Thoracic-abdominopelvic contrast-enhanced dual-source computed tomography with a high-pitch acquisition protocol and free breathing for reducing motion artifacts and scan time in patients with cancer: a prospective study.

BACKGROUND

Contrast-enhanced computed tomography (CECT) is critical for cancer management. Although high-pitch dual-source computed tomography (DSCT) effectively reduces radiation and enhances image quality, its clinical benefits in free-breathing thoracic-abdominopelvic scans remain unclear. This study investigated DSCT-based high-pitch CECT in terms of image quality and scan efficiency in non-breath-holding patients with cancer.

METHODS

A total of 169 patients with cancer who underwent thoracic-abdominopelvic contrast-enhanced DSCT were enrolled: 84 non-breath-holding patients underwent a free-breathing high-pitch examination (Group 1: pitch 3.0), and 85 breath-holding capable patients matched for age, sex, and body mass index underwent the standard-pitch examination with breathing instructions (Group 2: pitch 1.0). Subjective image scores were graded using 5-point scales. Noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and scan time were compared.

RESULTS

Compared to Group 2, Group 1 demonstrated significantly fewer motion artifacts in both the lung (P=0.027) and the mediastinum (P<0.001), with a particularly notable reduction and less graded severity distribution in the mediastinum (P<0.001). Chest noise levels were significantly lower in Group 1 than in Group 2 (P<0.001). The SNR (measured in the aortic arch and erector spinae of the chest for noncontrast phase (NCP) and arterial phase (AP) and in the gluteus maximus of the pelvis for the venous phase) and CNR (measured in the aortic arch and erector spinae of the chest for NCP and AP) of Group 1 were significantly higher (P<0.001) than those of Group 2. The average scan time in Group 1 was up to 81.4% lower than that of Group 2.

CONCLUSIONS

High-pitch DSCT in non-breath-holding patients with cancer can largely reduce scan time while preserving image quality and maintaining a lower effective radiation dose. For non-breath-holding patients, the high-pitch DSCT may greatly improve image quality and the success rate of CT examinations.