Influence of tube potential on quantitative coronary plaque analyses by low radiation dose computed tomography: a phantom study

  • Chunhong Wang
  • Yuliang Liao
  • Haibin Chen
  • Xin Zhen
  • Jianhong Li
  • Yikai Xu
  • Linghong Zhou
Original Paper


Previous studies have shown that employing the low dose computed tomography (CT) technique based on low tube potential reduces the radiation dose required for the coronary artery examination protocol. However, low tube potential may adversely influence the CT number of plaque composition. Therefore, we aimed to determine whether quantitative atherosclerotic plaque analysis by a multi-slice, low radiation dose CT protocol using 80 kilovolts (kV) yields results comparable to those of the standard 120 kV protocol. Artificial plaque samples (n = 17) composed of three kinds of plaque were scanned at 120 and 80 kV. Relative low-density and medium-density plaque component volumes obtained by three protocols (80 kV, 60 Hounsfield units [HU] threshold; 120 kV, 60 HU threshold; and 80 kV, 82 HU threshold) were compared. Using the 60 HU threshold, relative volume of the low-density plaque component obtained at 80 kV was lower than that obtained at 120 kV (27 ± 3% vs. 51 ± 5%, P < 0.001), whereas relative volume of the medium-density plaque component obtained at 80 kV was higher than that obtained at 120 kV (73 ± 3% vs. 48 ± 5%, P < 0.001). By contrast, no significant difference in relative volume obtained at 80 kV (82 HU threshold) versus 120 kV (60 HU threshold) was observed for either low-density (52 ± 5% vs. 51 ± 5%) or medium-density (48 ± 5% vs. 48 ± 5%) plaque component. Low tube potential may affect the accuracy of quantitative atherosclerotic plaque analysis. For our phantom test, 82 HU was the optimal threshold for scanning at 80 kV.


Atherosclerotic plaque Computed tomography Phantom Radiation dose Tube potential Coronary artery disease Cardiac computed tomography angiography 



Computed tomography






Hounsfield units


Acute coronary syndrome


Intravascular ultrasound


Coronary computed tomography angiography


Polyvinyl chloride


Iterative model reconstruction


Window width


Window level


Multiplanar reformat


Volume-rendering technique


Coronary artery calcium score



The authors are grateful to Fang Zhou, MD for his expertise and assistance with the statistical analysis. The authors also thank Medjaden Bioscience Ltd for language services.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyXinyang Central HospitalXinyangChina
  2. 2.Department of Biomedical EngineeringSouthern Medical UniversityGuangzhouChina
  3. 3.Department of Medical Imaging Center, Nanfang HospitalSouthern Medical UniversityGuangzhouChina

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