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BrightSpeed Elite CT with ASiR:

Comparing Dose & Image Quality
Rule Out Pulmonary Embolism on
Initial & Follow-Up Exam

Michael Swack, MD
Diagnostic Radiologist
Irvington Radiologists, PC
Community Hospital East, Indianapolis, IN

Patient History:
A 48-year-old male patient has a history of presenting to the emergency department (ED)
with symptoms including shortness of breath, severe right-sided chest pain, history of a
pulmonary embolism (PE) and deep vein thrombosis (DVT). Patient had a CT scan in May
2011 on a BrightSpeed Elite.
He subsequently returned to the ED with the same symptoms for rule out PE back in June of
2011. Based on this patients previous history, we felt it was appropriate to perform another
CT scan. Radiation dose was a concern since his last CT exam was only 21 days prior. This
scan was performed on the same BrightSpeed Elite but with newly-installed ASiR (Adaptive
Statistical Iterative Reconstruction) low dose technology.
Staff was able to pull archived images from our PACs system in order to compare the
radiation dose levels from initial findings in November 2010 to the patients most recent
scan.
CT Exam from May 2011
Scan type conducted: Chest with contrast for PE
Scanner type: BrightSpeed Elite
Scan protocol:
Slice thickness: 1.25 x 0.625
Pitch: 1.375:1
Table speed or travel distance of scan: 27.5mm/rot- 29cm
Rotation time: 0.5sec
Total Acquisition 5.78 sec
mA = 433
mAs = 216.6
kV= 120
Recon kernel: Standard
Noise Index 21.45
ASiR = 0
Dose Report
- DLP = 20.69 mGy
- CTDIvol = 659.41
- Phantom type = Body 32
- Total dose = 11.20 mSv

CT Exam from June 2011

Scan type conducted: Chest with contrast for PE

Scanner type: BrightSpeed Elite with ASiR

Scan protocol:
Slice thickness: 1.25 x 0.625
Pitch: 1.375:1
Table speed or travel distance of scan: 27.5mm/rot- 35cm
Rotation time: 0.5sec
Total Acquisition 6.92 sec
mA = 380
mAs = 190
kV= 120
Recon kernel: Chest
Noise Index 28.22
ASiR = 40%
Dose Report
- DLP = 14.30 mGy
- CTDIvol = 544.29
- Phantom type = Body 32
- Total dose = 9.25 mSv

Clinical Findings:
There remains a significant amount of pulmonary emboli throughout both pulmonary
arteries with a saddle type embolus extending toward the distal main pulmonary artery. This
portion of the thrombus within the distal main appears to have undergone slight lysis. There
is no clear evidence of progression of the emboli.
Patient dose on this exam was 18% less than the previous CT exam.

Advantages of BrightSpeed Elite with ASiR in this exam:

The patient was scanned on the same Bright Speed Elite pre and post ASiR.
The CT imaging staff set the ASiR at 40% and subsequently increased the noise index 24%
from 21.45 to 28.09. We had the opportunity to compare the dose as well as the image
quality from the patients previous scan.
The radiologist reading the exam noted the image quality of the BrightSpeed Elite is
comparable to images seen on the LightSpeed VCT XTe. Community Hospital East also has a
LightSpeed VCT XTe with ASiR used for diagnostic imaging.

Initial scan parameters:

Dose
DLP

20.69

CTDIvol

659.41

Coverage

289 mm

Estimated effective*

11.2 mSv

Follow-up scan parameters:

Dose
DLP

14.30

CTDIvol

544.29

Coverage

350 mm

Estimated effective*

9.2 mSv

Please note there is 17% less coverage

in initial scan vs. the follow up scan

*Obtained by EUR-16262 EN chest factor of 0.017 x DLP using a 32 cm phantom.

2011 General Electric Company All rights reserved.

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GE, GE Monogram, and Discovery are trademarks of
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GE Healthcare, a division of General Electric Company.

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