Dose levels at coronary CT angiography—a comparison of Dual Energy-, Dual Source- and 16-slice CT

PurposeTo compare the dose estimates and image quality of Dual Energy CT (DECT), Dual Source CT (DSCT) and 16-slice CT for coronary CT angiography (cCTA).MethodsSixty-eight patients were examined with 16 - slice MDCT (group 1), 68 patients with DSCT (group 2) and 68 patients using DSCT in dual energy mode (DECT group 3). CT dose index volume, dose length product, effective dose, signal-to-noise, and contrast-to-noise ratio were compared. Subjective image quality was rated by two observers, blinded to technique.ResultsThe mean estimated radiation dose of all patients investigated on a 16 - slice MDCT was 12 ± 3.59 mSv, for DSCT in single energy 9.8 ± 4.77 mSv and for DECT 4.54 ± 1.87 mSv. Dose for CTA was significantly lower in group 3 compared to group 1 and 2. The image noise was significantly lower in Group 2 in comparison to group 1 and group 3. There was no significant difference in diagnostic image quality comparing DECT and DSCT.ConclusioncCTA shows better dose levels at both DECT and DSCT compared to 16-slice CT. Further, DECT delivers significantly less dose than regular DSCT or single source single energy cCTA while maintaining diagnostic image quality.

[1]  M. L. R. D. Christenson,et al.  Image Quality and Radiation Exposure at Pulmonary CT Angiography with 100- or 120-kVp Protocol: Prospective Randomized Study , 2008 .

[2]  Dieter Ropers,et al.  Image quality in a low radiation exposure protocol for retrospectively ECG-gated coronary CT angiography. , 2009, AJR. American journal of roentgenology.

[3]  Dirk Ertel,et al.  Cardiac spiral dual-source CT with high pitch: a feasibility study , 2009, European Radiology.

[4]  H. Alkadhi,et al.  Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. , 2008, European journal of radiology.

[5]  C. Herzog,et al.  Coronary CT angiography. , 2007, Radiology.

[6]  Annet Waaijer,et al.  Circle of Willis at CT angiography: dose reduction and image quality--reducing tube voltage and increasing tube current settings. , 2007, Radiology.

[7]  L. Pike,et al.  Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. , 2004, The British journal of radiology.

[8]  16-MDCT angiography in living kidney donors at various tube potentials: impact on image quality and radiation dose. , 2007, AJR. American journal of roentgenology.

[9]  John M Boone,et al.  Dose reduction in pediatric CT: a rational approach. , 2003, Radiology.

[10]  James C Carr,et al.  ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Ra , 2006, Journal of the American College of Cardiology.

[11]  Masao Kiguchi,et al.  Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. , 2008, Radiology.

[12]  Walter Huda,et al.  Converting dose-length product to effective dose at CT. , 2008, Radiology.

[13]  A. Schmermund,et al.  Radiation dose exposure of computed tomography coronary angiography: comparison of dual-source, 16-slice and 64-slice CT , 2009, Heart.

[14]  J. Paul,et al.  Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. , 2004, Radiology.

[15]  Jonathan G Goldin,et al.  Assessment of Coronary Artery Disease by Cardiac Computed Tomography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiolog , 2006, Circulation.

[16]  B. Ohnesorge,et al.  Heart Rate Adaptive Optimization of Spatial and Temporal Resolution for Electrocardiogram-Gated Multislice Spiral CT of the Heart , 2001, Journal of computer assisted tomography.

[17]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[18]  J. Roelandt,et al.  Images in Cardiovascular Medicine , 2000 .

[19]  Borut Marincek,et al.  Radiation dose estimates in dual-source computed tomography coronary angiography , 2008, European Radiology.

[20]  Jörg Hausleiter,et al.  Estimated radiation dose associated with cardiac CT angiography. , 2009, JAMA.

[21]  Thomas L Toth,et al.  Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. , 2008, AJR. American journal of roentgenology.

[22]  K Nikolaou,et al.  Dual-Energy CT Angiography of the Lung in Patients with Suspected Pulmonary Embolism: Initial Results , 2008, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[23]  T. Flohr,et al.  Images in cardiovascular medicine. Myocardial ischemia diagnosed by dual-energy computed tomography: correlation with single-photon emission computed tomography. , 2008, Circulation.

[24]  Fuminari Tatsugami,et al.  Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. , 2007, European heart journal.

[25]  Konstantin Nikolaou,et al.  Contrast Bolus Optimization for Cardiac 16-Slice Computed Tomography: Comparison of Contrast Medium Formulations Containing 300 and 400 Milligrams of Iodine Per Milliliter , 2006, Investigative radiology.

[26]  E. Samei,et al.  Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm--initial clinical experience. , 2010, Radiology.

[27]  Mulugeta Gebregziabher,et al.  Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience , 2008, European Radiology.

[28]  Stephan Achenbach,et al.  Computed tomography coronary angiography. , 2006, Journal of the American College of Cardiology.

[29]  W Huda,et al.  Technique factors and image quality as functions of patient weight at abdominal CT. , 2000, Radiology.

[30]  Takeshi Nakaura,et al.  Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. , 2005, Radiology.

[31]  Ne Pacific Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose , 2008 .

[32]  H. Alkadhi,et al.  Aortic regurgitation: assessment with 64-section CT. , 2007, Radiology.

[33]  Manesh R. Patel,et al.  ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group. , 2006, Journal of the American College of Radiology : JACR.

[34]  Simon Wildermuth,et al.  Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose , 2008, European Radiology.

[35]  W. Kalender,et al.  Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience , 2009, European Radiology.

[36]  Jörg Hausleiter,et al.  Radiation Dose Estimates From Cardiac Multislice Computed Tomography in Daily Practice: Impact of Different Scanning Protocols on Effective Dose Estimates , 2006, Circulation.

[37]  R. Frye,et al.  A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. , 1975, Circulation.

[38]  Rainer Raupach,et al.  Dose performance of a 64-channel dual-source CT scanner. , 2007, Radiology.

[39]  Matthew J. Walker,et al.  Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique , 2009, European Radiology.

[40]  M. Reiser,et al.  Material differentiation by dual energy CT: initial experience , 2007, European Radiology.

[41]  Roman Fischbach,et al.  Left ventricular function studied with MDCT , 2006, European Radiology.

[42]  Peter Boesiger,et al.  Low-dose CT coronary angiography for the prediction of myocardial ischaemia , 2009, European Radiology.

[43]  H. Alkadhi,et al.  Image Quality and Reconstruction Intervals of Dual-Source CT Coronary Angiography: Recommendations for ECG-Pulsing Windowing , 2007, Investigative radiology.