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Dose levels and image quality of second-generation 128-slice dual-source coronary CT angiography in clinical routine

  • CARDIAC RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objectives

To compare radiation exposure and image quality of second-generation 128-slice dual-source CT (DSCT) coronary angiography (cCTA) protocols.

Materials and methods

We retrospectively analyzed data from four groups with 25 patients, each examined by one of the following DSCT cCTA protocols: prospectively ECG-gated high-pitch (group 1) or sequential (group 2) acquisition, retrospectively ECG-gated acquisition in dual-energy (DECT, group 3) or dual-source (group 4) mode. CT dose index volume, dose length product, estimated radiation dose, contrast-to-noise- and signal-to-noise-ratios were compared. Subjective image quality was rated by two observers blinded to the protocols.

Results

High-pitch DSCT showed a mean estimated radiation dose of 1.27 ± 0.62 mSv, significantly (p < 0.01) lower than sequential (2.04 ± 0.94 mSv), dual-energy (3.97 ± 1.29 mSv) or dual-source (8.11 ± 4.95 mSv) acquisition. Image noise showed no statistical difference (p > 0.91), ranging from 15.2 ± 4.4 (group 2) up to 24.5 ± 22.0 (group 4). Each protocol showed diagnostic image quality in at least 98.1 % of evaluated coronary segments without significant differences (p > 0.05).

Conclusions

Prospectively ECG-gated DSCT protocols enable cCTA with significant dose reduction and consistently diagnostic image quality. In patients requiring retrospectively ECG-gated DSCT for functional analysis or due to arrhythmia, dual-energy mode should be preferred over dual-source mode as it significantly decreases estimated dose without compromising image quality.

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Abbreviations

CAD:

Coronary artery disease

cCTA:

Coronary computed tomography angiography

CNR:

Contrast-to-noise-ratio

CTDIvol :

Volume computed tomography index

DECT:

Dual-energy computed tomography

DLP:

Dose length product

DSCT:

Dual-source computed tomography

ECG:

Electrocardiogram

LCA:

Left coronary artery

RCA:

Right coronary artery

ROI:

Region of interest

SD:

Standard deviation

SNR:

Signal-to-noise-ratio

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Conflict of interest

Ralf W. Bauer and J. Matthias Kerl are on the speakers’ bureau of Siemens Healthcare, Computed Tomography division. However, both co-authors did not analyze or control any data in this study. All other authors have nothing to disclose.

Ethical standards

This retrospective study was approved with waiver of the requirement for informed consent.

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany

    Julian L. Wichmann, Xiaohan Hu, J. Matthias Kerl, Martin Beeres, Claudia Frellesen, Wolfgang Luboldt, Thomas J. Vogl, Ralf W. Bauer & Thomas Lehnert

  2. Department of Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Frankfurt, Frankfurt, Germany

    Alexander Engler

  3. Universitätsklinikum Frankfurt Am Main, Institut für Diagnostische Und Interventionelle Radiologie, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Julian L. Wichmann

Authors
  1. Julian L. Wichmann
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  2. Xiaohan Hu
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  3. Alexander Engler
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  4. J. Matthias Kerl
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  5. Martin Beeres
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  10. Thomas Lehnert
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Correspondence to Julian L. Wichmann.

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Wichmann, J.L., Hu, X., Engler, A. et al. Dose levels and image quality of second-generation 128-slice dual-source coronary CT angiography in clinical routine. Radiol med 120, 1112–1121 (2015). https://doi.org/10.1007/s11547-015-0546-9

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  • DOI: https://doi.org/10.1007/s11547-015-0546-9

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