Simon Deseive1, Marcus Y Chen2, Grigorios Korosoglou3, Jonathon Leipsic4, Eugenio Martuscelli5, Patricia Carrascosa6, Saeed Mirsadraee7, Charles White8, Martin Hadamitzky9, Stefan Martinoff9, Anna-Leonie Menges1, Bernhard Bischoff10, Steffen Massberg1, Jörg Hausleiter11. 1. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Institut für Radiologie und Nuklearmedizin; Deutsches Herzzentrum München; Klinik an der Technischen Universität München, Munich, Germany. 2. National Institutes of Health, Bethesda, Maryland. 3. Klinik für Innere Medizin III, Universitätsklinikum Heidelberg; Heidelberg, Germany. 4. Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, Canada. 5. Department of Internal Medicine, University of Rome Tor Vergata and Clinica Paideia, Rome, Italy. 6. Departamento de Tomografía Computada e Investigación de Diagnóstico Maipú, Buenos Aires, Argentina. 7. Department of Radiology, University of Edinburgh, Edinburgh, United Kingdom. 8. University of Maryland School of Medicine, Baltimore, Maryland. 9. Institut für Radiologie und Nuklearmedizin; Deutsches Herzzentrum München; Klinik an der Technischen Universität München, Munich, Germany. 10. Institut für Klinische Radiologie, Ludwig-Maximilians-Universität München, Munich, Germany. 11. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Institut für Radiologie und Nuklearmedizin; Deutsches Herzzentrum München; Klinik an der Technischen Universität München, Munich, Germany. Electronic address: joerg.hausleiter@med.uni-muenchen.de.
Abstract
OBJECTIVES: The purpose of this study was to assess the potential of iterative image reconstruction (IR) of images for radiation dose reduction in coronary computed tomography angiography (CTA). Therefore, IR in combination with 30% tube current reduction was compared with standard scanning with filtered back projection (FBP) reconstruction. BACKGROUND: Lately, new IR techniques with advanced raw data processing have been introduced by different computed tomography vendors, thus allowing for either image noise reduction at unchanged radiation dose levels or radiation dose reductions at comparable image noise levels. METHODS: In this prospective, multicenter, multivendor noninferiority trial, we randomized 400 consecutive patients to 1 of 2 groups: acontrol group using standard FBP image reconstruction and standard tube current or an interventional group using IR technique and 30% tube current reduction. The primary endpoint was to demonstrate noninferiority in image quality (IQ) in the IR group. IQ was assessed on a 4-point scale (1, nondiagnostic IQ; 4, excellent IQ). Secondary endpoints included total radiation dose estimates and the rate of downstream testing during 30-day follow-up. RESULTS:Median IQ in the IR group was noninferior compared with the conventional FBP group (IR, 3.5 [interquartile range: 3.0 to 4.0]; FBP, 3.4 [interquartile range: 2.8 to 4.0], p for noninferiority <0.016). The radiation exposure was significantly lower in the IR group (median dose-length-product 157 [interquartile range: 114 to 239] mGy·cm vs. 222 [interquartile range: 141 to 319] mGy·cm for IR vs. FBP, respectively, p < 0.0001). The rate of downstream testing did not differ significantly (7.7% vs. 7.9% for IR vs. FBP, respectively, p = 0.94). CONCLUSIONS: Coronary CTA image quality is maintained with the combined use of a 30% reduced tube current and IR algorithms when compared with conventional FBP image reconstruction techniques and standard tube current. (Prospective Randomized Trial On RadiaTion Dose Estimates Of CT AngIOgraphy In PatieNts: NCT01453712).
