Effect of Acquisition Technique on Radiation Dose and Image Quality in Multidetector Row Computed Tomography Coronary Angiography With Submillimeter Collimation

Gerber, Thomas C.; Stratmann, Brian P.; Kuzo, Ronald S.; Kantor, Birgit; Morin, Richard L.

doi:10.1097/01.rli.0000170628.69792.cb

Cited by 85 publications

(56 citation statements)

References 19 publications

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“…This becomes important when tracking changes over time in order to assess the efficacy of therapies [6]. Because protocols using retrospective ECG-gating are generally associated with a higher dose as compared to protocols employing the prospective technique, various efforts have been made for developing and optimizing dose saving algorithms for retrospective ECG-gated CT [12,17,18,34,35].…”

Section: Discussionmentioning

confidence: 99%

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Stolzmann

Leschka

Betschart

et al. 2008

Int J Cardiovasc Imaging

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Purpose The purpose of this study was to assess the radiation dose and associated image noise of previously suggested calcium scoring protocols using dual-source CT. Methods One hundred consecutive patients underwent coronary calcium scoring using dual-source CT. Patients were randomly assigned to five different protocols: retrospective ECG-gating and tube current reduction to 4% outside the pulsing window at 120 (protocol A) and 100 kV (B), prospective ECG-triggering at 120 (C) and 100 kV (D), and prospective ECG-triggering at 100 kV with attenuation-based tube current modulation (E). Radiation dose parameters and image noise were determined and compared. Results Protocol A resulted in an effective dose of 1.3 ± 0.2 mSv, protocol B in 0.8 ± 0.2 mSv, protocol C in 1.0 ± 0.2 mSv, protocol D in 0.6 ± 0.1 mSv, and protocol E in 0.7 ± 0.1 mSv. Effective doses were significantly lower (P \ 0.001) with 100 kV when compared to 120 kV protocols, and were significantly lower (P \ 0.001) for prospective versus retrospective ECG-gating. No significant difference was found between protocol D and E. Significant negative correlations were found between the CTDI vol and heart rate for both retrospective ECGgating protocols (protocol A: r = -0.98, P \ 0.001; protocol B: r = -0.83, P \ 0.001). The mean image noise was 29.0 ± 6.7 HU, with no significant differences between the five protocols. The image noise was significantly correlated with the body weight (r = 0.21, P \ 0.05) and BMI (r = 0.31, P \ 0.01). Conclusions Effective dose of calcium scoring using dual-source CT ranges from 0.6 to 1.3 mSv. Prospective triggering and lower tube voltage significantly reduces the radiation but yield similar image noise.

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Section: Discussionmentioning

confidence: 99%

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Stolzmann

Leschka

Betschart

et al. 2008

Int J Cardiovasc Imaging

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“…Reconstruction of axial images was performed with a slice thickness of 1.0 mm and an increment of 0.8 mm. All images were reconstructed using a medium-soft and a sharp tissue convolution kernel (B30f and B46f, the latter for the evaluation of calcified lesions) [25] and were transferred to an external workstation (Leonardo, Siemens Medical Solutions).…”

Section: Ct Image Reconstruction and Analysismentioning

confidence: 99%

Impact of vessel attenuation on quantitative coronary angiography with 64-slice CT

