - methods; Animals; Emergency Medicine; Feasibility Studies; Imaging; Medicine; Medicine & Public Health; Original Article; Predictive Value of Tests; Prospective Studies; Pulmonary Embolism - diagnostic imaging; Radiographic Image Interpretation, Computer-Assisted; Radiology; Respiratory-Gated Imaging Techniques - methods; Sensitivity and Specificity; Statistics, Nonparametric; Swine; Tomography, X-Ray Computed - methods
• ISSN: 1070-3004; 1438-1435
• DOI: 10.1007/s10140-010-0887-6

The objective of this study is to investigate the feasibility of prospectively respiratory-triggered CT pulmonary angiography (CTPA) for detection of pulmonary embolism (PE) in a porcine model. A free-breathing respiratory-triggered multislice CTPA (120 kV, 140 mAs eff , 2.5-mm slice thickness) and two CTPA in breath-hold technique (120 kV, 140 mAs eff. and 250mAs eff , 1-mm and 3-mm image reconstruction) were performed in six pigs with pulmonary embolism. Diagnostic accuracy was computed, and differences in detection rates between both techniques were assessed on a per-embolus basis with the Wilcoxon test. Thin-sliced 1-mm images, acquired with 250mAs eff , served as the standard of reference. Respiratory-triggered CTPA reached high diagnostic accuracy in detection of lobar and segmental PE equal to the results with the breath-hold technique ( p  > 0.05). For detection of subsegmental emboli, standard breath-hold techniques performed significantly better than respiratory-gated CTPA (sensitivity, 68.3% versus 24.4%; p