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04.02.2016 | Cardiac

Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3^rd generation dual-source CT

verfasst von: Stefanie Mangold, Julian L. Wichmann, U. Joseph Schoepf, Zachary B. Poole, Christian Canstein, Akos Varga-Szemes, Damiano Caruso, Fabian Bamberg, Konstantin Nikolaou, Carlo N. De Cecco

Erschienen in: European Radiology | Ausgabe 10/2016

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Abstract

Objectives

To investigate the relationship between automated tube voltage selection (ATVS) and body mass index (BMI) and its effect on image quality and radiation dose of coronary CT angiography (CCTA).

Methods

We evaluated 272 patients who underwent CCTA with 3^rd generation dual-source CT (DSCT). Prospectively ECG-triggered spiral acquisition was performed with automated tube current selection and advanced iterative reconstruction. Tube voltages were selected by ATVS (70-120 kV). BMI, effective dose (ED), and vascular attenuation in the coronary arteries were recorded. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Five-point scales were used for subjective image quality analysis.

Results

Image quality was rated good to excellent in 98.9 % of examinations without significant differences for proximal and distal attenuation (all p ≥ .0516), whereas image noise was rated significantly higher at 70 kV compared to ≥100 kV (all p < .0266). However, no significant differences were observed in SNR or CNR at 70–120 kV (all p ≥ .0829). Mean ED at 70-120 kV was 1.5 ± 1.2 mSv, 2.4 ± 1.5 mSv, 3.6 ± 2.7 mSv, 5.9 ± 4.0 mSv, 7.9 ± 4.2 mSv, and 10.7 ± 4.1 mSv, respectively (all p ≤ .0414). Correlation analysis showed a moderate association between tube voltage and BMI (r = .639).

Conclusion

ATVS allows individual tube voltage adaptation for CCTA performed with 3^rd generation DSCT, resulting in significantly decreased radiation exposure while maintaining image quality.

Key Points

• Automated tube voltage selection allows an individual tube voltage adaption in CCTA.

• A tube voltage-based reduction of contrast medium volume is feasible.

• Image quality was maintained while radiation exposure was significantly decreased.

• A moderate association between tube voltage and body mass index was found.

Nur mit Berechtigung zugänglich

Meyer M, Haubenreisser H, Schoepf UJ et al (2014) Closing in on the K edge: coronary CT angiography at 100, 80, and 70 kV-initial comparison of a second- versus a third-generation dual-source CT system. Radiology 273:373–382CrossRefPubMed

Zhang LJ, Zhao YE, Schoepf UJ et al (2015) Seventy-Peak Kilovoltage high-pitch thoracic aortic CT angiography without ECG gating: evaluation of image quality and radiation dose. Acad Radiol 22:890–897CrossRefPubMed

Zhang LJ, Qi L, Wang J et al (2014) Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience. Eur Radiol 24:1537–1546CrossRefPubMed

Lu GM, Luo S, Meinel FG et al (2014) High-pitch computed tomography pulmonary angiography with iterative reconstruction at 80 kVp and 20 mL contrast agent volume. Eur Radiol 24:3260–3268CrossRefPubMed

Hell MM, Bittner D, Schuhbaeck A et al (2014) 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. J Cardiovasc Comput Tomogr 8:418–425CrossRefPubMed

Hu L, Wang Y, Hou H, Wei F, Yang G, Chen Y (2014) Radiation dose and image quality with abdominal computed tomography with automated dose-optimized tube voltage selection. J Int Med Res 42:1011–1017CrossRefPubMed

Winklehner A, Gordic S, Lauk E et al (2015) Automated attenuation-based tube voltage selection for body CTA: performance evaluation of 192-slice dual-source CT. Eur Radiol 25:2346–2353CrossRefPubMed

Winklehner A, Goetti R, Baumueller S et al (2011) Automated attenuation-based tube potential selection for thoracoabdominal computed tomography angiography: improved dose effectiveness. Invest Radiol 46:767–773CrossRefPubMed

Goetti R, Winklehner A, Gordic S et al (2012) Automated attenuation-based kilovoltage selection: preliminary observations in patients after endovascular aneurysm repair of the abdominal aorta. AJR Am J Roentgenol 199:W380–385CrossRefPubMed

10.

Siegel MJ, Ramirez-Giraldo JC, Hildebolt C, Bradley D, Schmidt B (2013) Automated low-kilovoltage selection in pediatric computed tomography angiography: phantom study evaluating effects on radiation dose and image quality. Invest Radiol 48:584–589CrossRefPubMed

11.

Schwarz F, Grandl K, Arnoldi A et al (2013) Lowering radiation exposure in CT angiography using automated tube potential selection and optimized iodine delivery rate. AJR Am J Roentgenol 200:W628–634CrossRefPubMed

12.

