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Dose reduction in spiral CT coronary angiography with dual-source equipment. Part I. A phantom study applying different prospective tube current modulation algorithms

Riduzione della dose in angiografia coronarica con TC spirale con apparecchiatura a doppia sorgente. Parte I. Studio su fantoccio della dose totale applicando differenti algoritmi di modulazione prospettica della corrente del tubo

  • Cardiac Radiology/Cardioradiologia
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The authors sought to compare different algorithms for dose reduction in retrospectively echocardiographically (ECG)-gated dual-source computed tomography (CT) coronary angiography (DSCT-CA) in a phantom model.

Materials and methods

Weighted CT dose index (CTDI) was measured by using an anthropomorphic phantom in spiral cardiac mode (retrospective ECG gating) at five pitch values adapted with two heart-rate-adaptive ECG pulsing windows using four algorithms: narrow pulsing window, with tube current reduction to 20% (A) and 4% (B) of peak current outside the pulsing window; wide pulsing window, with tube current reduction to 20% (C) and 4% (D). Each algorithm was applied at different heart rates (45, 60, 75, 90, 120 bpm).

Results

Mean CTDI volume (CTDIvol) was 36.9±9.7 mGy, 23.9±5.6 mGy, 49.7±16.2 mGy and 38.5±12.3 mGy for A, B, C and D, respectively. Consistent dose reduction was observed with protocols applying the 4% tube current reduction (B and D). Using the conversion coefficient for the chest, the mean effective dose was the highest for C (9.6 mSv) and the lowest for B (4.6 mSv). Heart-ratedependent pitch values (pitch=0.2, 0.26, 0.34, 0.43, 0.5) and the use of heart-rate-adaptive ECG pulsing windows provided a significant decrease in the CTDIvol with progressively higher heart rates (45, 60, 75, 90, 120 bpm), despite using wider pulsing windows.

Conclusions

Radiation exposure with DSCT-CA using a narrow pulsing window significantly decreases when compared with a wider pulsing window. When using a protocol with reduced tube current to 4%, the radiation dose is significantly lower.

Riassunto

Obiettivi

Lo scopo di questo studio è valutare mediante un fantoccio gli algoritmi di riduzione della dose in angiografia coronarica con tomografia computerizzata a doppia sorgente (DSCT-CA) con modalità di scansione spirale.

Materiali e metodi

Sono stati valutati 4 protocolli electrocardiographic (ECG)-gated retrospettivo DSCT-CA delle arterie coronarie, acquisiti con pitch ECG adattativo e modulazione ECG prospettica della corrente del tubo. Nei protocolli A e B è stata utilizzata una finestra di pulsing stretta (narrow), con riduzione della corrente del tubo al 20% (A) e al 4% (B) del valore nominale della corrente, al di fuori della finestra di pulsing; nei protocolli C e D è stata utilizzata una finestra di pulsing ampia (wide), con riduzione della corrente del tubo al 20% (C) e al 4% (D) del valore nominale della corrente, al di fuori della finestra di pulsing.

Risultati

Il valore medio del computed tomography dose index volume (CTDIvol) è risultato 36,9±9,7 mGy e 23,9±5,6 mGy nei protocolli A e B, rispettivamente (r=0,97; p<0,005); 49,7±16,19 mGy e 38,5±12,25 mGy nei protocolli C e D, rispettivamente (r=1,0; p<0,005). Una consistente riduzione di dose è stata osservata con i protocolli di modulazione della corrente al 4% (B e D). Utilizzando il coefficiente di conversione per il torace, il valore medio di dose è stato maggiore nel protocollo C (9,6 mSv) e minore nel protocollo B (4,6 mSv). L’utilizzo del pitch ECG adattativo (pitch=0,2-0,26-0,34-0,43-0,5) e gli algoritmi di pulsing con finestra stretta forniscono una consistente riduzione della dose (vale a dire >60%) all’aumentare della frequenza cardiaca.

Conclusioni

In DSCT-CA, l’utilizzo di una finestra di pulsing stretta riduce significativamente la dose da radiazioni, se comparata ad una finestra di pulsing più ampia. Con l’utilizzo di un protocollo con modulazione della corrente al 4%, la dose di radiazione è significativamente minore.

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Authors and Affiliations

  1. Dipartimento di Radiologia e Cardiologia, Azienda Ospedaliero-Universitaria, Parma, Italy

    C. Martini, A. Palumbo, E. Maffei & F. Cademartiri

  2. Dipartimento di Radiologia e Cardiologia, Erasmus Medical Center, Rotterdam, the Netherlands

    C. Martini, A. Palumbo, A. Rossi, M. Rengo, R. Malagò, M. Dijkshoorn, A. Weustink, N. Mollet, G. Krestin & F. Cademartiri

  3. Dipartimento di Radiologia e Diagnostica per Immagine, c/o Piastra Tecnica - Piano 0, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy

    F. Cademartiri

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Martini, C., Palumbo, A., Maffei, E. et al. Dose reduction in spiral CT coronary angiography with dual-source equipment. Part I. A phantom study applying different prospective tube current modulation algorithms. Radiol med 114, 1037–1052 (2009). https://doi.org/10.1007/s11547-009-0437-z

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  • DOI: https://doi.org/10.1007/s11547-009-0437-z

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