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Erschienen in: European Radiology 9/2014

01.09.2014 | Cardiac

The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring

verfasst von: Martin J. Willemink, Richard A. P. Takx, Pim A. de Jong, Ricardo P. J. Budde, Ronald L. A. W. Bleys, Marco Das, Joachim E. Wildberger, Mathias Prokop, Nico Buls, Johan de Mey, Arnold M. R. Schilham, Tim Leiner

Erschienen in: European Radiology | Ausgabe 9/2014

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Abstract

Objectives

To analyse the effects of radiation dose reduction and iterative reconstruction (IR) algorithms on coronary calcium scoring (CCS).

Methods

Fifteen ex vivo human hearts were examined in an anthropomorphic chest phantom using computed tomography (CT) systems from four vendors and examined at four dose levels using unenhanced prospectively ECG-triggered protocols. Tube voltage was 120 kV and tube current differed between protocols. CT data were reconstructed with filtered back projection (FBP) and reduced dose CT data with IR. CCS was quantified with Agatston scores, calcification mass and calcification volume. Differences were analysed with the Friedman test.

Results

Fourteen hearts showed coronary calcifications. Dose reduction with FBP did not significantly change Agatston scores, calcification volumes and calcification masses (P > 0.05). Maximum differences in Agatston scores were 76, 26, 51 and 161 units, in calcification volume 97, 27, 42 and 162 mm3, and in calcification mass 23, 23, 20 and 48 mg, respectively. IR resulted in a trend towards lower Agatston scores and calcification volumes with significant differences for one vendor (P < 0.05). Median relative differences between reference FBP and reduced dose IR for Agatston scores remained within 2.0–4.6 %, 1.0–5.3 %, 1.2–7.7 % and 2.6–4.5 %, for calcification volumes within 2.4–3.9 %, 1.0–5.6 %, 1.1–6.4 % and 3.7–4.7 %, for calcification masses within 1.9–4.1 %, 0.9–7.8 %, 2.9–4.7 % and 2.5–3.9 %, respectively. IR resulted in increased, decreased or similar calcification masses.

Conclusions

CCS derived from standard FBP acquisitions was not affected by radiation dose reductions up to 80 %. IR resulted in a trend towards lower Agatston scores and calcification volumes.

