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21.01.2022 | Computed Tomography

High-strength deep learning image reconstruction in coronary CT angiography at 70-kVp tube voltage significantly improves image quality and reduces both radiation and contrast doses

verfasst von: Wanjiang Li, Kaiyue Diao, Yuting Wen, Tao Shuai, Yongchun You, Jin Zhao, Kai Liao, Chunyan Lu, Jianqun Yu, Yong He, Zhenlin Li

Erschienen in: European Radiology | Ausgabe 5/2022

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Abstract

Objectives

To explore the use of 70-kVp tube voltage combined with high-strength deep learning image reconstruction (DLIR-H) in reducing radiation and contrast doses in coronary CT angiography (CCTA) in patients with body mass index (BMI) < 26 kg/m², in comparison with the conventional scan protocol using 120 kVp and adaptive statistical iterative reconstruction (ASIR-V).

Methods

A total of 100 patients referred to CCTA were prospectively enrolled and randomly divided into two groups: low-dose group (n = 50) with 70 kVp, Smart mA for noise index (NI) of 36HU, contrast dose rate of 16mgI/kg/s, and DLIR-H, and conventional group (n = 50) with 120 kV, Smart mA for NI of 25HU, contrast dose rate of 32mgI/kg/s, and 60%ASIR-V. Radiation and contrast dose, subjective image quality score, and objective image quality measurement (image noise, contrast-noise-ratio (CNR), and signal–noise-ratio (SNR) for vessel) were compared between the two groups.

Results

Low-dose group used significantly reduced contrast dose (23.82 ± 3.69 mL, 50.6% reduction) and radiation dose (0.75 ± 0.14 mSv, 54.5% reduction) compared to the conventional group (48.23 ± 6.38 mL and 1.65 ± 0.66 mSv, respectively) (all p < 0.001). Both groups had similar enhancement in vessels. However, the low-dose group had lower background noise (23.57 ± 4.74 HU vs. 35.04 ± 8.41 HU), higher CNR in RCA (48.63 ± 10.76 vs. 29.32 ± 5.52), LAD (47.33 ± 10.20 vs. 29.27 ± 5.12), and LCX (46.74 ± 9.76 vs. 28.58 ± 5.12) (all p < 0.001) compared to the conventional group.

Conclusions

The use of 70-kVp tube voltage combined with DLIR-H for CCTA in normal size patients significantly reduces radiation dose and contrast dose while further improving image quality compared with the conventional 120-kVp tube voltage with 60%ASIR-V.

Key Points

• The combination of 70-kVp tube voltage and high-strength deep learning image reconstruction (DLIR-H) algorithm protocol reduces approximately 50% of radiation and contrast doses in coronary computed tomography angiography (CCTA) compared with the conventional scan protocol.

• CCTA of normal size (BMI < 26 kg/m²) patients acquired at sub-mSv radiation dose and 24 mL contrast dose through the combination of 70-kVp tube voltage and DLIR-H algorithm achieves excellent diagnostic image quality with a good inter-rater agreement.

• DLIR-H algorithm shows a higher capacity of significantly reducing image noise than adaptive statistical iterative reconstruction algorithm in CCTA examination.

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Titel: High-strength deep learning image reconstruction in coronary CT angiography at 70-kVp tube voltage significantly improves image quality and reduces both radiation and contrast doses
verfasst von: Wanjiang Li
Kaiyue Diao
Yuting Wen
Tao Shuai
Yongchun You
Jin Zhao
Kai Liao
Chunyan Lu
Jianqun Yu
Yong He
Zhenlin Li
Publikationsdatum: 21.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 5/2022
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08424-5

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High-strength deep learning image reconstruction in coronary CT angiography at 70-kVp tube voltage significantly improves image quality and reduces both radiation and contrast doses