OBJECTIVES: To compare the image quality and radiation dose using image-noise (IN)-based determination of X-ray tube settings compared with a body mass index (BMI)-based protocol during CT coronary angiography (CTCA). METHODS: Two hundred consecutive patients referred for CTCA to our institution were divided into two groups: BMI-based, 100 patients had CTCA with the X-ray tube current adjusted to the patient's BMI while maintaining a fixed tube potential of 120 kV; IN-based, 100 patients underwent imaging with the X-ray tube current and voltage adjusted to the IN measured within the mid-left ventricle on a pre-acquisition trans-axial image. Two independent cardiac radiologists performed blinded image quality assessment with quantification of the IN and signal-to-noise ratio (SNR) from the mid-LV and qualitative assessment using a three-point score. Radiation dose (CTDI and DLP) was recorded from the console. RESULTS: Results showed: IN (HU): BMI-based, 30.1 ± 9.9; IN-based, 33.1 ± 6.7; 32 % variation reduction (P = 0.001); SNR: BMI-based, 18.6 ± 7.1; IN-based, 15.4 ± 3.7; 48 % variation reduction (P < 0.0001). Visual scores: BMI-based, 2.3 ± 0.6; IN-based, 2.2 ± 0.5 (P = 0.54). Radiation dose: CTDI (mGy), BMI-based, 22.68 ± 8.9; IN-based, 17.16 ± 7.6; 24.3 % reduction (P < 0.001); DLP (mGy.cm), BMI-based, 309.3 ± 127.5; IN-based, 230.6 ± 105.5; 25.4 % reduction (P < 0.001). CONCLUSIONS: Image-noise-based stratification of X-ray tube parameters for CTCA results in 32 % improvement in image quality and 25 % reduction in radiation dose compared with a BMI-based protocol. KEY POINTS: • Image quality and radiation dose are closely related in CT coronary angiography. • So too are the image quality, radiation dose and body mass index (BMI). • An image-noise-based CTCA protocol reduces the radiation dose by 25 %. • It improves inter-patient image homogeneity by 32 %.
OBJECTIVES: To compare the image quality and radiation dose using image-noise (IN)-based determination of X-ray tube settings compared with a body mass index (BMI)-based protocol during CT coronary angiography (CTCA). METHODS: Two hundred consecutive patients referred for CTCA to our institution were divided into two groups: BMI-based, 100 patients had CTCA with the X-ray tube current adjusted to the patient's BMI while maintaining a fixed tube potential of 120 kV; IN-based, 100 patients underwent imaging with the X-ray tube current and voltage adjusted to the IN measured within the mid-left ventricle on a pre-acquisition trans-axial image. Two independent cardiac radiologists performed blinded image quality assessment with quantification of the IN and signal-to-noise ratio (SNR) from the mid-LV and qualitative assessment using a three-point score. Radiation dose (CTDI and DLP) was recorded from the console. RESULTS: Results showed: IN (HU): BMI-based, 30.1 ± 9.9; IN-based, 33.1 ± 6.7; 32 % variation reduction (P = 0.001); SNR: BMI-based, 18.6 ± 7.1; IN-based, 15.4 ± 3.7; 48 % variation reduction (P < 0.0001). Visual scores: BMI-based, 2.3 ± 0.6; IN-based, 2.2 ± 0.5 (P = 0.54). Radiation dose: CTDI (mGy), BMI-based, 22.68 ± 8.9; IN-based, 17.16 ± 7.6; 24.3 % reduction (P < 0.001); DLP (mGy.cm), BMI-based, 309.3 ± 127.5; IN-based, 230.6 ± 105.5; 25.4 % reduction (P < 0.001). CONCLUSIONS: Image-noise-based stratification of X-ray tube parameters for CTCA results in 32 % improvement in image quality and 25 % reduction in radiation dose compared with a BMI-based protocol. KEY POINTS: • Image quality and radiation dose are closely related in CT coronary angiography. • So too are the image quality, radiation dose and body mass index (BMI). • An image-noise-based CTCA protocol reduces the radiation dose by 25 %. • It improves inter-patient image homogeneity by 32 %.
Authors: Jörg Hausleiter; Tanja S Meyer; Eugenio Martuscelli; Pietro Spagnolo; Hiroaki Yamamoto; Patricia Carrascosa; Thomas Anger; Lukas Lehmkuhl; Hatem Alkadhi; Stefan Martinoff; Martin Hadamitzky; Franziska Hein; Bernhard Bischoff; Miriam Kuse; Albert Schömig; Stephan Achenbach Journal: JACC Cardiovasc Imaging Date: 2012-05
Authors: William P Shuman; Jonathon A Leipsic; Janet M Busey; Douglas E Green; Sudhakar N Pipavath; Cameron J Hague; Kent M Koprowicz Journal: Eur J Radiol Date: 2011-06-23 Impact factor: 3.528
Authors: Narinder S Paul; Hany Kashani; Devang Odedra; Ali Ursani; Chris Ray; Patrik Rogalla Journal: AJR Am J Roentgenol Date: 2011-12 Impact factor: 3.959
Authors: Reza Fazel; Harlan M Krumholz; Yongfei Wang; Joseph S Ross; Jersey Chen; Henry H Ting; Nilay D Shah; Khurram Nasir; Andrew J Einstein; Brahmajee K Nallamothu Journal: N Engl J Med Date: 2009-08-27 Impact factor: 91.245
Authors: Jan-Erik Scholtz; Julian L Wichmann; Kristina Hüsers; Moritz H Albrecht; Martin Beeres; Ralf W Bauer; Thomas J Vogl; Boris Bodelle Journal: Eur Radiol Date: 2015-11-11 Impact factor: 5.315
Authors: J D van Dijk; E D Huizing; P L Jager; J P Ottervanger; S Knollema; C H Slump; J A van Dalen Journal: Int J Cardiovasc Imaging Date: 2015-11-12 Impact factor: 2.357