Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction
- 1.6k Downloads
We evaluated the potential of prospectively ECG-triggered high-pitch spiral acquisition with low tube voltage and current in combination with iterative reconstruction to achieve coronary CT angiography with sufficient image quality at an effective dose below 0.1 mSv.
Contrast-enhanced coronary dual source CT angiography (2 × 128 × 0.6 mm, 80 kV, 50 mAs) in prospectively ECG-triggered high-pitch spiral acquisition mode was performed in 21 consecutive individuals (body weight <100 kg, heart rate ≤60/min). Images were reconstructed with raw data-based filtered back projection (FBP) and iterative reconstruction (IR). Image quality was assessed on a 4-point scale (1 = no artefacts, 4 = unevaluable).
Mean effective dose was 0.06 ± 0.01 mSv. Image noise was significantly reduced in IR (128.9 ± 46.6 vs. 158.2 ± 44.7 HU). The mean image quality score was lower for IR (1.9 ± 1.1 vs. 2.2 ± 1.0, P < 0.0001). Of 292 coronary segments, 55 in FBP and 40 in IR (P = 0.12) were graded “unevaluable”. In patients with a body weight ≤75 kg, both in FBP and in IR, the rates of fully evaluable segments were significantly higher in comparison to patients >75 kg.
Coronary CT angiography with an estimated effective dose <0.1 mSv may provide sufficient image quality in selected patients through the combination of high-pitch spiral acquisition and raw data-based iterative reconstruction.
• Coronary CT angiography with an estimated effective dose <0.1 mSv is possible.
• Combination of high-pitch spiral acquisition with iterative reconstruction achieves sufficient image quality.
• Diagnostic accuracy remains to be assessed in future trials.
KeywordsUltra low-dose coronary CT angiography High-pitch spiral acquisition Dual source CT Iterative reconstruction Image quality
This study was supported by the German Government, Bundesministerium für Bildung und Forschung (01EX1012B, “Spitzencluster Medical Valley”)
- 2.Budoff MJ, Dowe D, Jollis JG et al (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 52:1724–1732PubMedCrossRefGoogle Scholar
- 5.van Velzen JE, Schuijf JD, de Graaf FR et al (2011) Diagnostic performance of non-invasive multidetector computed tomography coronary angiography to detect coronary artery disease using different endpoints: detection of significant stenosis vs. detection of atherosclerosis. Eur Heart J 32:637–645PubMedCrossRefGoogle Scholar
- 20.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 21:2130–2138PubMedCrossRefGoogle Scholar
- 23.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 254:145–153PubMedCrossRefGoogle Scholar
- 28.Bongartz G, Golding SJ, Jurik AG et al (2004) European Guidelines for Multislice Computed Tomography: Appendix C Funded by the European Commission. Contract number FIGM-CT2000-20078-CT-TIP. Available via http://w3.tue.nl/fileadmin/sbd/Documenten/Leergang/BSM/European_Guidelines_Quality_Criteria_Computed_Tomography_Eur_16252.pdf. Accessed 04 June 2012
- 30.Gosling O, Loader R, Venables P et al (2010) A comparison of radiation doses between state-of-the-art multislice CT coronary angiography with iterative reconstruction, multislice CT coronary angiography with standard filtered back-projection and invasive diagnostic coronary angiography. Heart 96:922–926PubMedCrossRefGoogle Scholar