Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain?

BACKGROUND

Multidetector-row computed tomography is often used as a first-line test in the diagnostic evaluation of cardiovascular diseases including aortic dissection, coronary artery disease and pulmonary embolism. This study evaluated the impact of reducing the tube potential from 120 kVp to 100 kVp in a selected group of patients presenting to the Emergency Room with acute chest pain. The primary end point was how the reduction of radiation dose affected image quality.

METHODS

The current study was performed over a period of 2 years between July, 2016 and July, 2018. This study included patients who presented to the Emergency Room or to an outpatient clinic and were suspected to have a coronary, a pulmonary (pulmonary embolism), or an aortic (aortic dissection) etiology. Suspicion was determined by the medical provider based on clinical picture, EKG, and lab results when available. All patients were referred for computed tomography angiography (CTA) testing as part of their diagnostic evaluation. A total of 84 patients were involved in the study. Seventy of the patients underwent the low acquisition Kvp technique (100 Kvp - Group I). In the remaining 14 patients, the standard acquisition technique (120-140 Kvp - Group II) was utilized.

RESULTS

This study showed the feasibility of using low energy CTA to significantly reduce the patient's radiation exposure without markedly affecting the image quality and diagnostic accuracy.

CONCLUSION

The use of low energy CTA protocols in cases of acute chest pain revealed no major difference regarding the image quality with marked reduction of the radiation dose received by the patient.