A prospective multicentre study aiming to validate the clinical utility and safety of an optimised low-dose computed-tomography pulmonary angiogram (CTPA) protocol for suspected pulmonary embolism in pregnancy
The OPTICA study is the first prospective study of a low-dose CTPA protocol for the pregnant population. It will define the achievable dose, image quality and safety of this protocol and provide an evidence base upon which modern CTPA protocols can be appropriately compared to scintigraphy for this population. Pregnant women undergoing the specified low-dose CTPA protocol for suspected pulmonary embolism (PE), agreed across study sites with equivalent computed-tomography (CT) capabilities, will be included. Independent review of CTPAs by two radiology consultants, image data analysis and 3-month patient follow up will be performed. The diagnostic algorithm employs chest-x-ray and lower limb Doppler if lower limb symptoms are present, followed by CTPA in cases where advanced imaging is required. D-dimer is permitted within the diagnostic algorithm for patients recruited after implementation of the updated 2019 "European Society of Cardiology guidelines for diagnosis and management of acute pulmonary embolism".
Study Type
OBSERVATIONAL
Enrollment
464
Low dose CT pulmonary angiogram protocol
Mater Misericordiae University Hospital
Dublin, Ireland
RECRUITINGIncidence of Venous Thrombo-Embolism (VTE)
3-month incidence of venous thromboembolism in pregnant patients in whom pulmonary embolism was excluded at baseline CT pulmonary angiogram.
Time frame: 3 months
Maternal Effective Dose
Maternal Effective Dose
Time frame: 3 months
Breast Radiation Dose
Breast Dose
Time frame: 3 months
Foetal Radiation Dose
Foetal (Uterine) Dose
Time frame: 3 months
Signal to Noise Ratio
Image Quality - Objective Variable
Time frame: 3 months
Contrast to Noise Ratio
Image Quality - Objective Variable
Time frame: 3 months
Mean Pulmonary Trunk Enhancement
Image Quality - Objective Variable (Hounsfield Units)
Time frame: 3 months
Subjective Imaging Quality Grade
Subjective Imaging Quality Score: Score 1 - 5. Lowest score of 1 indicates a non diagnostic quality study. Best score of 5 indicates excellent quality / excellent opacification to the segmental pulmonary vessel level.
Time frame: 3 months
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