Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose &lt;0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction

Schuhbaeck, Annika; Achenbach, Stephan; Layritz, Christian; Eisentopf, Jasmin; Hecker, F.; Pflederer, Tobias; Gauss, Soeren; Rixe, Johannes; Kalender, Willi A.; Daniel, Werner G.; Lell, Michael; Ropers, Dieter

doi:10.1007/s00330-012-2656-2

Cited by 137 publications

(93 citation statements)

References 30 publications

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“…While SNR and CNR improved in SAFIRE images of patients weighing 75 kg and below, no improvements were noted in patients that were heavier than 75 kg, in a study which evaluated the performance of SAFIRE in coronary CT angiography. 45 The results are in line with a separate study by Wang et al 46 on obese patients with a body mass index (BMI) larger than 30 kg/m 2 . Another study investigating the use of SAFIRE in cervical spine CT examinations meanwhile noted that while increasing the iteration strength level of the SAFIRE algorithm improved visualization of the intervertebral discs and ligaments, the use of a higherstrength SAFIRE algorithm resulted in poorer visualization of soft tissues and trabecular bone.…”

Section: Performance Of Safire and Admire Algorithmssupporting

confidence: 87%

Does Iterative Reconstruction Improve Image Quality and Reduce Dose in Computed Tomography?

Qiu¹,

Seeram²

2016

Radiol Open J

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CitationA total of 57 articles were categorized as either synopsis articles or performance evaluation clinical studies, where the latter was further divided into 6 sub-categories according to the type of IR algorithm examined. The results show that the use of IR algorithms reduces objective image noise, and at least preserves spatial resolution and low contrast detectability, even when dose is reduced. The findings are also applicable to specific patient groups, such as pediatrics and obese patients. In conclusion, there is a general consensus that IR algorithms can faithfully reduce radiation dose and improve image quality in CT in comparison with the FBP algorithm.

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Section: Performance Of Safire and Admire Algorithmssupporting

confidence: 87%

Does Iterative Reconstruction Improve Image Quality and Reduce Dose in Computed Tomography?

Qiu¹,

Seeram²

2016

Radiol Open J

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“…An alternative approach for obtaining single heart beat coverage is by using fast table movement (high-pitch) spiral acquisition protocols, currently only possible with DSCT systems. 34 …”

Section: Patient Selection and Preparationmentioning

confidence: 99%

Image quality in coronary CT angiography: challenges and technical solutions

Ghekiere

Salgado

Buls

et al. 2017

BJR

114

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Multidetector CT angiography (CTA) has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high-quality examinations. In this review, we discuss several key elements that may adversely affect coronary CTA image quality as well as potential measures that can be taken to mitigate their impact. In addition, several recent vendor-specific advances and future directions to improve image quality are discussed. INTRODUCTIONThe high negative-predictive value of coronary CT angiography (CTA) makes it a suitable tool for excluding significant coronary artery disease.1 Coronary CTA is technically complex and places a greater emphasis on scanning technologies than any other type of CT examination. Indeed, coronary arteries both have small calibre and varying degrees of motion during the cardiac cycle.2 Image quality can be degraded by many patient-and technique-related factors. Image artefacts are causes for misinterpretation, making the diagnostic accuracy of coronary CTA to a great extent dependent on their recognition and operator-awareness.2,3 Potential problems related to these artefacts include insufficient tissue contrast, limited spatial and temporal resolution and inadequate volume coverage. The aim of this review was to discuss these technical issues, important recent vendorspecific solutions as well as future directions.

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“…7,25,26 Schuhbaeck et al demonstrated that for a coronary-CT, the addition of high-pitch with raw databased iterative reconstruction results in a furthermore decrease in dose, while providing sufficient image quality with an estimated effective dose <0.1 mSv. 27 In the present study, the acquisition protocol was optimized for CTA of the thoraco-abdominal aorta and not exclusively for the heart. Yet the effective dose was a mean of 3.9 ± 1.5 mSv.…”

Section: Discussionmentioning

confidence: 99%

ECG-triggered high-pitch CT for simultaneous assessment of the aorta and coronary arteries

Hachulla

Ronot

Noble

et al. 2016

Journal of Cardiovascular Computed Tomography

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a b s t r a c tObjectives: To study the image quality of ECG-gated-computed tomography (CT) acquisition with a highpitch CT imaging for the exploration of both the aorta and coronary arteries.Methods: Eighty-four patients underwent high-pitch ECG-gated aortic CT without b-blockers with iterative reconstruction algorithms. Contrast-to-noise ratio (CNR) between vessels and adjacent perivascular fat tissue were calculated on the aorta and the coronary arteries. Dose-length-products (DLP) were recorded. Two blinded readers graded image quality of the aorta and the coronary arteries on a 3-point scale. Coronary artery stenoses were compared with coronary angiograms in 24 patients. Kappa values were calculated. Results: High-pitch acquisition resulted in a mean DLP of 234 ± 93 mGy cm(4.2 mSv) for an acquisition of the entire aorta, (mean 73 ± 16 bpm). CNR for ascending aorta was 10.6 ± 4 and CNR for coronary arteries was 9.85 ± 4.1. Image quality was excellent in 79/84 patients (94%), and excellent or moderate but diagnostic in 1087/1127 coronary artery segments (96%). 74 significant stenoses were observed, and 38/ 40 significant stenoses were confirmed by coronary angiography (K ¼ 0.91, Sensitivity ¼ 0.97, Specificity ¼ 0.98). Conclusion: High-pitch ECG-gated aortic CT with iterative reconstructions allows an accurate exploration of both aorta and coronary arteries during the same acquisition, with limited dose deposition, despite the lack of b-blockers and relatively high heart rate. Radiologists need to be aware of the necessity to analyze and report coronary artery disease in aortic examination.

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Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction

Abstract: Coronary CT angiography with an estimated effective dose <0.1 mSv may provide sufficient image quality in selected patients through the combination of high-pitch spiral acquisition and raw data-based iterative reconstruction.

Cited by 137 publications

References 30 publications

Does Iterative Reconstruction Improve Image Quality and Reduce Dose in Computed Tomography?

Does Iterative Reconstruction Improve Image Quality and Reduce Dose in Computed Tomography?

Image quality in coronary CT angiography: challenges and technical solutions

ECG-triggered high-pitch CT for simultaneous assessment of the aorta and coronary arteries

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