PURPOSE: To assess the impact of body mass index (BMI)-adapted protocols and iterative reconstruction algorithms (iDose) on patient radiation exposure and image quality in patients undergoing prospective ECG-triggered 256-slice coronary computed tomography angiography (CCTA). METHODS: Image quality and radiation exposure were systematically analyzed in 100 patients. 60 Patients underwent prospective ECG-triggered CCTA using a non-tailored protocol and served as a 'control' group (Group 1: 120 kV, 200 mAs). 40 Consecutive patients with suspected coronary artery disease (CAD) underwent prospective CCTA, using BMI-adapted tube voltage and standard (Group 2: 100/120 kV, 100-200 mAs) versus reduced tube current (Group 3: 100/120 kV, 75-150 mAs). Iterative reconstructions were provided with different iDose levels and were compared to filtered back projection (FBP) reconstructions. Image quality was assessed in consensus of 2 experienced observers and using a 5-grade scale (1=best to 5=worse), and signal- and contrast-to-noise ratios (SNR and CNR) were quantified. RESULTS: CCTA was performed without adverse events in all patients (n=100, heart rate of 47-87 bpm and BMI of 19-38 kg/m2). Patients examined using the non-tailored protocol in Group 1 had the highest radiation exposure (3.2±0.4 mSv), followed by Group 2 (1.7±0.7 mSv) and Group 3 (1.2±0.6 mSv) (radiation savings of 47% and 63%, respectively, p<0.001). Iterative reconstructions provided increased SNR and CNR, particularly when higher iDose level 5 was applied with Multi-Frequency reconstruction (iDose5 MFR) (14.1±4.6 versus 21.2±7.3 for SNR and 12.0±4.2 versus 18.1±6.6 for CNR, for FBP versus iDose5 MFR, respectively, p<0.001). The combination of BMI adaptation with iterative reconstruction reduced radiation exposure and simultaneously improved image quality (subjective image quality of 1.4±0.4 versus 1.9±0.5 for Group 2 reconstructed using iDose5 MFR versus Group 1 reconstructed using FBP, p<0.05). CONCLUSIONS: Prospective ECG-triggered 256-slice CCTA allows for visualization of the coronary artery tree with high image quality within a wide range of heart rates and BMIs. The combination of BMI-adapted protocols with iterative reconstruction algorithms can reduce radiation exposure for the patients and simultaneously improve image quality.
PURPOSE: To assess the impact of body mass index (BMI)-adapted protocols and iterative reconstruction algorithms (iDose) on patient radiation exposure and image quality in patients undergoing prospective ECG-triggered 256-slice coronary computed tomography angiography (CCTA). METHODS: Image quality and radiation exposure were systematically analyzed in 100 patients. 60 Patients underwent prospective ECG-triggered CCTA using a non-tailored protocol and served as a 'control' group (Group 1: 120 kV, 200 mAs). 40 Consecutive patients with suspected coronary artery disease (CAD) underwent prospective CCTA, using BMI-adapted tube voltage and standard (Group 2: 100/120 kV, 100-200 mAs) versus reduced tube current (Group 3: 100/120 kV, 75-150 mAs). Iterative reconstructions were provided with different iDose levels and were compared to filtered back projection (FBP) reconstructions. Image quality was assessed in consensus of 2 experienced observers and using a 5-grade scale (1=best to 5=worse), and signal- and contrast-to-noise ratios (SNR and CNR) were quantified. RESULTS:CCTA was performed without adverse events in all patients (n=100, heart rate of 47-87 bpm and BMI of 19-38 kg/m2). Patients examined using the non-tailored protocol in Group 1 had the highest radiation exposure (3.2±0.4 mSv), followed by Group 2 (1.7±0.7 mSv) and Group 3 (1.2±0.6 mSv) (radiation savings of 47% and 63%, respectively, p<0.001). Iterative reconstructions provided increased SNR and CNR, particularly when higher iDose level 5 was applied with Multi-Frequency reconstruction (iDose5 MFR) (14.1±4.6 versus 21.2±7.3 for SNR and 12.0±4.2 versus 18.1±6.6 for CNR, for FBP versus iDose5 MFR, respectively, p<0.001). The combination of BMI adaptation with iterative reconstruction reduced radiation exposure and simultaneously improved image quality (subjective image quality of 1.4±0.4 versus 1.9±0.5 for Group 2 reconstructed using iDose5 MFR versus Group 1 reconstructed using FBP, p<0.05). CONCLUSIONS: Prospective ECG-triggered 256-slice CCTA allows for visualization of the coronary artery tree with high image quality within a wide range of heart rates and BMIs. The combination of BMI-adapted protocols with iterative reconstruction algorithms can reduce radiation exposure for the patients and simultaneously improve image quality.
Authors: B M Gramer; D Muenzel; V Leber; A-K von Thaden; H Feussner; A Schneider; M Vembar; N Soni; E J Rummeny; A M Huber Journal: Eur Radiol Date: 2012-07-03 Impact factor: 5.315
Authors: Sebastian J Buss; Felix Schulz; David Wolf; Waldemar Hosch; Christian Galuschky; Georg Schummers; Evangelos Giannitsis; Hans-Ulrich Kauczor; Christian Zugck; Ruediger Becker; Stefan E Hardt; Hugo A Katus; Grigorios Korosoglou Journal: Eur Radiol Date: 2012-01-22 Impact factor: 5.315
Authors: Richard A P Takx; Martin J Willemink; Hendrik M Nathoe; Arnold M R Schilham; Ricardo P J Budde; Pim A de Jong; Tim Leiner Journal: Int J Cardiovasc Imaging Date: 2013-09-18 Impact factor: 2.357
Authors: Gitsios Gitsioudis; Waldemar Hosch; Johannes Iwan; Andreas Voss; Edem Atsiatorme; Nina P Hofmann; Sebastian J Buss; Stefan Siebert; Hans-Ulrich Kauczor; Evangelos Giannitsis; Hugo A Katus; Grigorios Korosoglou Journal: PLoS One Date: 2014-04-08 Impact factor: 3.240
Authors: M C Williams; N W Weir; S Mirsadraee; F Millar; A Baird; F Minns; N G Uren; G McKillop; R K Bull; E J R van Beek; J H Reid; D E Newby Journal: Clin Radiol Date: 2013-07-06 Impact factor: 2.350
Authors: Martin Andrassy; H Christian Volz; Bjoern Maack; Alena Schuessler; Gitsios Gitsioudis; Nina Hofmann; Danai Laohachewin; Alexandra R Wienbrandt; Ziya Kaya; Angelika Bierhaus; Evangelos Giannitsis; Hugo A Katus; Grigorios Korosoglou Journal: PLoS One Date: 2012-12-17 Impact factor: 3.240