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Image quality of Adaptive Iterative Dose Reduction 3D of coronary CT angiography of 640-slice CT: comparison with filtered back-projection

  • Roh-Eul Yoo
  • Eun-Ah ParkEmail author
  • Whal Lee
  • Hackjoon Shim
  • Yeo Koon Kim
  • Jin Wook Chung
  • Jae Hyung Park
Original Paper

Abstract

To assess the image quality of coronary CT angiography (CCTA) of 640-slice CT reconstructed by Adaptive Iterative Dose Reduction (AIDR) three-dimensional (3D) in comparison with the conventional filtered back-projection (FBP). CCTA images of 51 patients were scanned at the lowest tube voltage possible on condition that the built-in automatic exposure control system could suggest the optimal tube current. They were, then, reconstructed with FBP and AIDR 3D (standard). Objective measurements including CT density, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were performed. Subjective assessment was done by two radiologists, using a 5-point scale (0:nondiagnostic-4:excellent) based on the 15-coronary segment model which was grouped into three parts as the proximal, mid, and distal segmental classes. Radiation dose was also measured. AIDR images showed lower noise than FBP images (45.0 ± 9.4 vs. 73.4 ± 14.6 HU, p < 0.001) without any significant difference in CT density (665.5 ± 131.7 vs. 668 ± 136.3 HU, p = 0.8). Both SNR (15.0 ± 2.1 vs. 9.2 ± 1.7) and CNR (16.8 ± 2.3 vs. 10.4 ± 1.8) were significantly higher for AIDR than FBP (p < 0.001). Total subjective image quality score was also significantly improved in AIDR compared with FBP (3.1 ± 0.6 vs. 1.6 ± 0.4, p < 0.001), with better interpretability of the mid and distal segmental classes (100 vs. 95 % for the mid, p < 0.001; 100 vs. 90 % for the distal, p < 0.001). Mean effective radiation dose was 2.0 ± 1.0 mSv. The AIDR 3D reconstruction algorithm reduced image noise by 39 % compared with the FBP without affecting CT density, thus improving SNR and CNR for CCTA. Its advantages in interpretability were also confirmed by subjective evaluation by experts.

Keywords

Low-dose coronary CT angiography (CCTA) 640-multi-slice coronary CT angiography (CCTA) Iterative reconstruction Image quality Radiation dose 

Abbreviations

AIDR

Adaptive Iterative Dose Reduction

ASIR

Adaptive Statistical Iterative Reconstruction

BHC

Beam hardening correction

BMI

Body mass index

bpm

Beats per minute

CNR

Contrast-to-noise ratio

CCTA

Coronary CT angiography

D1

First diagonal branch

D2

Second diagonal branch

DLP

Dose-length product

ED

Effective dose

FBP

Filtered back-projection

HR

Heart rate

HU

Hounsfield unit

IRIS

Iterative reconstruction in image space

LAD

Left anterior descending artery

LCx

Left circumflex artery

LM

Left main coronary artery

OM

Obtuse marginalis

PDA

Posterior descending artery

RCA

Right coronary artery

R. intermedius

Ramus intermedius

ROI

Region of interest

SNR

Signal-to-noise ratio

3D

Three-dimensional

Notes

Acknowledgments

This research was supported by Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (MEST) (K21002001824-11E0100-02910). Hackjoon Shim is an employee of TI Medical Systems, the distributor in Korea for Toshiba Medical Systems Corporation, Tochiki-ken, Japan.

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media, B.V. 2012

Authors and Affiliations

  • Roh-Eul Yoo
    • 1
  • Eun-Ah Park
    • 1
    • 2
    Email author
  • Whal Lee
    • 1
    • 2
  • Hackjoon Shim
    • 3
  • Yeo Koon Kim
    • 1
    • 2
  • Jin Wook Chung
    • 1
  • Jae Hyung Park
    • 1
    • 2
  1. 1.Department of Radiology, Institute of Radiation MedicineSeoul National University HospitalSeoulKorea
  2. 2.SNU-Duke Cardiovascular MR Research CenterSeoul National UniversitySeoulKorea
  3. 3.TI Medical SystemsSeoulKorea

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