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Erschienen in: European Radiology 3/2011

01.03.2011 | Cardiac

Dose levels at coronary CT angiography—a comparison of Dual Energy-, Dual Source- and 16-slice CT

verfasst von: J. Matthias Kerl, Ralf W. Bauer, Tobias B. Maurer, Rene Aschenbach, Huedayi Korkusuz, Thomas Lehnert, Simon Deseive, Hanns Ackermann, Thomas J. Vogl

Erschienen in: European Radiology | Ausgabe 3/2011

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Abstract

Purpose

To compare the dose estimates and image quality of Dual Energy CT (DECT), Dual Source CT (DSCT) and 16-slice CT for coronary CT angiography (cCTA).

Methods

Sixty-eight patients were examined with 16 - slice MDCT (group 1), 68 patients with DSCT (group 2) and 68 patients using DSCT in dual energy mode (DECT group 3). CT dose index volume, dose length product, effective dose, signal-to-noise, and contrast-to-noise ratio were compared. Subjective image quality was rated by two observers, blinded to technique.

Results

The mean estimated radiation dose of all patients investigated on a 16 - slice MDCT was 12 ± 3.59 mSv, for DSCT in single energy 9.8 ± 4.77 mSv and for DECT 4.54 ± 1.87 mSv. Dose for CTA was significantly lower in group 3 compared to group 1 and 2. The image noise was significantly lower in Group 2 in comparison to group 1 and group 3. There was no significant difference in diagnostic image quality comparing DECT and DSCT.

