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Coronary CT angiography in obese patients using 3rd generation dual-source CT: effect of body mass index on image quality

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the image quality of coronary CT angiography (CCTA) in obese patients using a 3rd generation, dual-source CT scanner.

Methods

We retrospectively evaluated 102 overweight and obese patients who had undergone CCTA. Studies were performed with 3rd generation dual-source CT, prospectively ECG-triggered acquisition at 120 kV, and automated tube current modulation. Advanced modeled iterative reconstruction was used. Patients were divided into three BMI groups: 1)25–29.9 kg/m2; 2)30–39.9 kg/m2; 3) ≥ 40 kg/m2. Vascular attenuation in the coronary arteries was measured. Contrast-to-noise ratio (CNR) was calculated. Image quality was subjectively evaluated using five-point scales.

Results

Image quality was considered diagnostic in 97.6 % of examinations. CNR was consistently adequate in all groups but decreased for groups 2 and 3 in comparison to group 1 as well as for group 3 compared to group 2 (p = 0.001, respectively). Subjective image quality was significantly higher in group 1 compared to group 3 (attenuation proximal: 4.8 ± 0.4 vs. 4.4 ± 0.6, p = 0.011; attenuation distal: 4.5 ± 0.7 vs. 4.0 ± 0.8, p = 0.019; noise: 4.7 ± 0.6 vs. 3.8 ± 0.7, p < 0.001). The mean effective dose was 9.5 ± 3.9 mSv for group 1, 11.4 ± 4.7 mSv for group 2 and 14.0 ± 6.4 mSv for group 3.

Conclusion

Diagnostic image quality can be routinely obtained at CCTA in obese patients with 3rd generation DSCT at 120 kV.

Key Points

• Diagnostic CCTA can be routinely performed in obese patients with 3 rd generation DSCT.

• 120-kV tube voltage allows diagnostic image quality in patients with BMI > 40 kg/m 2.

• 80-ml contrast medium can be administered without significant decline in vascular attenuation.

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Acknowledgments

The scientific guarantor of this publication is U. Joseph Schoepf. The authors of this manuscript declare relationships with the following companies: Dr. Schoepf is a consultant for and receives research support from Bayer, Bracco, GE, Medrad, and Siemens. Mr. Canstein is a Siemens employee. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA

    Stefanie Mangold, Julian L. Wichmann, U. Joseph Schoepf, Akos Varga-Szemes, Giuseppe Muscogiuri, Stephen R. Fuller, Andrew C. Stubenrauch & Carlo N. De Cecco

  2. Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany

    Stefanie Mangold & Konstantin Nikolaou

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

    Julian L. Wichmann

  4. Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    U. Joseph Schoepf & Sheldon E. Litwin

  5. Siemens Medical Solutions, Malvern, PA, USA

    Christian Canstein

  6. Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza”, Rome, Italy

    Giuseppe Muscogiuri

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  1. Stefanie Mangold
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Corresponding author

Correspondence to U. Joseph Schoepf.

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Mangold, S., Wichmann, J.L., Schoepf, U.J. et al. Coronary CT angiography in obese patients using 3rd generation dual-source CT: effect of body mass index on image quality. Eur Radiol 26, 2937–2946 (2016). https://doi.org/10.1007/s00330-015-4161-x

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  • DOI: https://doi.org/10.1007/s00330-015-4161-x

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