Highlights
High-pitch allows for significant reduction ( P < .001) of motion artifacts.
Free breathing allows for significant reduction of Valsalva maneuver.
High-pitch provides diagnostic confidence without the need for patient compliance.
High-pitch at 80 kVp allows for significant dose reduction ( P < .001).
Rationale and Objectives
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Materials and Methods
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Results
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Conclusions
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Introduction
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Materials and Methods
Patient Population
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Table 1
Patient Characteristics
Total
(n = 100) SPCT-BH
(n = 50) HPCT-FB
(n = 50)P Value_Female : Male_ 47:53 20:30 27:23 —Mean age (j) 58.74(±16.9) 57.22(±16.4) 60.26 .317Mean height (cm) 170(±0.1) 172(±0.1) 1.68 .083Mean weight (kg) 70.33(±13.3) 72.56(±14.7) 68.1 .140Mean BMI (kg/m 2 ) 24.17(±3.5) 24.44(±3.6) 23.89 .248
BMI, body mass index; HPCT-FB, high-pitch computed tomography under free breathing; SPCT-BH, standard-pitch computed tomography under breath-hold.
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CT Protocols
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Radiation Dose
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Quantitative Analysis
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Qualitative Analysis
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Statistical Analysis
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Results
Radiation Dose
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Table 2
Radiation Dose
Total
(n = 100) SPCT-BH
(n = 50) HPCT-FB
(n = 50)P Value_DLP (mGy × cm)_ 160.17 223.85 96.49 <.001CTDI (mGy) 4.35 6.01 2.68 <.001SSDE (mGy) 5.39 7.41 3.38 <.001
CTDI, computed tomography dose index; DLP, dose-length product; HPCT-FB, high-pitch computed tomography under free breathing; SPCT-BH, standard-pitch computed tomography under breath-hold; SSDE, size-specific dose estimate.
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Quantitative Analysis
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Table 3
Attenuation and Noise
Total
(n = 100) SPCT-BH
(n = 50) HPCT-FB
(n = 50)P Value_Mean attenuation PA_ 410.67 342.45 478.92 <.001Mean attenuation subcutaneous fat −77 -65.33 -121.33 <.001Noise 12.76 9.59 15.94 <.001SNR 36.06 38.05 34.07 .258CNR 33.30 40.60 28.01 <.001
CNR, contrast-to-noise ratio; HPCT-FB, high-pitch computed tomography under free breathing; PA, pulmonary artery; SNR, signal-to-noise ratio; SPCT-BH, standard-pitch computed tomography under breath-hold.
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Qualitative Analysis
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Table 4
Presence of Movement Artifacts and Valsalva Artifact
SPCT-BH
(n = 50) HPCT-FB
(n = 50)P Value R1 (%) R2 (%) R1 (%) R2 (%)Breathing 94 70 36 42 <.001Heart pulsation 90 76 16 9 <.001Valsalva artifact 28 30 6 4 <.001
HPCT-FB, high-pitch computed tomography under free breathing; R1, reader 1; R2, reader 2; SPCT-BH, standard-pitch computed tomography under breath-hold.
P value between the SPCT-BH and the HPCT-FB.
Table 5
Assessability of Anatomical Structures
Heart (Chambers, Septum, Morphology) Vascular Structures (Upper Field) Vascular Structures (Middle Field) Vascular Structures (Lower Field) SPCT-BH
(n = 50) HPCT-FB
(n = 50) SPCT-BH
(n = 50) HPCT-FB
(n = 50) SPCT-BH
(n = 50) HPCT-FB
(n = 50) SPCT-BH
(n = 50) HPCT-FB
(n = 50)R1 (%)R2 (%)R1 (%)R2 (%)R1 (%)R2 (%)R1 (%)R2 (%)R1 (%)R2 (%)R1 (%)R2 (%)R1 (%)R2 (%)R1 (%)R2 (%)Nondiagnostic0__0__0__0__2__2__0__0__0__2__0__0__0__2__0__0Restricted assessment2__12__2__4__8__6__2__4__4__4__0__6__4__4__0__6Good80__60__22__28__30__32__20__22__22__30__14__16__20__30__26__20Excellent__18__28__76__68__60__60__78__74__74__64__86__78__76__64__74__74
HPCT-FB, high-pitch computed tomography under free breathing; R1, reader 1; R2, reader 2; SPCT-BH, standard-pitch computed tomography under breath-hold.
P value between the SPCT-BH and the HPCT-FB.
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Discussion
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