Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(03): 236-246
DOI: 10.4103/ijri.IJRI_34_19
Chest Imaging

Imaging protocols for CT chest: A recommendation

Ashu Seith Bhalla
Department of Radiodiagnosis, All India Institute of Medical Sciences
,
Abanti Das
Department of Radiodiagnosis, Safdarjung Hospital and Vardhaman Mahavir Medical College
,
Priyanka Naranje
Department of Radiodiagnosis, All India Institute of Medical Sciences
,
Aparna Irodi
Department of Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu
,
Vimal Raj
Department of Radiology, Narayana Institute of Cardiac Sciences, 258A, Hosur Rd, Bommasandra Industrial Area, Bengaluru, Karnataka, India
,
Ankur Goyal
Department of Radiodiagnosis, All India Institute of Medical Sciences
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
   Permissions and Reprints

Abstract

Computed Tomography (CT) is the mainstay of diagnostic imaging evaluation of thoracic disorders. However, there are a number of CT protocols ranging from a simple non-contrast CT at one end of the spectrum, and CT perfusion as a complex protocol available only on high-end scanners.With the growing diversity, there is a pressing need for radiologists, and clinicians to have a basic understanding of the recommended CT examinations for individual indications. This brief review aims to summarise the currently prevalent CT examination protocols, including their recommended indications, as well as technical specifications for performing them.

Keywords

Computed tomography angiography - computed tomography chest - computed tomography contrast - dual energy computed tomography - low-dose computed tomography - protocol - pulmonary embolism


