Abstract
We aimed to investigate the effect of a patient’s body mass index (BMI) on radiation dose and image quality in prospectively ECG-triggered coronary CT angiography (CCTA) performed on a 256-slice multi-detector CT scanner. In total, 87 consecutive patients receiving CCTA examinations acquired with tube current modulation (TCM) and iterative reconstruction (IR) were enrolled in this study. The dose report recorded from the CT scanner console was used to derive the effective dose for patients. Subjective image quality scoring and objective noise measurements were conducted to quantify the impact of BMI on the image quality of CCTA. Because of the TCM technique, we expected tube current and radiation dose to increase as BMI increased. However, using TCM did not always guarantee sufficient radiation exposure to achieve consistent image quality for overweight or obese patients since the maximum X-ray tube output in milliamperes and kilovoltage peak was reached. The impact of photon starvation noise on image quality was not significant until BMI ≥ 27 kg/m2; this result could be due to IR’s noise reduction capability. Our results also suggest that using TCM with a noise index of 25 HU can reduce radiation dose without compromising image quality compared to images obtained based on the manufacturer’s default settings.
Highlights
Obesity is a global epidemic, and its prevalence continues to increase in many countries
Because tube current modulation (TCM) and iterative reconstruction (IR) methods have good dose efficiency to achieve desired image quality, they may prove beneficial to improving the diagnostic accuracy of Coronary CT angiography (CCTA) by reducing the photon starvation noise that is due to patient attenuation
The aim of this study was to investigate the image quality and radiation dose of prospectively ECG-triggered CCTA acquired with TCM and IR performed on a 256-slice multi-detector CT (MDCT) scanner for patients with body mass index (BMI) < 25 and ≥25 kg/m2
Summary
Obesity is a global epidemic, and its prevalence continues to increase in many countries. High photon attenuation and scatter both affect the image quality of CCTA scans of obese patients. In addition to TCM, iterative reconstruction (IR) has the ability to reduce photon starvation noise resulting from patient attenuation. Because TCM and IR methods have good dose efficiency to achieve desired image quality, they may prove beneficial to improving the diagnostic accuracy of CCTA by reducing the photon starvation noise that is due to patient attenuation. The aim of this study was to investigate the image quality and radiation dose of prospectively ECG-triggered CCTA acquired with TCM and IR performed on a 256-slice multi-detector CT (MDCT) scanner for patients with BMIs < 25 and ≥25 kg/m2
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