RCT Entities:
OBJECTIVES: The purpose of this study was to assess the potential of iterative image reconstruction (IR) of images for radiation dose reduction in coronary computed tomography angiography (CTA). Therefore, IR in combination with 30% tube current reduction was compared with standard scanning with filtered back projection (FBP) reconstruction. BACKGROUND: Lately, new IR techniques with advanced raw data processing have been introduced by different computed tomography vendors, thus allowing for either image noise reduction at unchanged radiation dose levels or radiation dose reductions at comparable image noise levels. METHODS: In this prospective, multicenter, multivendor noninferiority trial, we randomized 400 consecutive patients to 1 of 2 groups: a control group using standard FBP image reconstruction and standard tube current or an interventional group using IR technique and 30% tube current reduction. The primary endpoint was to demonstrate noninferiority in image quality (IQ) in the IR group. IQ was assessed on a 4-point scale (1, nondiagnostic IQ; 4, excellent IQ). Secondary endpoints included total radiation dose estimates and the rate of downstream testing during 30-day follow-up. RESULTS: Median IQ in the IR group was noninferior compared with the conventional FBP group (IR, 3.5 [interquartile range: 3.0 to 4.0]; FBP, 3.4 [interquartile range: 2.8 to 4.0], p for noninferiority <0.016). The radiation exposure was significantly lower in the IR group (median dose-length-product 157 [interquartile range: 114 to 239] mGy·cm vs. 222 [interquartile range: 141 to 319] mGy·cm for IR vs. FBP, respectively, p < 0.0001). The rate of downstream testing did not differ significantly (7.7% vs. 7.9% for IR vs. FBP, respectively, p = 0.94). CONCLUSIONS: Coronary CTA image quality is maintained with the combined use of a 30% reduced tube current and IR algorithms when compared with conventional FBP image reconstruction techniques and standard tube current. (Prospective Randomized Trial On RadiaTion Dose Estimates Of CT AngIOgraphy In PatieNts: NCT01453712).
Authors: Thomas J Stocker; Simon Deseive; Jonathon Leipsic; Martin Hadamitzky; Marcus Y Chen; Ronen Rubinshtein; Mathias Heckner; Jeroen J Bax; Xiang-Ming Fang; Erik Lerkevang Grove; John Lesser; Pál Maurovich-Horvat; James Otton; Sanghoon Shin; Gianluca Pontone; Hugo Marques; Benjamin Chow; Cesar H Nomura; Ramzi Tabbalat; Axel Schmermund; Joon-Won Kang; Christopher Naoum; Melany Atkins; Eugenio Martuscelli; Steffen Massberg; Jörg Hausleiter Journal: Eur Heart J Date: 2018-11-01 Impact factor: 29.983
Authors: Bernhard Bischoff; Simon Deseive; Martin Rampp; Andrei Todica; Marc Wermke; Stefan Martinoff; Steffen Massberg; Maximilian F Reiser; Hans-Christoph Becker; Jörg Hausleiter Journal: Int J Cardiovasc Imaging Date: 2016-11-15 Impact factor: 2.357
Authors: Thomas J Stocker; Simon Deseive; Marcus Chen; Jonathon Leipsic; Martin Hadamitzky; Ronen Rubinshtein; Erik L Grove; Xiang-Ming Fang; John Lesser; Pál Maurovich-Horvat; Hugo Marques; Daniele Andreini; Ramzi Tabbalat; Joon-Won Kang; Joachim Eckert; Patricia Dickson; Signe H Forsdahl; Jess Lambrechtsen; Roberto C Cury; Jörg Hausleiter Journal: J Cardiovasc Comput Tomogr Date: 2017-12-05
Authors: Mohamed Marwan; Stephan Achenbach; Grigorios Korosoglou; Axel Schmermund; Steffen Schneider; Oliver Bruder; Jörg Hausleiter; Stephen Schroeder; Sebastian Barth; Sebastian Kerber; Alexander Leber; Werner Moshage; Jochen Senges Journal: Int J Cardiovasc Imaging Date: 2017-12-01 Impact factor: 2.357
Authors: Jason M Tarkin; Marc R Dweck; Nicholas R Evans; Richard A P Takx; Adam J Brown; Ahmed Tawakol; Zahi A Fayad; James H F Rudd Journal: Circ Res Date: 2016-02-19 Impact factor: 17.367