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Image quality and radiation dose of low tube voltage 3rd generation dual-source coronary CT angiography in obese patients: a phantom study

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

Abstract

Objectives

To assess the influence of tube potential on radiation dose and image quality of third-generation dual-source coronary CT angiography (CTA) in a phantom simulating an obese patient.

Methods

A thoracic phantom was equipped with tubular inserts containing iodine solution and water. A soft-tissue-equivalent ring around the phantom simulated an obese patient. Images were acquired at tube potentials of 80, 100, 120 and 140 kV with second-generation dual-source CT (DSCT) and 70–150 kV (in 10-kV increments) with third-generation DSCT. Contrast-to-noise ratio (CNR) was calculated and CT dose index was recorded.

Results

With second-generation DSCT, CNR was highest for 120 kV (19.0) and decreased with lower tube potential (12.0 at 80 kV) owing to disproportionately increased image noise. With third-generation DSCT, 70- and 80-kV acquisitions showed a smaller increase in noise. CNRs for third-generation DSCT were highest for 70 and 80 kV (21.1 and 21.2, respectively). Compared to 120 kV, radiation dose was 68 % and 49 % lower at 70 kV and 80 kV, respectively.

Conclusion

Third-generation DSCT enables one to perform coronary CTA at 70–80 kV in obese patients without compromising CNR and thus reduces radiation dose by 49–68 %.

Key points

• Low tube potential CT angiography is currently not suitable for obese patients.

• Third-generation DSCT offers substantially increased tube power at low tube potential.

• This enables one to perform coronary CT angiography at 70–80 kV in obese patients.

• Signal-to-noise ratio is maintained owing to increased tube current.

• This approach can be expected to reduce radiation dose by 49–68 %.

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Acknowledgements

The scientific guarantor of this publication is U. Joseph Schoepf, MD. 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 and Siemens. Mr. Canstein, Dr. Sedlmaier, Dr. Schmidt and Dr. Flohr are Siemens employees. The other authors have no conflict of interest to disclose. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because this is a phantom study and does not involve human subjects. None of the study subjects or cohorts have been previously reported. Methodology: experimental phantom study, performed at one institution.

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Authors and Affiliations

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

    Felix G. Meinel, U. Joseph Schoepf, Brett S. Harris & Carlo N. De Cecco

  2. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany

    Felix G. Meinel

  3. Siemens Medical Solutions USA, Malvern, PA, USA

    Christian Canstein

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

    U. Joseph Schoepf

  5. Siemens Healthcare, Computed Tomography Division, Forchheim, Germany

    Martin Sedlmaier, Bernhard Schmidt & Thomas G. Flohr

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

    Carlo N. De Cecco

Authors
  1. Felix G. Meinel
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  2. Christian Canstein
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  3. U. Joseph Schoepf
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Correspondence to U. Joseph Schoepf.

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Meinel, F.G., Canstein, C., Schoepf, U.J. et al. Image quality and radiation dose of low tube voltage 3rd generation dual-source coronary CT angiography in obese patients: a phantom study. Eur Radiol 24, 1643–1650 (2014). https://doi.org/10.1007/s00330-014-3194-x

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  • DOI: https://doi.org/10.1007/s00330-014-3194-x

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