Publication History

Received: 15 January 2019

Accepted: 21 March 2019

Article published online:
22 July 2021

© 2019. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM. et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011; 365: 395-409
    CrossrefPubMedGoogle Scholar
  • 2 Gartenschläger M, Schweden F, Gast K, Westermeier T, Kauczor H, von Zitzewitz H. et al. Pulmonary nodules: Detection with low-dose vs conventional-dose spiral CT. Eur Radiol 1998; 8: 609-14
    CrossrefPubMedGoogle Scholar
  • 3 Hein PA, Romano VC, Rogalla P, Klessen C, Lembcke A, Bornemann L. et al. Variability of semiautomated lung nodule volumetry on ultralow-dose CT: Comparison with nodule volumetry on standard-dose CT. J Digit Imaging 2010; 23: 8-17
    CrossrefPubMedGoogle Scholar
  • 4 Christe A, Torrente JC, Lin M, Yen A, Hallett R, Roychoudhury K. et al. CT screening and follow-up of lung nodules: Effects of tube current-time setting and nodule size and density on detectability and of tube current-time setting on apparent size. AJR Am J Roentgenol 2011; 197: 623-30
    CrossrefPubMedGoogle Scholar
  • 5 Karabulut N, Törü M, Gelebek V, Gülsün M, Ariyürek OM. Comparison of low-dose and standard-dose helical CT in the evaluation of pulmonary nodules. Eur Radiol 2002; 12: 2764-9
    CrossrefPubMedGoogle Scholar
  • 6 Larke FJ, Kruger RL, Cagnon CH, Flynn MJ, McNitt-Gray MM, Wu X. et al. Estimated radiation dose associated with low-dose chest CT of average-size participants in the National Lung Screening Trial. AJR Am J Roentgenol 2011; 197: 1165-9
    CrossrefPubMedGoogle Scholar
  • 7 Raghu G, Remy-Jardin M, Myers JL, Richeldi L, Ryerson CJ, Lederer DJ. et al. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2018; 198: e44-68
    CrossrefPubMedGoogle Scholar
  • 8 Zanon M, Pacini GS, de Souza VVS, Marchiori E, Meirelles GS, Szarf G. et al. Early detection of lung cancer using ultra-low-dose computed tomography in coronary CT angiography scans among patients with suspected coronary heart disease. Lung Cancer 2017; 114: 1-5
    CrossrefPubMedGoogle Scholar
  • 9 Heussel CP, Hafner B, Lill J, Schreiber W, Thelen M, Kauczor HU. Paired inspiratory/expiratory spiral CT and continuous respiration cine CT in the diagnosis of tracheal instability. Eur Radiol 2001; 11: 982-9
    CrossrefPubMedGoogle Scholar
  • 10 Baroni RH, Feller-Kopman D, Nishino M, Hatabu H, Loring SH, Ernst A. et al. Tracheobronchomalacia: Comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology 2005; 235: 635-41
    CrossrefPubMedGoogle Scholar
  • 11 Lee EY, Litmanovich D, Boiselle PM. Multidetector CT evaluation of tracheobronchomalacia. Radiol Clin North Am 2009; 47: 261-9
    CrossrefPubMedGoogle Scholar
  • 12 Zhang J, Hasegawa I, Feller-Kopman D, Boiselle PM. 2003 AUR memorial award. Dynamic expiratory volumetric CT imaging of the central airways: Comparison of standard-dose and low-dose techniques. Acad Radiol 2003; 10: 719-24
    CrossrefPubMedGoogle Scholar
  • 13 Boiselle PM, Lee KS, Lin S, Raptopoulos V. Cine CT during coughing for assessment of tracheomalacia: Preliminary experience with 64-MDCT. AJR Am J Roentgenol 2006; 187: W175-7
    CrossrefPubMedGoogle Scholar
  • 14 Wagnetz U, Roberts HC, Chung T, Patsios D, Chapman KR, Paul NS. Dynamic airway evaluation with volume CT: Initial experience. Can Assoc Radiol J 2010; 61: 90-7
    CrossrefPubMedGoogle Scholar
  • 15 Wielpütz MO, Eberhardt R, Puderbach M, Weinheimer O, Kauczor HU, Heussel CP. Simultaneous assessment of airway instability and respiratory dynamics with low-dose 4D-CT in chronic obstructive pulmonary disease: Atechnical note. Respiration 2014; 87: 294-300
    CrossrefPubMedGoogle Scholar
  • 16 Iezzi R, Larici AR, Franchi P, Marano R, Magarelli N, Posa A. et al. Tailoring protocols for chest CT applications: When and how?. Diagn Interv Radiol 2017; 23: 420-7
    CrossrefPubMedGoogle Scholar
  • 17 García-Garrigós E, Arenas-Jiménez JJ, Sánchez-Payá J. Best protocol for combined contrast-enhanced thoracic and abdominal CT for lung cancer: A single-institution randomized crossover clinical trial. AJR Am J Roentgenol 2018; 210: 1226-34
    CrossrefPubMedGoogle Scholar
  • 18 Raj V, Kirke R, Bankart MJ, Entwisle JJ. Multidetector CT imaging of pleura: Comparison of two contrast infusion protocols. Br J Radiol 2011; 84: 796-9
    CrossrefPubMedGoogle Scholar
