Literature DB >> 25439789

Prospectively ECG-triggered high-pitch coronary angiography with third-generation dual-source CT at 70 kVp tube voltage: feasibility, image quality, radiation dose, and effect of iterative reconstruction.

Michaela M Hell1, Daniel Bittner2, Annika Schuhbaeck2, Gerd Muschiol2, Michael Brand3, Michael Lell3, Michael Uder3, Stephan Achenbach2, Mohamed Marwan2.   

Abstract

BACKGROUND: Low tube voltage reduces radiation exposure in coronary CT angiography (CTA). Using 70 kVp tube potential has so far not been possible because CT systems were unable to provide sufficiently high tube current with low voltage.
OBJECTIVE: We evaluated feasibility, image quality (IQ), and radiation dose of coronary CTA using a third-generation dual-source CT system capable of producing 450 mAs tube current at 70 kVp tube voltage.
METHODS: Coronary CTA was performed in 26 consecutive patients with suspected coronary artery disease, selected for body weight <100 kg and heart rate <60 beats/min. High-pitch spiral acquisition was used. Filtered back projection (FBP) and iterative reconstruction (IR) algorithms were applied. IQ was assessed using a 4-point rating scale (1 = excellent, 4 = nondiagnostic) and objective parameters.
RESULTS: Mean age was 62 ± 9 years (46% males; mean body mass index, 27.7 ± 3.8 kg/m(2); mean heart rate, 54 ± 5 beats/min). Mean dose-length product was 20.6 ± 1.9 mGy × cm; mean estimated effective radiation dose was 0.3 ± 0.03 mSv. Diagnostic IQ was found in 365 of 367 (FBP) and 366 of 367 (IR) segments (P nonsignificant). IQ was rated "excellent" in 53% (FBP) and 86% (IR) segments (P = .001) and "nondiagnostic" in 2 (FBP) and 1 segment (IR) (P nonsignificant). Mean IQ score was lesser in FBP vs IR (1.5 ± 0.4 vs 1.1 ± 0.2; P < .001). Image noise was lower in IR vs FBP (60 ± 10 HU vs 74 ± 8 HU; P < .001).
CONCLUSION: In patients <100 kg and with a regular heart rate <60 beats/min, third-generation dual-source CT using high-pitch spiral acquisition and 70 kVp tube voltage is feasible and provides both robust IQ and very low radiation exposure.
Copyright © 2014 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Dual-source CT; High-pitch spiral acquisition; Image quality; Iterative reconstruction; Ultra-low dose coronary CT angiography

Mesh:

Year:  2014        PMID: 25439789     DOI: 10.1016/j.jcct.2014.09.003

Source DB:  PubMed          Journal:  J Cardiovasc Comput Tomogr        ISSN: 1876-861X


  29 in total

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10.  Declining radiation dose of coronary computed tomography angiography: German cardiac CT registry experience 2009-2014.

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