Conclusion

cCTA shows better dose levels at both DECT and DSCT compared to 16-slice CT. Further, DECT delivers significantly less dose than regular DSCT or single source single energy cCTA while maintaining diagnostic image quality.
Literatur
1.
Zurück zum Zitat Schoepf UJ, Zwerner PL, Savino G, Herzog C, Kerl JM, Costello P (2007) Coronary CT angiography. Radiology 244:48–63CrossRefPubMed Schoepf UJ, Zwerner PL, Savino G, Herzog C, Kerl JM, Costello P (2007) Coronary CT angiography. Radiology 244:48–63CrossRefPubMed
2.
Zurück zum Zitat Achenbach S (2006) Computed tomography coronary angiography. J Am Coll Cardiol 48:1919–1928CrossRefPubMed Achenbach S (2006) Computed tomography coronary angiography. J Am Coll Cardiol 48:1919–1928CrossRefPubMed
3.
Zurück zum Zitat Budoff MJ, Achenbach S, Blumenthal RS et al (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114:1761–1791CrossRefPubMed Budoff MJ, Achenbach S, Blumenthal RS et al (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114:1761–1791CrossRefPubMed
4.
Zurück zum Zitat Hendel RC, Patel MR, Kramer CM et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 48:1475–1497CrossRefPubMed Hendel RC, Patel MR, Kramer CM et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 48:1475–1497CrossRefPubMed
5.
Zurück zum Zitat Heyer CM, Mohr PS, Lemburg SP, Peters SA, Nicolas V (2007) Image quality and radiation exposure at pulmonary CT angiography with 100- or 120-kVp protocol: prospective randomized study. Radiology 245:577–583CrossRefPubMed Heyer CM, Mohr PS, Lemburg SP, Peters SA, Nicolas V (2007) Image quality and radiation exposure at pulmonary CT angiography with 100- or 120-kVp protocol: prospective randomized study. Radiology 245:577–583CrossRefPubMed
6.
Zurück zum Zitat Fink C, Johnson TR, Michaely HJ et al (2008) Dual-energy CT angiography of the lung in patients with suspected pulmonary embolism: initial results. Rofo 180:879–883PubMed Fink C, Johnson TR, Michaely HJ et al (2008) Dual-energy CT angiography of the lung in patients with suspected pulmonary embolism: initial results. Rofo 180:879–883PubMed
7.
Zurück zum Zitat Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517CrossRefPubMed Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517CrossRefPubMed
8.
Zurück zum Zitat Marin D, Nelson RC, Schindera ST et al (2010) Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm—initial clinical experience. Radiology 254:145–153 Marin D, Nelson RC, Schindera ST et al (2010) Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm—initial clinical experience. Radiology 254:145–153
9.
Zurück zum Zitat Waaijer A, Prokop M, Velthuis BK, Bakker CJ, de Kort GA, van Leeuwen MS (2007) Circle of Willis at CT angiography: dose reduction and image quality-reducing tube voltage and increasing tube current settings. Radiology 242:832–839CrossRefPubMed Waaijer A, Prokop M, Velthuis BK, Bakker CJ, de Kort GA, van Leeuwen MS (2007) Circle of Willis at CT angiography: dose reduction and image quality-reducing tube voltage and increasing tube current settings. Radiology 242:832–839CrossRefPubMed
10.
Zurück zum Zitat Sahani DV, Kalva SP, Hahn PF, Saini S (2007) 16-MDCT angiography in living kidney donors at various tube potentials: impact on image quality and radiation dose. AJR Am J Roentgenol 188:115–120CrossRefPubMed Sahani DV, Kalva SP, Hahn PF, Saini S (2007) 16-MDCT angiography in living kidney donors at various tube potentials: impact on image quality and radiation dose. AJR Am J Roentgenol 188:115–120CrossRefPubMed
11.
Zurück zum Zitat Schindera ST, Nelson RC, Toth TL et al (2008) Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. AJR Am J Roentgenol 190:W100–W105CrossRefPubMed Schindera ST, Nelson RC, Toth TL et al (2008) Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. AJR Am J Roentgenol 190:W100–W105CrossRefPubMed
12.
Zurück zum Zitat Ruzsics B, Lee H, Powers ER, Flohr TG, Costello P, Schoepf UJ (2008) Images in cardiovascular medicine. Myocardial ischemia diagnosed by dual-energy computed tomography: correlation with single-photon emission computed tomography. Circulation 117:1244–1245CrossRefPubMed Ruzsics B, Lee H, Powers ER, Flohr TG, Costello P, Schoepf UJ (2008) Images in cardiovascular medicine. Myocardial ischemia diagnosed by dual-energy computed tomography: correlation with single-photon emission computed tomography. Circulation 117:1244–1245CrossRefPubMed
13.
Zurück zum Zitat Ruzsics B, Lee H, Zwerner PL, Gebregziabher M, Costello P, Schoepf UJ (2008) Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur Radiol 18:2414–2424CrossRefPubMed Ruzsics B, Lee H, Zwerner PL, Gebregziabher M, Costello P, Schoepf UJ (2008) Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur Radiol 18:2414–2424CrossRefPubMed
