Direct chest area measurement: A potential anthropometric replacement for BMI to inform cardiac CT dose parameters?

Predicting the image noise level of prospective ECG-triggered coronary computed tomography angiography: quantitative measurement of thoracic component versus body mass index

“…However, basic biometric parameters do not reflect these characteristics [6]. Ghoshhajra et al [13] speculated that differences in composition of adipose tissue, muscle or tissue out of the scan range lead to weak correlation between BMI and chest area in certain groups. They suggest that chest area might be a better predictor of image noise than BMI.…”

“…Factors that are considered predictors in maintaining image quality include subject height, body weight (BW), body circumference, and body mass index (BMI) [7]. In daily practice, BMI is usually used as the predictor to select adaptive tube voltage [1,13,14]. However, the correlation values between image noise and BMI have shown a wide range [1,6].…”

“…However, the correlation values between image noise and BMI have shown a wide range [1,6]. Quantitative parameters from CT images, including chest area, chest circumference, and chest diameter, have been proposed as surrogates for BMI [13,15]. Among them, the area of the thoracic solid tissue showed a higher correlation with image noise than BMI [6,16].…”

Coronary computed tomography angiography during arrhythmia: Radiation dose reduction with prospectively ECG-triggered axial and retrospectively ECG-gated helical 128-slice dual-source CT

“…14 Third, the relative amount of chest wall adipose or soft tissue was determined according to physical inspection of the patient, and the scout and axial test-bolus images were obtained before the scan. 15 The use of a 3-dimensional sequence protocol with prospectively ECG-triggered axial acquisition (Sequential Scanning ''Adaptive Cardio Sequential Flex mode''; Siemens Healthcare) was generally selected for younger patients (age , 50 years) with low (,65 beats/min) and regular heart rate ( Figure 1). This scan algorithm provides an advanced arrhythmia rejection/compensation mode (Adaptive Cardio Sequence; Siemens Healthcare), which compensates for gradual changes in heart rate and for the scan position to be immediately repeated in the case of an ectopic or widely irregular beat.…”

Low-tube-voltage selection for triple-rule-out CTA: relation to patient size

“…Empiric selection criteria for application of reduced peak tube potential include markers of body size (e.g., body mass index [BMI]); however, body size selection criteria are likely crude given interpatient differences in weight distribution and body composition [15]. Patients’ chest area and BMI have been found to frequently be discordant, which can lead to over radiating patients when using BMI to select tube potential [16]. However, there remains hesitation among clinicians to lower kV out of fear for not achieving adequate image quality for diagnosis.…”