Low-dose and low-contrast computed tomography pulmonary angiography in pediatric with pulmonary embolism: a prospective study.

Abstract

Objective: We evaluated the feasibility of reducing contrast agent and radiation dose in pediatric computed tomography pulmonary angiography (CTPA) while ensuring image quality.

Materials and methods: In this prospective study, two readers assessed the computed tomography (CT) image quality (using a 5-point scale (1: undiagnosable and 5: excellent) and objective evaluation criteria (measuring CT and noise values of the left atrium and pulmonary trunk) of 116 patients who underwent pulmonary artery computed tomography angiography (CTA) from January 2023 to April 2024. independent sample t-test and Chi-square test were used to analyze and evaluate group differences.

Result: Fifty-eight participants were enrolled in the study group (mean age, 6.86 years ± 2.74, 30 males) and fifty-eight participants were enrolled in the control group (mean age, 6.71 years ± 2.59, 22 males). The radiation dose was significantly decreased in the study group (study group, 3.01 ± 0.24 mGy, control group 3.77 ± 1.06 mGy, p < 0.001). Overall quality was higher in control group, but displaying ability of pulmonary artery trunk and branch was higher in study group (p < 0.001).

Conclusion: This study proved that a low-dose, low-contrast CTPA strategy could reduce radiation dosage by 50% and contrast agent by 20% while maintaining a satisfying image quality.