Key points

• In this ex vivo study, radiation dose could be reduced by 80 % for coronary calcium scoring
• Iterative reconstruction resulted in a trend towards lower Agatston scores and calcification volumes
• Caution should be taken for coronary calcium scoring with iterative reconstruction
Literatur
1.
Zurück zum Zitat Greenland P, Alpert JS, Beller GA et al (2010) 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 56:e50–e103PubMedCrossRef Greenland P, Alpert JS, Beller GA et al (2010) 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 56:e50–e103PubMedCrossRef
2.
Zurück zum Zitat Lloyd-Jones D, Adams RJ, Brown TM et al (2010) Heart disease and stroke statistics–2010 update: a report from the American Heart Association. Circulation 121:e46–e215PubMedCrossRef Lloyd-Jones D, Adams RJ, Brown TM et al (2010) Heart disease and stroke statistics–2010 update: a report from the American Heart Association. Circulation 121:e46–e215PubMedCrossRef
3.
Zurück zum Zitat Vliegenthart R, Oudkerk M, Hofman A et al (2005) Coronary calcification improves cardiovascular risk prediction in the elderly. Circulation 112:572–577PubMedCrossRef Vliegenthart R, Oudkerk M, Hofman A et al (2005) Coronary calcification improves cardiovascular risk prediction in the elderly. Circulation 112:572–577PubMedCrossRef
4.
Zurück zum Zitat Detrano R, Guerci AD, Carr JJ et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345PubMedCrossRef Detrano R, Guerci AD, Carr JJ et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345PubMedCrossRef
5.
Zurück zum Zitat Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215PubMedCrossRef Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215PubMedCrossRef
6.
Zurück zum Zitat Rumberger JA, Brundage BH, Rader DJ, Kondos G (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74:243–252PubMedCrossRef Rumberger JA, Brundage BH, Rader DJ, Kondos G (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74:243–252PubMedCrossRef
7.
Zurück zum Zitat Jacobs PC, Gondrie MJ, van der Graaf Y et al (2012) Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer. AJR Am J Roentgenol 198:505–511PubMedCrossRef Jacobs PC, Gondrie MJ, van der Graaf Y et al (2012) Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer. AJR Am J Roentgenol 198:505–511PubMedCrossRef
8.
Zurück zum Zitat Lu B, Budoff MJ, Zhuang N et al (2002) Causes of interscan variability of coronary artery calcium measurements at electron-beam CT. Acad Radiol 9:654–661PubMedCrossRef Lu B, Budoff MJ, Zhuang N et al (2002) Causes of interscan variability of coronary artery calcium measurements at electron-beam CT. Acad Radiol 9:654–661PubMedCrossRef
9.
Zurück zum Zitat McCollough CH, Ulzheimer S, Halliburton SS, Shanneik K, White RD, Kalender WA (2007) Coronary artery calcium: a multi-institutional, multimanufacturer international standard for quantification at cardiac CT. Radiology 243:527–538PubMedCrossRef McCollough CH, Ulzheimer S, Halliburton SS, Shanneik K, White RD, Kalender WA (2007) Coronary artery calcium: a multi-institutional, multimanufacturer international standard for quantification at cardiac CT. Radiology 243:527–538PubMedCrossRef
10.
Zurück zum Zitat Braunwald E (2006) Epilogue: what do clinicians expect from imagers? J Am Coll Cardiol 47:C101–C103PubMedCrossRef Braunwald E (2006) Epilogue: what do clinicians expect from imagers? J Am Coll Cardiol 47:C101–C103PubMedCrossRef
11.
12.
Zurück zum Zitat Kim KP, Einstein AJ, de Berrington GA (2009) Coronary artery calcification screening: estimated radiation dose and cancer risk. Arch Intern Med 169:1188–1194PubMedCentralPubMedCrossRef Kim KP, Einstein AJ, de Berrington GA (2009) Coronary artery calcification screening: estimated radiation dose and cancer risk. Arch Intern Med 169:1188–1194PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Willemink MJ, de Jong PA, Leiner T et al (2013) Iterative reconstruction techniques for computed tomography Part 1: technical principles. Eur Radiol 23:1623–1631PubMedCrossRef Willemink MJ, de Jong PA, Leiner T et al (2013) Iterative reconstruction techniques for computed tomography Part 1: technical principles. Eur Radiol 23:1623–1631PubMedCrossRef
14.
Zurück zum Zitat Willemink MJ, Leiner T, de Jong PA et al (2013) Iterative reconstruction techniques for computed tomography part 2: initial results in dose reduction and image quality. Eur Radiol 23:1632–1642PubMedCrossRef Willemink MJ, Leiner T, de Jong PA et al (2013) Iterative reconstruction techniques for computed tomography part 2: initial results in dose reduction and image quality. Eur Radiol 23:1632–1642PubMedCrossRef
