Abstract
The aims of this study were to compare the image noise and quality of coronary computed tomographic angiography (CCTA) at 80 kVp with knowledge-based iterative model reconstruction (IMR) to those of CCTA at 100 kVp with hybrid iterative reconstruction (IR), and to evaluate the feasibility of a low-dose radiation protocol with IMR. Thirty subjects who underwent prospective electrocardiogram-gating CCTA at 80 kVp, 150 mAs, and IMR (Group A), and 30 subjects with 100 kVp, 150 mAs, and hybrid IR (Group B) were retrospectively enrolled after sample-size calculation. A BMI of less than 25 kg/m2 was required for inclusion. The attenuation value and image noise of CCTA were measured and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated at the proximal right coronary artery and left main coronary artery. The image noise was analyzed using a non-inferiority test. The CCTA images were qualitatively evaluated using a four-point scale. The radiation dose was significantly lower in Group A than Group B (0.69 ± 0.08 mSv vs. 1.39 ± 0.15 mSv, p < 0.001). The attenuation values were higher in Group A than Group B (p < 0.001). The SNR and CNR in Group A were higher than those of Group B. The image noise of Group A was non-inferior to that of Group B. Qualitative image quality of Group A was better than that of Group B (3.6 vs. 3.4, p = 0.017). CCTA at 80 kVp with IMR could reduce the radiation dose by about 50%, with non-inferior image noise and image quality than those of CCTA at 100 kVp with hybrid IR.
Highlights
Coronary computed tomographic angiography (CCTA) has been considered a reliable imaging modality for detecting and ruling out coronary artery disease (CAD) [1], but there are stillPLOS ONE | DOI:10.1371/journal.pone.0163410 September 22, 2016CCTA with 80 kVp and iterative model reconstruction (IMR) Is Non-Inferior to that with 100 kVp and iterative reconstruction (IR) artery disease; (CCTA), Coronary computed tomographic angiography; (DLP), Dose-length product; (ECG), Electrocardiogram; (FBP), Filtered back projection; (IMR), Iterative model reconstruction algorithm; (IR), Iterative reconstruction; (LAD), Left anterior descending artery; (LM), Left main coronary artery;, Proximal right coronary artery; (SNR), Signal-tonoise ratio.concerns regarding radiation exposure [2]
We examined a total of 60 subjects (30 in Group A and 30 in Group B)
There was a significant reduction in the mean radiation dose in Group A compared to Group B, which was measured by the estimated effective dose (0.69 ± 0.08 mSv vs. 1.39 ± 0.15 mSv, p < 0.001)
Summary
Coronary computed tomographic angiography (CCTA) has been considered a reliable imaging modality for detecting and ruling out coronary artery disease (CAD) [1], but there are stillPLOS ONE | DOI:10.1371/journal.pone.0163410 September 22, 2016CCTA with 80 kVp and IMR Is Non-Inferior to that with 100 kVp and IR artery disease; (CCTA), Coronary computed tomographic angiography; (DLP), Dose-length product; (ECG), Electrocardiogram; (FBP), Filtered back projection; (IMR), Iterative model reconstruction algorithm; (IR), Iterative reconstruction; (LAD), Left anterior descending artery; (LM), Left main coronary artery; (pRCA), Proximal right coronary artery; (SNR), Signal-tonoise ratio.concerns regarding radiation exposure [2]. Iterative reconstruction (IR) has been widely used for CCTA image reconstruction; it is advantageous in that it can reduce the noise that is caused by a decrease in spatial resolution in traditional filtered back-projection (FBP) algorithms [4,5,6]. By using this technique, it was possible to reduce the dose through decreasing the tube potential to 100 kVp through IR. It has been difficult to further reduce the tube voltage to 80 kVp with IR as a consequence of increased noise and degradation of image quality [7,8,9]
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