14.
Zurück zum Zitat Yates SJ, Pike LC, Goldstone KE (2004) Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. Br J Radiol 77:472–478CrossRefPubMed Yates SJ, Pike LC, Goldstone KE (2004) Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. Br J Radiol 77:472–478CrossRefPubMed
15.
Zurück zum Zitat Hausleiter J, Meyer T, Hermann F et al (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301:500–507CrossRefPubMed Hausleiter J, Meyer T, Hermann F et al (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301:500–507CrossRefPubMed
16.
Zurück zum Zitat Leschka S, Scheffel H, Desbiolles L et al (2007) Image quality and reconstruction intervals of Dual-Source CT coronary angiography: recommendations for ECG-Pulsing Windowing. Invest Radiol 42:543–549CrossRefPubMed Leschka S, Scheffel H, Desbiolles L et al (2007) Image quality and reconstruction intervals of Dual-Source CT coronary angiography: recommendations for ECG-Pulsing Windowing. Invest Radiol 42:543–549CrossRefPubMed
17.
Zurück zum Zitat Flohr T, Ohnesorge B (2001) Heart rate adaptive optimization of spatial and temporal resolution for electrocardiogram-gated multislice spiral CT of the heart. J Comput Assist Tomogr 25:907–923CrossRefPubMed Flohr T, Ohnesorge B (2001) Heart rate adaptive optimization of spatial and temporal resolution for electrocardiogram-gated multislice spiral CT of the heart. J Comput Assist Tomogr 25:907–923CrossRefPubMed
18.
Zurück zum Zitat Stolzmann P, Scheffel H, Schertler T et al (2008) Radiation dose estimates in dual-source computed tomography coronary angiography. Eur Radiol 18:592–599CrossRefPubMed Stolzmann P, Scheffel H, Schertler T et al (2008) Radiation dose estimates in dual-source computed tomography coronary angiography. Eur Radiol 18:592–599CrossRefPubMed
19.
Zurück zum Zitat Huda W, Ogden KM, Khorasani MR (2008) Converting dose-length product to effective dose at CT. Radiology 248:995–1003CrossRefPubMed Huda W, Ogden KM, Khorasani MR (2008) Converting dose-length product to effective dose at CT. Radiology 248:995–1003CrossRefPubMed
20.
Zurück zum Zitat 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(4 Suppl):5–40PubMed 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(4 Suppl):5–40PubMed
21.
Zurück zum Zitat Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
22.
Zurück zum Zitat McCollough CH, Primak AN, Saba O et al (2007) Dose performance of a 64-channel dual-source CT scanner. Radiology 243:775–784CrossRefPubMed McCollough CH, Primak AN, Saba O et al (2007) Dose performance of a 64-channel dual-source CT scanner. Radiology 243:775–784CrossRefPubMed
23.
Zurück zum Zitat Husmann L, Valenta I, Gaemperli O et al (2008) Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J 29:191–197CrossRefPubMed Husmann L, Valenta I, Gaemperli O et al (2008) Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J 29:191–197CrossRefPubMed
24.
Zurück zum Zitat Shuman WP, Branch KR, May JM et al (2008) Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Radiology 248:431–437CrossRefPubMed Shuman WP, Branch KR, May JM et al (2008) Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Radiology 248:431–437CrossRefPubMed
25.
Zurück zum Zitat Hirai N, Horiguchi J, Fujioka C et al (2008) Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. Radiology 248:424–430CrossRefPubMed Hirai N, Horiguchi J, Fujioka C et al (2008) Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. Radiology 248:424–430CrossRefPubMed
26.
Zurück zum Zitat Alkadhi H, Stolzmann P, Scheffel H et al (2008) Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol 68:385–391CrossRefPubMed Alkadhi H, Stolzmann P, Scheffel H et al (2008) Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol 68:385–391CrossRefPubMed
27.
Zurück zum Zitat Leschka S, Stolzmann P, Schmid FT et al (2008) Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur Radiol 18:1809–1817CrossRefPubMed Leschka S, Stolzmann P, Schmid FT et al (2008) Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur Radiol 18:1809–1817CrossRefPubMed
28.
Zurück zum Zitat Hausleiter J, Meyer T, Hadamitzky M et al (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 113:1305–1310CrossRefPubMed Hausleiter J, Meyer T, Hadamitzky M et al (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 113:1305–1310CrossRefPubMed
29.
