Motion Artifact Reduction From High-Pitch Dual-Source Computed Tomography Pulmonary Angiography

Purpose The purpose of this study was to compare quantitative and qualitative measures of aortic, cardiac, and respiratory motion artifact between high-pitch dual-source (DS) and single-source (SS) computed tomography pulmonary angiography (CTPA) protocols. Methods This institutional review board–approved, Health Insurance Portability and Accountability Act–compliant study retrospectively reviewed 80 non–electrocardiogram-gated CTPA examinations acquired with a second-generation DS system at 100 kVp following 50 mL iodinated contrast injection — 40 consecutive SS and 40 consecutive DS studies. Quantitative measures of aortic, left ventricular, and diaphragmatic motion were recorded as the maximal excursion of a structure's “double image,” and 3 independent readers performed qualitative motion assessments. Pulmonary arterial contrast enhancement, image noise, and radiation dose metrics were recorded. Statistical analyses were performed with 1-way analysis of variance and Fisher exact test. Results Dual source outperformed SS technique in both quantitative and qualitative measures of motion. Mean distances between motion-artifact double images were reduced with DS protocol at each location (all P ≤ 0.004), and DS examinations were more likely to receive an assessment of no motion in all locations (all P < 0.0001). The DS protocol demonstrated increases in contrast enhancement, although increased image noise resulted in lower enhancement to noise ratio. Mean radiation dose was 60% lower using the DS protocol. Conclusion High-pitch DS CTPA significantly reduces artifacts resulting from ascending aortic, cardiac, and diaphragmatic motion.