Feasibility study of low radiation dose bronchial artery computed tomography angiography before bronchial artery embolisation

doi:10.3877/cma.j.issn.2095-5782.2025.01.005

Abstract

Abstract:

Objective

To explore the feasibility of using low radiation dose bronchial artery computed tomography angiography （BA-CTA） instead of routine dose BA-CTA before bronchial artery embolization.

Methods

The clinical data of 96 patients with massive or recurrent hemoptysis in our hospital from October 2020 to February 2024 were selected.BA-CTA was obtained from 90 patients with a body mass index （BMI）＜30 kg/m² using a 256 multi-section iCT system before bronchial artery embolization.Ninety patients were randomly divided randomly into two groups using a random number table， with 45 patients in each group.Scanning acquisition parameters：（1） Low radiation dose group： 100 kVp tube voltage， 100 mAs tube current， 50 mL contrast medium；（2） Routine dose group： 120 kVp tube voltage， tube current was used automatic tube current modulation， 80 mL contrast medium.CT attenuation of the thoracic aorta， image noise，signal-to-noise ratio （SNR） and contrast-to-noise ratio （CNR） of BA-CTA images between the two groups of patients were compared.The subjective image quality scores and vascular traceability scores of BA-CTA images between the two groups of patients were scored and compared.The effective radiation dose in both groups were calculated.The immediate hemostasis rate of bronchial artery embolization and one month recurrence rate in both groups were calculated.

Results

The effective radiation dose in the low radiation dose group （2.44 ± 0.18） mSv was reduced by 79.67% compared with the routine dose group （12.00 ± 2.13） mSv（P＜0.05）.Compared with the routine dose group （341.94 ± 59.40） HU， the low radiation dose group （406.20± 86.92） HU showed an increase of approximately 64.26 HU in CT attenuation of the thoracic aorta （P＜0.05）.The image noise in the low radiation dose group （22.80 ± 4.95） HU was higher than that in the routine dose group （13.52 ± 2.55） HU.SNR （18.93 ± 6.39 vs 26.07 ± 6.13） and CNR （16.52 ± 6.03 vs 22.24 ± 5.74） in the low radiation dose group were lower than that in the routine dose group （all P＜0.05）.There were no statistically significant difference in subjective image quality scores and traceability scores between the two groups （all P＜0.05）.The immediate hemostasis rate of bronchial artery embolization was 100% in both the two groups.The recurrence rates of the low radiation group and the routine dose group at one month after BAE were 4.4% and 8.9%， respectively， with no statistically significant difference （χ²=0.179， P=0.673）.

Conclusion

For patients with BMI ＜ 30 kg/m²， BA-CTA protocol examination with low tube voltage（100 kVp）， low tube current （100 mAs） combined with low contrast medium volume （50 mL） is feasible in patients with massive hemoptysis and recurrent hemoptysis， before bronchial artery embolizationwith.The radiation dose was reduced by 79.67%， the amount of contrast medium volume was reduced by 37.50%， and the diagnostic value of the images was ensured.

Key words: Bronchial artery embolisation, Hemoptysis, Low radiation dose, Computed tomography angiography

Huijun Ma, Xiaohui Zhao, Lei Xu, Ziyin He, Nan Yang, Ai Li, Hongtao Niu, Biao Du. Feasibility study of low radiation dose bronchial artery computed tomography angiography before bronchial artery embolisation[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2025, 13(01): 23-28.

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URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2025.01.005

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Figures/Tables 6

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）	扫描范围（mm， $\overset{ˉ}{x}$ ±s）	性别［例（%）］
组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）	扫描范围（mm， $\overset{ˉ}{x}$ ±s）	男姓	女姓
低剂量组	45	61.58±12.97	24.10±2.80	321.97±32.30	31（68.9）	14（31.1）
常规剂量组	45	63.73±11.21	23.77±2.70	331.98±32.13	34（75.6）	11（24.4）
t/χ²值		0.843	0.586	1.474	0.498
P值		0.401	0.559	0.144	0.480

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）	扫描范围（mm， $\overset{ˉ}{x}$ ±s）	性别［例（%）］
组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）	扫描范围（mm， $\overset{ˉ}{x}$ ±s）	男姓	女姓
低剂量组	45	61.58±12.97	24.10±2.80	321.97±32.30	31（68.9）	14（31.1）
常规剂量组	45	63.73±11.21	23.77±2.70	331.98±32.13	34（75.6）	11（24.4）
t/χ²值		0.843	0.586	1.474	0.498
P值		0.401	0.559	0.144	0.480

组别	例数	主观图像质量评分				血管可追溯性评分
组别	例数	医师1（分， $\overset{ˉ}{x}$ ±s）	医师2（分， $\overset{ˉ}{x}$ ±s）	最终评分（分， $\overset{ˉ}{x}$ ±s）	Kappa值	医师1（分， $\overset{ˉ}{x}$ ±s）	医师2（分， $\overset{ˉ}{x}$ ±s）	最终评分（分， $\overset{ˉ}{x}$ ±s）	Kappa值
低剂量组	45	4.31±0.93	4.27±0.89	4.29±0.92	0.821	2.60±0.64	2.63±0.62	2.64±0.61	0.785
常规剂量组	45	4.40±0.84	4.40±0.92	4.42±0.84	0.739	2.67±0.60	2.67±0.60	2.65±0.61	0.843
P值		0.721	0.341	0.483		0.33	0.58	0.728

组别	例数	主观图像质量评分				血管可追溯性评分
组别	例数	医师1（分， $\overset{ˉ}{x}$ ±s）	医师2（分， $\overset{ˉ}{x}$ ±s）	最终评分（分， $\overset{ˉ}{x}$ ±s）	Kappa值	医师1（分， $\overset{ˉ}{x}$ ±s）	医师2（分， $\overset{ˉ}{x}$ ±s）	最终评分（分， $\overset{ˉ}{x}$ ±s）	Kappa值
低剂量组	45	4.31±0.93	4.27±0.89	4.29±0.92	0.821	2.60±0.64	2.63±0.62	2.64±0.61	0.785
常规剂量组	45	4.40±0.84	4.40±0.92	4.42±0.84	0.739	2.67±0.60	2.67±0.60	2.65±0.61	0.843
P值		0.721	0.341	0.483		0.33	0.58	0.728

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