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European Radiology

, Volume 26, Issue 2, pp 459–468 | Cite as

Optimizing radiation dose by using advanced modelled iterative reconstruction in high-pitch coronary CT angiography

  • Sonja Gordic
  • Lotus Desbiolles
  • Martin Sedlmair
  • Robert Manka
  • André Plass
  • Bernhard Schmidt
  • Daniela B. Husarik
  • Francesco Maisano
  • Simon Wildermuth
  • Hatem Alkadhi
  • Sebastian Leschka
Cardiac

Abstract

Purpose

To evaluate the potential of advanced modeled iterative reconstruction (ADMIRE) for optimizing radiation dose of high-pitch coronary CT angiography (CCTA).

Methods

High-pitch 192-slice dual-source CCTA was performed in 25 patients (group 1) according to standard settings (ref. 100 kVp, ref. 270 mAs/rot). Images were reconstructed with filtered back projection (FBP) and ADMIRE (strength levels 1–5). In another 25 patients (group 2), high-pitch CCTA protocol parameters were adapted according to results from group 1 (ref. 160 mAs/rot), and images were reconstructed with ADMIRE level 4. In ten patients of group 1, vessel sharpness using full width at half maximum (FWHM) analysis was determined. Image quality was assessed by two independent, blinded readers.

Results

Interobserver agreements for attenuation and noise were excellent (r = 0.88/0.85, p < 0.01). In group 1, ADMIRE level 4 images were most often selected (84 %, 21/25) as preferred data set; at this level noise reduction was 40 % compared to FBP. Vessel borders showed increasing sharpness (FWHM) at increasing ADMIRE levels (p < 0.05). Image quality in group 2 was similar to that of group 1 at ADMIRE levels 2–3. Radiation dose in group 2 (0.3 ± 0.1 mSv) was significantly lower than in group 1 (0.5 ± 0.3 mSv; p < 0.05).

Conclusions

In a selected population, ADMIRE can be used for optimizing high-pitch CCTA to an effective dose of 0.3 mSv.

Key points

• Advanced modeled IR (ADMIRE) reduces image noise up to 50 % as compared to FBP.

• Coronary artery vessel borders show an increasing sharpness at higher ADMIRE levels.

• High-pitch CCTA with ADMIRE is possible at a radiation dose of 0.3 mSv.

Keywords

Computed tomography Radiation dose Iterative reconstruction Coronary angiography Image quality 

Notes

Acknowledgements

The scientific guarantor of this publication is H. Alkadhi. The authors of this manuscript declare relationships with the following companies: M. Sedlmair and B. Schmidt with Siemens Healthcare.

All other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, case-control study, performed at one institution.

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Sonja Gordic
    • 1
  • Lotus Desbiolles
    • 1
    • 2
  • Martin Sedlmair
    • 3
  • Robert Manka
    • 1
    • 4
    • 5
  • André Plass
    • 6
  • Bernhard Schmidt
    • 3
  • Daniela B. Husarik
    • 1
  • Francesco Maisano
    • 6
  • Simon Wildermuth
    • 2
  • Hatem Alkadhi
    • 1
  • Sebastian Leschka
    • 1
    • 2
  1. 1.Institute of Diagnostic and Interventional RadiologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
  2. 2.Divison of Radiology and Nuclear MedicineKantonsspitalSt. GallenSwitzerland
  3. 3.Siemens Healthcare, Computed Tomography DivisionForchheimGermany
  4. 4.Clinic of CardiologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
  5. 5.Institute for Biomedical EngineeringUniversity and ETH ZurichZurichSwitzerland
  6. 6.Clinic for Cardiovascular SurgeryUniversity Hospital Zurich, University of ZurichZurichSwitzerland

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