Vincenzo Vingiani1, Andres F Abadia2, U Joseph Schoepf3, Andreas M Fischer4, Akos Varga-Szemes5, Pooyan Sahbaee6, Thomas Allmendinger7, Christian Tesche8, L Parkwood Griffith9, Riccardo Marano10, Simon S Martin11. 1. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA; Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: vincenzovingiani@gmail.com. 2. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA. Electronic address: Abadia@musc.edu. 3. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA. Electronic address: schoepf@musc.edu. 4. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA. Electronic address: AndreasMarco.Fischer@googlemail.com. 5. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA. Electronic address: Vargaasz@musc.edu. 6. Siemens Medical Solutions USA, Malvern, PA, USA. Electronic address: pooyan.sahbaee@siemens-healthineers.com. 7. Computed Tomography - Research & Development, Siemens Healthcare GmbH, Forchheim, Siemensstrasse 1, 91301, Forchheim, Germany. Electronic address: Thomas.allmendinger@siemens.com. 8. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA; Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, Germany; Department of Internal Medicine, St. Johannes-Hospital, Dortmund, Germany. Electronic address: tesche.christian@gmail.com. 9. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA. Electronic address: griffile@musc.edu. 10. Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: Riccardo.Marano@unicatt.it. 11. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, USA; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany. Electronic address: simartin@outlook.com.
Abstract
PURPOSE: To investigate the accuracy of Agatston scoring and potential for radiation dose reduction of a coronary artery calcium scoring (CACS) CT protocol at 100 kV with tin filtration (Sn100kV) and kV-independent iterative reconstruction, compared to standard 120 kV acquisitions. MATERIALS AND METHODS: With IRB approval and in HIPAA compliance, 114 patients (61.8 ± 9.6 years; 66 men) underwent CACS using a standard 120 kV protocol and an additional Sn100kV CACS scan. The two datasets were reconstructed using a medium sharp convolution algorithm and in addition the Sn100kV scans were reconstructed iteratively based on a kV-independent algorithm. Agatston scores and radiation dose values were compared between the Sn100kV and the standard 120 kV protocol. RESULTS: Median Agatston scores derived from the Sn100kV protocol with the kV-independent algorithm and the standard 120 kV were 21.4 (IQR, 0-173.8) and 24.7 (IQR, 0-171.1) respectively, with no significant differences (p=0.18). Agatston scores derived from the two different protocols had an excellent correlation (r = 0.99). The dose-length-product was 11.5 ± 4.1 mGy × cm using Sn100kV and 50.4 ± 24.9 mGy × cm using the standard 120 kV protocol (p < 0.01), resulting in a significantly lower (77%) effective dose at Sn100kV (0.16 ± 0.06 mSv vs. 0.71 ± 0.35 mSv, p < 0.01). Additionally, 99% of the patients were classified into the same risk category (0, 1-10, 11-100, 101-400, or >400) using the Sn100kV protocol. CONCLUSION: CACS at Sn100kV using the kV-independent iterative algorithm is feasible and provides high accuracy when compared to standard 120 kV scanning. Furthermore, radiation dose can be significantly reduced for this screening application in a priori healthy individuals.
PURPOSE: To investigate the accuracy of Agatston scoring and potential for radiation dose reduction of a coronary artery calcium scoring (CACS) CT protocol at 100 kV with tin filtration (Sn100kV) and kV-independent iterative reconstruction, compared to standard 120 kV acquisitions. MATERIALS AND METHODS: With IRB approval and in HIPAA compliance, 114 patients (61.8 ± 9.6 years; 66 men) underwent CACS using a standard 120 kV protocol and an additional Sn100kV CACS scan. The two datasets were reconstructed using a medium sharp convolution algorithm and in addition the Sn100kV scans were reconstructed iteratively based on a kV-independent algorithm. Agatston scores and radiation dose values were compared between the Sn100kV and the standard 120 kV protocol. RESULTS: Median Agatston scores derived from the Sn100kV protocol with the kV-independent algorithm and the standard 120 kV were 21.4 (IQR, 0-173.8) and 24.7 (IQR, 0-171.1) respectively, with no significant differences (p=0.18). Agatston scores derived from the two different protocols had an excellent correlation (r = 0.99). The dose-length-product was 11.5 ± 4.1 mGy × cm using Sn100kV and 50.4 ± 24.9 mGy × cm using the standard 120 kV protocol (p < 0.01), resulting in a significantly lower (77%) effective dose at Sn100kV (0.16 ± 0.06 mSv vs. 0.71 ± 0.35 mSv, p < 0.01). Additionally, 99% of the patients were classified into the same risk category (0, 1-10, 11-100, 101-400, or >400) using the Sn100kV protocol. CONCLUSION: CACS at Sn100kV using the kV-independent iterative algorithm is feasible and provides high accuracy when compared to standard 120 kV scanning. Furthermore, radiation dose can be significantly reduced for this screening application in a priori healthy individuals.
Authors: S Baumann; D Overhoff; C Tesche; G Korosoglou; S Kelle; M Nassar; S J Buss; F Andre; M Renker; U J Schoepf; I Akin; S Waldeck; S O Schoenberg; D Lossnitzer Journal: Herz Date: 2022-03-04 Impact factor: 1.443
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Authors: Niels R van der Werf; Ronald Booij; Bernhard Schmidt; Thomas G Flohr; Tim Leiner; Joël J de Groen; Daniël Bos; Ricardo P J Budde; Martin J Willemink; Marcel J W Greuter Journal: Eur Radiol Date: 2021-05-28 Impact factor: 5.315