15.
Zurück zum Zitat Mohlenkamp S, Behrenbeck TR, Pump H et al (2001) Reproducibility of two coronary calcium quantification algorithms in patients with different degrees of calcification. Int J Cardiovasc Imaging 17:133–142PubMedCrossRef Mohlenkamp S, Behrenbeck TR, Pump H et al (2001) Reproducibility of two coronary calcium quantification algorithms in patients with different degrees of calcification. Int J Cardiovasc Imaging 17:133–142PubMedCrossRef
16.
Zurück zum Zitat Rutten A, Isgum I, Prokop M (2008) Coronary calcification: effect of small variation of scan starting position on Agatston, volume, and mass scores. Radiology 246:90–98PubMedCrossRef Rutten A, Isgum I, Prokop M (2008) Coronary calcification: effect of small variation of scan starting position on Agatston, volume, and mass scores. Radiology 246:90–98PubMedCrossRef
17.
Zurück zum Zitat Oudkerk M, Stillman AE, Halliburton SS et al (2008) Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging. Eur Radiol 18:2785–2807PubMedCrossRef Oudkerk M, Stillman AE, Halliburton SS et al (2008) Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging. Eur Radiol 18:2785–2807PubMedCrossRef
18.
Zurück zum Zitat Ghadri JR, Goetti R, Fiechter M et al (2011) Inter-scan variability of coronary artery calcium scoring assessed on 64-multidetector computed tomography vs. dual-source computed tomography: a head-to-head comparison. Eur Heart J 32:1865–1874PubMedCrossRef Ghadri JR, Goetti R, Fiechter M et al (2011) Inter-scan variability of coronary artery calcium scoring assessed on 64-multidetector computed tomography vs. dual-source computed tomography: a head-to-head comparison. Eur Heart J 32:1865–1874PubMedCrossRef
19.
Zurück zum Zitat Gebhard C, Fiechter M, Fuchs TA et al (2012) Coronary artery calcium scoring: influence of adaptive statistical iterative reconstruction using 64-MDCT. Int J Cardiol 167:2932–2937PubMedCrossRef Gebhard C, Fiechter M, Fuchs TA et al (2012) Coronary artery calcium scoring: influence of adaptive statistical iterative reconstruction using 64-MDCT. Int J Cardiol 167:2932–2937PubMedCrossRef
20.
Zurück zum Zitat Funabashi N, Irie R, Aiba M et al (2013) Adaptive-iterative-dose-reduction 3D with multisector-reconstruction method in 320-slice CT may maintain accurate-measurement of the Agatston-calcium-score of severe-calcification even at higher pulsating-beats and low tube-current in vitro. Int J Cardiol 168:601–603PubMedCrossRef Funabashi N, Irie R, Aiba M et al (2013) Adaptive-iterative-dose-reduction 3D with multisector-reconstruction method in 320-slice CT may maintain accurate-measurement of the Agatston-calcium-score of severe-calcification even at higher pulsating-beats and low tube-current in vitro. Int J Cardiol 168:601–603PubMedCrossRef
21.
Zurück zum Zitat Love A, Olsson ML, Siemund R, Stalhammar F, Bjorkman-Burtscher IM, Soderberg M (2013) Six iterative reconstruction algorithms in brain CT: a phantom study on image quality at different radiation dose levels. Br J Radiol 86:20130388PubMedCrossRef Love A, Olsson ML, Siemund R, Stalhammar F, Bjorkman-Burtscher IM, Soderberg M (2013) Six iterative reconstruction algorithms in brain CT: a phantom study on image quality at different radiation dose levels. Br J Radiol 86:20130388PubMedCrossRef
22.
Zurück zum Zitat Budoff MJ, Kessler P, Gao YL, Qunibi W, Moustafa M, Mao SS (2008) The interscan variation of CT coronary artery calcification score: analysis of the calcium acetate renagel comparison (CARE)-2 study. Acad Radiol 15:58–61PubMedCrossRef Budoff MJ, Kessler P, Gao YL, Qunibi W, Moustafa M, Mao SS (2008) The interscan variation of CT coronary artery calcification score: analysis of the calcium acetate renagel comparison (CARE)-2 study. Acad Radiol 15:58–61PubMedCrossRef
Metadaten
Titel
The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring
verfasst von
Martin J. Willemink
Richard A. P. Takx
Pim A. de Jong
Ricardo P. J. Budde
Ronald L. A. W. Bleys
Marco Das
Joachim E. Wildberger
Mathias Prokop
Nico Buls
Johan de Mey
Arnold M. R. Schilham
Tim Leiner
Publikationsdatum
01.09.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 9/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3217-7

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