Literature DB >> 21984448

Radiation dose considerations by intra-individual Monte Carlo simulations in dual source spiral coronary computed tomography angiography with electrocardiogram-triggered tube current modulation and adaptive pitch.

Matthias S May1, Paul Deak, Axel Kuettner, Michael M Lell, Wolfgang Wuest, Michael Scharf, Andrea K Keller, Lothar Häberle, Stephan Achenbach, Martin Seltmann, Michael Uder, Willi A Kalender.   

Abstract

OBJECTIVES: To evaluate radiation dose levels in patients undergoing spiral coronary computed tomography angiography (CTA) on a dual-source system in clinical routine.
METHODS: Coronary CTA was performed for 56 patients with electrocardiogram-triggered tube current modulation (TCM) and heart-rate (HR) dependent pitch adaptation. Individual Monte Carlo (MC) simulations were performed for dose assessment. Retrospective simulations with constant tube current (CTC) served as reference. Lung tissue was segmented and used for organ and effective dose (ED) calculation.
RESULTS: Estimates for mean relative ED was 7.1 ± 2.1 mSv/100 mAs for TCM and 12.5 ± 5.3 mSv/100 mAs for CTC (P < 0.001). Relative dose reduction at low HR (≤60 bpm) was highest (49 ± 5%) compared to intermediate (60-70 bpm, 33 ± 12%) and high HR (>70 bpm, 29 ± 12%). However lowest ED is achieved at high HR (5.2 ± 1.5 mSv/100 mAs), compared with intermediate (6.7 ± 1.6 mSv/100 mAs) and low (8.3 ± 2.1 mSv/100 mAs) HR when automated pitch adaptation is applied.
CONCLUSIONS: Radiation dose savings up to 52% are achievable by TCM at low and regular HR. However lowest ED is attained at high HR by pitch adaptation despite inferior radiation dose reduction by TCM. KEY POINTS: • Monte Carlo simulations allow for individual radiation dose calculations. • ECG-triggered tube current modulation (TCM) can effectively reduce radiation dose. • Slow and regular heart rates allow for highest dose reductions by TCM. • Adaptive pitch accounts for lowest radiation dose at high heart rates. • Women receive higher effective dose than men undergoing spiral coronary CT-angiography.

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Year:  2011        PMID: 21984448     DOI: 10.1007/s00330-011-2300-6

Source DB:  PubMed          Journal:  Eur Radiol        ISSN: 0938-7994            Impact factor:   5.315


  40 in total

1.  Dose levels at coronary CT angiography--a comparison of Dual Energy-, Dual Source- and 16-slice CT.

Authors:  J Matthias Kerl; Ralf W Bauer; Tobias B Maurer; Rene Aschenbach; Huedayi Korkusuz; Thomas Lehnert; Simon Deseive; Hanns Ackermann; Thomas J Vogl
Journal:  Eur Radiol       Date:  2010-09-23       Impact factor: 5.315

Review 2.  Computed tomography coronary angiography.

Authors:  Stephan Achenbach
Journal:  J Am Coll Cardiol       Date:  2006-11-01       Impact factor: 24.094

3.  Assessment of image quality of 64-row Dual Source versus Single Source CT coronary angiography on heart rate: a phantom study.

Authors:  R Dikkers; M J W Greuter; W Kristanto; P M A van Ooijen; P E Sijens; T P Willems; M Oudkerk
Journal:  Eur J Radiol       Date:  2008-03-04       Impact factor: 3.528

4.  Dual-source CT coronary angiography: image quality, mean heart rate, and heart rate variability.

Authors:  David Matt; Hans Scheffel; Sebastian Leschka; Thomas G Flohr; Borut Marincek; Philipp A Kaufmann; Hatem Alkadhi
Journal:  AJR Am J Roentgenol       Date:  2007-09       Impact factor: 3.959

5.  Diagnostic accuracy of dual-source CT coronary angiography with prospective ECG-triggering on different heart rate patients.

Authors:  Ming-Li Sun; Bin Lu; Run-Ze Wu; Laura Johnson; Lei Han; Gang Liu; Fang-Fang Yu; Zhi-Hui Hou; Yang Gao; Hong-Yu Wang; Shiliang Jiang; Yue-Jin Yang; Shu-Bin Qiao
Journal:  Eur Radiol       Date:  2011-04-12       Impact factor: 5.315

6.  The effect of heart rhythm on patient radiation dose with dual-source cardiac computed tomography.

Authors:  Tust Techasith; Brian B Ghoshhajra; Quynh A Truong; Rodrigo Pale; Khurram Nasir; Michael A Bolen; Udo Hoffmann; Ricardo C Cury; Suhny Abbara; Thomas J Brady; Ron Blankstein
Journal:  J Cardiovasc Comput Tomogr       Date:  2011-05-25

7.  A PC program for estimating organ dose and effective dose values in computed tomography.

Authors:  W A Kalender; B Schmidt; M Zankl; M Schmidt
Journal:  Eur Radiol       Date:  1999       Impact factor: 5.315

8.  Step and shoot coronary CT angiography using 256-slice CT: effect of heart rate and heart rate variability on image quality.

Authors:  D Muenzel; P B Noel; F Dorn; M Dobritz; E J Rummeny; A Huber
Journal:  Eur Radiol       Date:  2011-06-28       Impact factor: 5.315

9.  Dual-source computed tomography: estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography.

Authors:  Dominik Ketelsen; Christoph Thomas; Matthias Werner; Marie H Luetkhoff; Markus Buchgeister; Ilias Tsiflikas; Anja Reimann; Christof Burgstahler; Harald Brodoefel; Andreas F Kopp; Claus D Claussen; Martin Heuschmid
Journal:  Eur J Radiol       Date:  2008-12-18       Impact factor: 3.528

10.  Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters.

Authors:  Hatem Alkadhi; Paul Stolzmann; Hans Scheffel; Lotus Desbiolles; Stephan Baumüller; André Plass; Michele Genoni; Borut Marincek; Sebastian Leschka
Journal:  Eur J Radiol       Date:  2008-10-30       Impact factor: 3.528

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  2 in total

1.  [Current strategies for dosage reduction in computed tomography].

Authors:  M S May; W Wuest; M M Lell; M Uder; W A Kalender; B Schmidt
Journal:  Radiologe       Date:  2012-10       Impact factor: 0.635

2.  Medical imaging in personalised medicine: a white paper of the research committee of the European Society of Radiology (ESR).

Authors: 
Journal:  Insights Imaging       Date:  2015-03-13
  2 in total

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