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Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism.
Phys Med 2017; 41:93-96PM

Abstract

PURPOSE

The aim of this study is to compare two routine protocols at our institution, CTPA and V/P-SPECT, in terms of radiation dose to the most exposed organs (lungs and breast) and to the embryo/fetus in the case of pregnant patients.

METHODS

At our institution, the CTPA protocol includes a contrast enhanced CT (scan parameters: 100kVp, 700mA, 0.5s/rot, pitch 0.984) and in some cases a non-contrast enhanced CT acquisition (120kVp, 400mA, 0.5s/rot, pitch 1.375). In the V/P-SPECT protocol, ventilation SPECT was performed after inhalation of 99mTc-Technegas, reaching 30MBq in the lungs; perfusion was performed after intravenous administration of 60-120MBq of 99mTc-MAA. The absorbed doses (mGy) to lungs and breast from CTPA were estimated using the "ImPACT CT Patient Dosimetry Calculator". The embryo/fetus dose was estimated for different gestational stages (0-7, 8-12, 13-25 and 26-40weeks) using the web based calculation tool "COnceptus Dose Estimation" (CODE). Doses to organs and embryo/fetus from V/P-SPECT were estimated based on published dose data normalized to administered activity (mGy/MBq).

RESULTS

Embryo/fetus absorbed doses are similar for CTPA and V/P-SPECT and bellow 1mGy. The calculated dose to the lungs (breast) was 1.3-10.6 (27-136) times higher from CTPA when compared with V/P-SPECT.

CONCLUSION

For the diagnosis of PE in women, if both imaging modalities are available, it is recommended to proceed with V/P-SPECT rather than CTPA due to the considerably lower radiation dose to the breast.

Authors+Show Affiliations

Medicina Nuclear, Centro Hospitalar e Universitário de Coimbra, Portugal. Electronic address: jisidoro@chuc.min-saude.pt.Medicina Nuclear, Centro Hospitalar e Universitário de Coimbra, Portugal.Medicina Nuclear, Centro Hospitalar e Universitário de Coimbra, Portugal.Medicina Nuclear, Centro Hospitalar e Universitário de Coimbra, Portugal; ICNAS - Instituto de Ciências Nucleares Aplicadas à Saúde, Universidade de Coimbra, Portugal.Imagem Médica, Centro Hospitalar e Universitário de Coimbra, Portugal.ICNAS - Instituto de Ciências Nucleares Aplicadas à Saúde, Universidade de Coimbra, Portugal; Instituto de Biofísica e Biomatemática, Faculdade de Medicina da Universidade de Coimbra, Portugal.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28487206

Citation

Isidoro, Jorge, et al. "Radiation Dose Comparison Between V/P-SPECT and CT-angiography in the Diagnosis of Pulmonary Embolism." Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB), vol. 41, 2017, pp. 93-96.
Isidoro J, Gil P, Costa G, et al. Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Phys Med. 2017;41:93-96.
Isidoro, J., Gil, P., Costa, G., Pedroso de Lima, J., Alves, C., & Ferreira, N. C. (2017). Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB), 41, pp. 93-96. doi:10.1016/j.ejmp.2017.04.026.
Isidoro J, et al. Radiation Dose Comparison Between V/P-SPECT and CT-angiography in the Diagnosis of Pulmonary Embolism. Phys Med. 2017;41:93-96. PubMed PMID: 28487206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. AU - Isidoro,Jorge, AU - Gil,Paulo, AU - Costa,Gracinda, AU - Pedroso de Lima,João, AU - Alves,Caseiro, AU - Ferreira,Nuno C, Y1 - 2017/05/06/ PY - 2016/12/31/received PY - 2017/04/26/revised PY - 2017/04/27/accepted PY - 2017/5/11/pubmed PY - 2018/1/19/medline PY - 2017/5/11/entrez SP - 93 EP - 96 JF - Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) JO - Phys Med VL - 41 N2 - PURPOSE: The aim of this study is to compare two routine protocols at our institution, CTPA and V/P-SPECT, in terms of radiation dose to the most exposed organs (lungs and breast) and to the embryo/fetus in the case of pregnant patients. METHODS: At our institution, the CTPA protocol includes a contrast enhanced CT (scan parameters: 100kVp, 700mA, 0.5s/rot, pitch 0.984) and in some cases a non-contrast enhanced CT acquisition (120kVp, 400mA, 0.5s/rot, pitch 1.375). In the V/P-SPECT protocol, ventilation SPECT was performed after inhalation of 99mTc-Technegas, reaching 30MBq in the lungs; perfusion was performed after intravenous administration of 60-120MBq of 99mTc-MAA. The absorbed doses (mGy) to lungs and breast from CTPA were estimated using the "ImPACT CT Patient Dosimetry Calculator". The embryo/fetus dose was estimated for different gestational stages (0-7, 8-12, 13-25 and 26-40weeks) using the web based calculation tool "COnceptus Dose Estimation" (CODE). Doses to organs and embryo/fetus from V/P-SPECT were estimated based on published dose data normalized to administered activity (mGy/MBq). RESULTS: Embryo/fetus absorbed doses are similar for CTPA and V/P-SPECT and bellow 1mGy. The calculated dose to the lungs (breast) was 1.3-10.6 (27-136) times higher from CTPA when compared with V/P-SPECT. CONCLUSION: For the diagnosis of PE in women, if both imaging modalities are available, it is recommended to proceed with V/P-SPECT rather than CTPA due to the considerably lower radiation dose to the breast. SN - 1724-191X UR - https://www.unboundmedicine.com/medline/citation/28487206/Radiation_dose_comparison_between_V/P_SPECT_and_CT_angiography_in_the_diagnosis_of_pulmonary_embolism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1120-1797(17)30112-6 DB - PRIME DP - Unbound Medicine ER -