Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study

Prashant Nagpal; Sarv Priya; Ali Eskandari; Aidan Mullan; Tanya Aggarwal; Sabarish Narayanasamy; Kamesh Parashar; Ambarish P. Bhat; Jessica C. Sieren

doi:10.25259/JCIS_168_2020

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Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study

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Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study

Prashant Nagpal, Sarv Priya, Ali Eskandari, Aidan Mullan, Tanya Aggarwal, Sabarish Narayanasamy, Kamesh Parashar, Ambarish P. Bhat and Jessica C. Sieren

Journal of clinical imaging science, Vol.10, pp.74-74

11/13/2020

DOI: 10.25259/JCIS_168_2020

PMCID: PMC7708960

PMID: 33274118

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Abstract

Objectives: Computed tomography pulmonary angiogram (CTPA) is one of the most commonly ordered and frequently overused tests. The purpose of this study was to evaluate the mean radiation dose to patients getting CTPA and to identify factors that are associated with higher dose. Material and Methods: This institutionally approved retrospective study included all patients who had a CTPA to rule out acute pulmonary embolism between 2016 and 2018 in a tertiary care center. Patient data (age, sex, body mass index [BMI], and patient location), CT scanner type, image reconstruction methodology, and radiation dose parameters (dose-length product [DLP]) were recorded. Effective dose estimates were obtained by multiplying DLP by conversion coefficient (0.014 mSv.mGy(-1).cm(-1)). Multivariate logistic regression analysis was performed to determine the factors affecting the radiation dose. Results: There were 2342 patients (1099 men and 1243 women) with a mean age of 58.1 years (range 0.2-104.4 years) and BMI of 31.3 kg/m(2) (range 12-91.5 kg/m(2)). The mean effective radiation dose was 5.512 mSv (median - 4.27 mSv; range 0.1-43.0 mSv). Patient factors, including BMI >25 kg/m(2), male sex, age >18 years, and intensive care unit (ICU) location, were associated with significantly higher dose (P < 0.05). CT scanning using third generation dual-source scanner with model-based iterative reconstruction (IR) had significantly lower dose (mean: 4.90 mSv) versus single-source (64-slice) scanner with filtered back projection (mean: 9.29 mSv, P < 0.001). Conclusion: Patients with high BMI and ICU referrals are associated with high CT radiation dose. They are most likely to benefit by scanning on newer generation scanner using advance model-based IR techniques.

Life Sciences & Biomedicine

Radiology, Nuclear Medicine & Medical Imaging

Science & Technology

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Title: Subtitle: Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study
Creators: Prashant Nagpal - University of Iowa Hospitals and Clinics
Sarv Priya - University of Iowa Hospitals and Clinics
Ali Eskandari - University of Iowa
Aidan Mullan - University of California, Berkeley
Tanya Aggarwal - University of Iowa
Sabarish Narayanasamy - University of Iowa
Kamesh Parashar - Thomas Jefferson University
Ambarish P. Bhat - University of Missouri
Jessica C. Sieren - University of Iowa
Resource Type: Journal article
Publication Details: Journal of clinical imaging science, Vol.10, pp.74-74
DOI: 10.25259/JCIS_168_2020
PMID: 33274118
PMCID: PMC7708960
NLM abbreviation: J Clin Imaging Sci
ISSN: 2156-7514
eISSN: 2156-5597
Publisher: Scientific Scholar Llc
Number of pages: 8
Grant note: T32 HL144461 / NHLBI NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
Language: English
Date published: 11/13/2020
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology
Record Identifier: 9984320011502771

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