  • 19 Albrecht MH, Bickford MW, Nance JW, Zhang L, De Cecco CN, Wichmann JL. et al. State-of-the-art pulmonary CT angiography for acute pulmonary embolism. AJR Am J Roentgenol 2017; 208: 495-504
    CrossrefPubMedGoogle Scholar
  • 20 Kerl JM, Bauer RW, Renker M, Weber E, Weisser P, Korkusuz H. et al. Triphasic contrast injection improves evaluation of dual energy lung perfusion in pulmonary CT angiography. Eur J Radiol 2011; 80: e483-7
    CrossrefPubMedGoogle Scholar
  • 21 Bae KT, Tao C, Gürel S, Hong C, Zhu F, Gebke TA. et al. Effect of patient weight and scanning duration on contrast enhancement during pulmonary multidetector CT angiography. Radiology 2007; 242: 582-9
    CrossrefPubMedGoogle Scholar
  • 22 Hong YJ, Kim JY, Choe KO, Hur J, Lee HJ, Choi BW. et al. Different perfusion pattern between acute and chronic pulmonary thromboembolism: Evaluation with two-phase dual-energy perfusion CT. AJR Am J Roentgenol 2013; 200: 812-7
    CrossrefPubMedGoogle Scholar
  • 23 Gupta M, Srivastava DN, Seith A, Sharma S, Thulkar S, Gupta R. Clinical impact of multidetector row computed tomography before bronchial artery embolization in patients with hemoptysis: Aprospective study. Can Assoc Radiol J 2013; 64: 61-73
    CrossrefPubMedGoogle Scholar
  • 24 Khalil A, Fartoukh M, Parrot A, Bazelly B, Marsault C, Carette MF. Impact of MDCT angiography on the management of patients with hemoptysis. AJR Am J Roentgenol 2010; 195: 772-8
    CrossrefPubMedGoogle Scholar
  • 25 Bruzzi JF, Rémy-Jardin M, Delhaye D, Teisseire A, Khalil C, Rémy J. Multi-detector row CT of hemoptysis. Radiographics 2006; 26: 3-22
    CrossrefPubMedGoogle Scholar
  • 26 Larici AR, Franchi P, Occhipinti M, Contegiacomo A, del Ciello A, Calandriello L. et al. Diagnosis and management of hemoptysis. Diagn Interv Radiol 2014; 20: 299-309
    CrossrefPubMedGoogle Scholar
  • 27 Cornea AM, McCullough BJ, Mitsumori LM, Gunn ML. Enhancement of the pulmonary arteries and thoracic aorta: Comparison of a biphasic contrast injection and fixed delay protocol with a monophasic injection and a timing bolus protocol. Emerg Radiol 2015; 22: 231-7
    CrossrefPubMedGoogle Scholar
  • 28 Meena P, Bhalla AS, Goyal A, Sharma R, Kumar A, Srivastva DN. et al. Single-phase split-bolus dual energy computed tomography angiography for evaluation of hemoptysis: A novel application. J Thorac Imaging 2018; 33: 366-76
    CrossrefPubMedGoogle Scholar
  • 29 Halpern EJ. Triple-rule-out CT angiography for evaluation of acute chest pain and possible acute coronary syndrome. Radiology 2009; 252: 332-45
    CrossrefPubMedGoogle Scholar
  • 30 O’Connor JP, Tofts PS, Miles KA, Parkes LM, Thompson G, Jackson A. Dynamic contrast-enhanced imaging techniques: CT and MRI. Br J Radiol 2011; 84: S112-20
    CrossrefPubMedGoogle Scholar
  • 31 Swensen SJ, Viggiano RW, Midthun DE, Müller NL, Sherrick A, Yamashita K. et al. Lung nodule enhancement at CT: Multicenter study. Radiology 2000; 214: 73-80
    CrossrefPubMedGoogle Scholar
  • 32 Qureshi NR, Shah A, Eaton RJ, Miles K, Gilbert FJ. investigators S. Dynamic contrast enhanced CT in nodule characterization: How we review and report. Cancer Imaging 2016; 16: 16
    CrossrefPubMedGoogle Scholar
  • 33 Wang J, Wu N, Cham MD, Song Y. Tumor response in patients with advanced non-small cell lung cancer: Perfusion CT evaluation of chemotherapy and radiation therapy. AJR Am J Roentgenol 2009; 193: 1090-6
    CrossrefPubMedGoogle Scholar
  • 34 Li Y, Yang ZG, Chen TW, Yu JQ, Sun JY, Chen HJ. First-pass perfusion imaging of solitary pulmonary nodules with 64-detector row CT: Comparison of perfusion parameters of malignant and benign lesions. Br J Radiol 2010; 83: 785-90
    CrossrefPubMedGoogle Scholar
  • 35 Sitartchouk I, Roberts HC, Pereira AM, Bayanati H, Waddell T, Roberts TP. Computed tomography perfusion using first pass methods for lung nodule characterization. Invest Radiol 2008; 43: 349-58
    CrossrefPubMedGoogle Scholar
  • 36 Fraioli F, Anzidei M, Zaccagna F, Mennini ML, Serra G, Gori B. et al. Whole-tumor perfusion CT in patients with advanced lung adenocarcinoma treated with conventional and antiangiogenetic chemotherapy: Initial experience. Radiology 2011; 259: 574-82
    CrossrefPubMedGoogle Scholar
  • 37 Bhimaniya S, Seith A, Sharma R, Kandasamy D, Kumar A, Mohan A. et al. Role of dynamic volume perfusion CT in differentiation of histopatholigical subtypes of NSCLC. In: The 71st Korean Congress of Radiology 2015 September. Seoul, South Korea:
    Google Scholar