The use of dual and triple rule out computerized tomography angiography by using diagnostic low-dose contrast material and radiation in acute chest pain

Objective: Our aim is to investigate the feasibility of dual and triple rule out CT angiography by reducing the radiation dose by using relatively high milliampereseconds with less contrast agent and low kilovoltage without affecting the diagnostic value. Materials-Methods: We acquired Dual/Triple rule out CT Angiographies at the Izzet Baysal Training and Research Hospital between April 2021 and February 2022, using both standard contrast amount and standard dose and low volume contrast medium and low radiation dose for the thorax or thoracoabdomen examinations. 93 patients with standard dose and 91 patients with low dose were included in the study. Results: Signal-to-noise ratio and contrast-to-noise ratio were calculated separately. There was no significant difference in CNR values between two groups in the aorta, pulmonary and coronary arteries, however, a significant difference was found in SNR values. According to the subjective image quality evaluation, no significant difference was found between the standard and low-dose patients. Radiation dose was reduced by 63.80% and the contrast material by 31.5%, in low dose group in comparison to standard dose. Conclusion: In our study, we have shown that Dual/Triple rule out CT angiography can be performed with low-dose radiation and low volume contrast medium. Although its routine use is not always appropriate, low-dose CT angiography may be preferred in emergency situations where kidney function tests cannot be performed, or in patients with borderline renal function tests or in the risk group.