Layritz C, Muschiol G, Flohr T et al (2013) Automated attenuation-based selection of tube voltage and tube current for coronary CT angiography: reduction of radiation exposure versus a BMI-based strategy with an expert investigator. J Cardiovasc Comput Tomogr 7:303–310CrossRefPubMed

13.

Lurz M, Lell MM, Wuest W et al (2015) Automated tube voltage selection in thoracoabdominal computed tomography at high pitch using a third-generation dual-source scanner: image quality and radiation dose performance. Invest Radiol 50:352–360CrossRefPubMed

14.

Krazinski AW, Meinel FG, Schoepf UJ et al (2014) Reduced radiation dose and improved image quality at cardiovascular CT angiography by automated attenuation-based tube voltage selection: intra-individual comparison. Eur Radiol 24:2677–2684CrossRefPubMed

15.

Spearman JV, Schoepf UJ, Rottenkolber M et al (2015) Effect of automated attenuation-based tube voltage selection on radiation dose at CT: an observational study on a global scale. radiology

16.

Meinel FG, Canstein C, Schoepf UJ et al (2014) Image quality and radiation dose of low tube voltage 3rd generation dual-source coronary CT angiography in obese patients: a phantom study. Eur Radiol 24:1643–1650CrossRefPubMed

17.

Austen WG, Edwards JE, Frye RL et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40CrossRefPubMed

18.

Szucs-Farkas Z, Strautz T, Patak MA, Kurmann L, Vock P, Schindera ST (2009) Is body weight the most appropriate criterion to select patients eligible for low-dose pulmonary CT angiography? Analysis of objective and subjective image quality at 80 kVp in 100 patients. Eur Radiol 19:1914–1922CrossRefPubMed

19.

Yuan R, Shuman WP, Earls JP et al (2012) Reduced iodine load at CT pulmonary angiography with dual-energy monochromatic imaging: comparison with standard CT pulmonary angiography--a prospective randomized trial. Radiology 262:290–297CrossRefPubMed

20.

Christner JA, Braun NN, Jacobsen MC, Carter RE, Kofler JM, McCollough CH (2012) Size-specific dose estimates for adult patients at CT of the torso. Radiology 265:841–847CrossRefPubMed

21.

Deak PD, Smal Y, Kalender WA (2010) Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 257:158–166CrossRefPubMed

22.

Boone JM SK, Cody DD, McCollough CH, McNitt-Gray MF, Toth TL (2011) Size-specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations. Report of Am Assoc Phys Med AAPM Task Group 204 2011 College Park, Md: American Association of Physicists in Medicine

23.

Geyer LL, Glenn GR, De Cecco CN et al (2015) CT evaluation of small-diameter coronary artery stents: effect of an integrated circuit detector with iterative reconstruction. Radiology 276:706–714CrossRefPubMed

24.

Wang R, Schoepf UJ, Wu R et al (2012) Image quality and radiation dose of low dose coronary CT angiography in obese patients: sinogram affirmed iterative reconstruction versus filtered back projection. Eur J Radiol 81:3141–3145CrossRefPubMed

25.

Wang R, Schoepf UJ, Wu R et al (2014) Diagnostic accuracy of coronary CT angiography: comparison of filtered back projection and iterative reconstruction with different strengths. J Comput Assist Tomogr 38:179–184CrossRefPubMed

26.

Moscariello A, Takx RA, Schoepf UJ et al (2011) Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique-comparison with traditional filtered back projection. Eur Radiol 21:2130–2138CrossRefPubMed

27.

Gordic S, Desbiolles L, Stolzmann P et al (2014) Advanced modelled iterative reconstruction for abdominal CT: qualitative and quantitative evaluation. Clin Radiol 69:e497–504CrossRefPubMed

28.

Moore BM, Brady SL, Mirro AE, Kaufman RA (2014) Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations. Med Phys 41:071917CrossRefPubMed

29.

Leschka S, Stinn B, Schmid F et al (2009) Dual source CT coronary angiography in severely obese patients: trading off temporal resolution and image noise. Invest Radiol 44:720–727CrossRefPubMed

30.

Lee AM, Engel LC, Hui GC et al (2014) Coronary computed tomography angiography at 140 kV versus 120 kV: assessment of image quality and radiation exposure in overweight and moderately obese patients. Acta Radiol 55:554–562CrossRefPubMed

Titel: Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3rd generation dual-source CT
verfasst von: Stefanie Mangold
Julian L. Wichmann
U. Joseph Schoepf
Zachary B. Poole
Christian Canstein
Akos Varga-Szemes
Damiano Caruso
Fabian Bamberg
Konstantin Nikolaou
Carlo N. De Cecco
Publikationsdatum: 04.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4191-4

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Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3^rd generation dual-source CT