Zurück zum Zitat Pflederer T, Rudofsky L, Ropers D et al (2009) Image quality in a low radiation exposure protocol for retrospectively ECG-gated coronary CT angiography. AJR Am J Roentgenol 192:1045–1050CrossRefPubMed Pflederer T, Rudofsky L, Ropers D et al (2009) Image quality in a low radiation exposure protocol for retrospectively ECG-gated coronary CT angiography. AJR Am J Roentgenol 192:1045–1050CrossRefPubMed
30.
Zurück zum Zitat Stolzmann P, Donati OF, Scheffel H et al (2010) Low-dose CT coronary angiography for the prediction of myocardial ischaemia. Eur Radiol 20:56–64 Stolzmann P, Donati OF, Scheffel H et al (2010) Low-dose CT coronary angiography for the prediction of myocardial ischaemia. Eur Radiol 20:56–64
31.
Zurück zum Zitat Huda W, Scalzetti EM, Levin G (2000) Technique factors and image quality as functions of patient weight at abdominal CT. Radiology 217:430–435PubMed Huda W, Scalzetti EM, Levin G (2000) Technique factors and image quality as functions of patient weight at abdominal CT. Radiology 217:430–435PubMed
32.
Zurück zum Zitat Nakayama Y, Awai K, Funama Y et al (2005) Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology 237:945–951CrossRefPubMed Nakayama Y, Awai K, Funama Y et al (2005) Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology 237:945–951CrossRefPubMed
33.
Zurück zum Zitat Boone JM, Geraghty EM, Seibert JA, Wootton-Gorges SL (2003) Dose reduction in pediatric CT: a rational approach. Radiology 228:352–360CrossRefPubMed Boone JM, Geraghty EM, Seibert JA, Wootton-Gorges SL (2003) Dose reduction in pediatric CT: a rational approach. Radiology 228:352–360CrossRefPubMed
34.
Zurück zum Zitat Rixe J, Conradi G, Rolf A et al (2009) Radiation dose exposure of computed tomography coronary angiography: comparison of dual-source, 16-slice and 64-slice CT. Heart 95:1337–1342CrossRefPubMed Rixe J, Conradi G, Rolf A et al (2009) Radiation dose exposure of computed tomography coronary angiography: comparison of dual-source, 16-slice and 64-slice CT. Heart 95:1337–1342CrossRefPubMed
35.
Zurück zum Zitat Klass O, Jeltsch M, Feuerlein S et al (2009) Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Eur Radiol 19:829–836CrossRefPubMed Klass O, Jeltsch M, Feuerlein S et al (2009) Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Eur Radiol 19:829–836CrossRefPubMed
36.
Zurück zum Zitat Lell M, Marwan M, Schepis T et al (2009) Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 19:2576–2583CrossRefPubMed Lell M, Marwan M, Schepis T et al (2009) Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 19:2576–2583CrossRefPubMed
37.
Zurück zum Zitat Ertel D, Lell MM, Harig F, Flohr T, Schmidt B, Kalender WA (2009) Cardiac spiral dual-source CT with high pitch: a feasibility study. Eur Radiol 19:2357–2362CrossRefPubMed Ertel D, Lell MM, Harig F, Flohr T, Schmidt B, Kalender WA (2009) Cardiac spiral dual-source CT with high pitch: a feasibility study. Eur Radiol 19:2357–2362CrossRefPubMed
38.
Zurück zum Zitat Sigal-Cinqualbre AB, Hennequin R, Abada HT, Chen X, Paul JF (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174CrossRefPubMed Sigal-Cinqualbre AB, Hennequin R, Abada HT, Chen X, Paul JF (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174CrossRefPubMed
39.
Zurück zum Zitat Rist C, Nikolaou K, Kirchin MA et al (2006) Contrast bolus optimization for cardiac 16-slice computed tomography: comparison of contrast medium formulations containing 300 and 400 milligrams of iodine per milliliter. Invest Radiol 41:460–467CrossRefPubMed Rist C, Nikolaou K, Kirchin MA et al (2006) Contrast bolus optimization for cardiac 16-slice computed tomography: comparison of contrast medium formulations containing 300 and 400 milligrams of iodine per milliliter. Invest Radiol 41:460–467CrossRefPubMed
40.
Zurück zum Zitat Juergens KU, Fischbach R (2006) Left ventricular function studied with MDCT. Eur Radiol 16:342–357CrossRefPubMed Juergens KU, Fischbach R (2006) Left ventricular function studied with MDCT. Eur Radiol 16:342–357CrossRefPubMed
41.
Zurück zum Zitat Alkadhi H, Desbiolles L, Husmann L et al (2007) Aortic regurgitation: assessment with 64-section CT. Radiology 245:111–121CrossRefPubMed Alkadhi H, Desbiolles L, Husmann L et al (2007) Aortic regurgitation: assessment with 64-section CT. Radiology 245:111–121CrossRefPubMed
Metadaten
Titel
Dose levels at coronary CT angiography—a comparison of Dual Energy-, Dual Source- and 16-slice CT
verfasst von
J. Matthias Kerl
Ralf W. Bauer
Tobias B. Maurer
Rene Aschenbach
Huedayi Korkusuz
Thomas Lehnert
Simon Deseive
Hanns Ackermann
Thomas J. Vogl
Publikationsdatum
01.03.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 3/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1954-9

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