Husmann

Gaemperli

Valenta

et al. 2009

BJR

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ABSTRACT. The aim of the study was to determine the impact of vessel attenuation on quantitative 64-slice computed tomography coronary angiography (CTCA). CTCA and invasive quantitative coronary angiography (QCA) were performed in 100 consecutive patients (42 women, 58 men; mean age 64.4¡9.4 years; age range 39-87 years). In QCA, stenoses were quantified with dedicated software, whereas in CTCA, stenosis severity was assessed with an electronic caliper tool: stenoses were graded in 10% steps and assigned as either a calcified or non-calcified lesion. Vessel attenuation in the left main (LMA) and the proximal right coronary artery (RCA) were measured and correlated with differences in quantifications of stenosis grade between QCA and CTCA. A total of 113 coronary stenoses were detected by both methods (94 significant and 19 nonsignificant); 52 stenoses were rated as non-calcified and 61 as calcified lesions. The mean difference between QCA and quantitative CTCA grading was 5.1¡16.9% (range 227 to 46%) overall; 1.9¡14.2% (range 227 to 38%) for non-calcified lesions and 7.8¡18.6% (range 223 to 46%) for calcified lesions. Mean vessel attenuation was 362¡76 HU (range 191-584 HU) in the LMA and 333¡81 HU (range 162-564 HU) in the RCA. Attenuation did not significantly correlate with differences in QCA and CTCA gradings, neither overall nor for calcified or non-calcified lesions. When 64-slice CTCA is used, coronary vessel attenuation had no impact on the quantitative grading of stenoses. 64-slice CT has been shown to reliably detect significant coronary artery disease (CAD) [1][2][3][4][5][6][7][8][9][10][11]. For clinical decision-making, exact quantification of lesion severity can be important [12]. However, the quantification of coronary artery stenoses by CT coronary angiography (CTCA) is subjected to relatively large limits of agreement compared to the clinical reference standard, quantitative coronary angiography (QCA) [2,3,[13][14][15]. It has been hypothesised that coronary vessel attenuation affects the accuracy of quantitative CTCA [16][17][18]. Several factors related to the contrast material regimen, such as the type and iodine concentration of the contrast material [18], the technique for bolus timing [17], and the injection volume and rate [19], have been shown to affect the attenuation of coronary arteries. Furthermore, current CTCA protocols [1-11] do not adapt to the individual patient's body mass index or to the individual's cardiac output, although these parameters may contribute to vessel attenuation [20][21][22][23]. As a consequence, attenuation in CTCA has been shown to vary strongly [17,18,22,23] and the ideal attenuation remains undefined.The purpose of this study was to determine the impact of vessel attenuation on quantitative CTCA. Methods and materialsPatients A total of 100 consecutive patients (42 women and 58 men; mean age 64.4¡9.4 years; age range 39-87 years; mean body mass index (BMI) 22.0¡3.5; BMI range 12.8-31.4) underwent QCA and CTCA and were prospectively enrolled in the present...

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“…To reduce radiation dose ECG-pulsed tube current modulation was used in all pts. However, as shown in prior studies 20,21 a radiation exposure of at least 6 mSv has to be calculated for calcium scoring and MSCT angiography. This remains one main limitation of noninvasive MSCT coronary angiography.…”

Section: Discussionmentioning

confidence: 99%

Image quality and diagnostic accuracy of 16-slice multidetector computed tomography for the detection of coronary artery disease in obese patients

et al. 2005

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Background: Cardiac multislice spiral computed tomography (MSCT) scanners permit visualization of the coronary arteries with an overall good sensitivity (sens) and specificity (spec). However, in obese patients (pts), who are at higher risk to develop coronary artery disease (CAD), image quality of MSCT is supposed to be limited. At present, there are no data whether the accuracy of MSCT depends on the body mass index (BMI). Thus, we compared the catheter-controlled MSCT results from normal weight and obese pts in a cohort of 117 pts with regard to sens, spec, positive predictive value (PPV), negative predictive value (NPV) and image quality. 3 pts (group I 1, group II 2) had to be excluded from analysis due to technical problems. Group I had significantly less risk factors (Po0.001) and image quality was significantly better than in group II and III (Po0.05). Group II and III did not differ with regard to risk factors or image quality. Conclusions: Overweight and obesity have an impact on MSCT image quality but did not hamper the diagnostic accuracy. Thus, MSCT is a noninvasive method to detect or rule out CAD also in pts with higher BMI. These retrospective data have to be confirmed in larger prospective trials.

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Effect of Acquisition Technique on Radiation Dose and Image Quality in Multidetector Row Computed Tomography Coronary Angiography With Submillimeter Collimation

Abstract: These quantitative findings about the relationships among scan acquisition parameters, radiation dose, and image quality have practical implications for using ECG pulsing to reduce radiation doses in MDCT coronary angiography.

Cited by 85 publications

References 19 publications

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Impact of vessel attenuation on quantitative coronary angiography with 64-slice CT

Image quality and diagnostic accuracy of 16-slice multidetector computed tomography for the detection of coronary artery disease in obese patients

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