Journal of Cardiovascular Computed Tomography
Volume 3, Issue 6 , Pages 394-400, November 2009

Coronary artery calcium scoring using a reduced tube voltage and radiation dose protocol with dual-source computed tomography

  • Ryo Nakazato, MD

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • ,
  • Damini Dey, PhD

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
    • ,
  • Ariel Gutstein, MD

      Affiliations

    • Rabin Medical Center, Sackler Medical School of Medicine, Tel-Aviv University, Petah Tikva, Israel
    • ,
  • Ludovic Le Meunier, PhD

      Affiliations

    • Siemens Medical Solutions (PET Division), Knoxville, TN, USA
    • ,
  • Victor Y. Cheng, MD

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • ,
  • Raymond Pimentel, BSc

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • ,
  • William Paz, BSc

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • ,
  • Sean W. Hayes, MD

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
    • ,
  • Louise E.J. Thomson, MBChB

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
    • ,
  • John D. Friedman, MD, FACC

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
    • ,
  • Daniel S. Berman, MD, FACC

      Affiliations

    • Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building Room 1258, Los Angeles, CA 90048, USA
    • David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
    • Corresponding Author InformationCorresponding author.

Received 13 June 2009; accepted 2 October 2009. published online 15 October 2009.

Background

Technical advances to minimize radiation exposure because of imaging are in accord with the “as low as reasonably achievable” principle.

Objective

We aimed to determine whether coronary calcium scoring (CCS) by multidetector CT at a tube voltage of 100 kVp yields comparable results to the standard 120-kVp protocol while reducing radiation dose.

Methods

Sixty consecutive outpatients were scanned with a dual-source CT scanner with both the120- and 100-kVp protocols. The calcium threshold was 130 Hounsfield units (HUs) for 120 kVp and 147 HU for 100 kVp, as determined from phantom data. All 100-kVp scans were scored by an experienced reader blinded to 120-kVp data.

Results

Image quality was comparable for 100- and 120- kVp scans. Mean Agatston scores for 100 and 120 kVp were 189 ± 484 and 189 ± 498 (P = 0.92), with perfect correlation (r = 1.0; P < 0.0001; 95% limits of agreement, -36 to 37; bias, 0.6). Mean coronary calcium volume scores for 100 and 120 kVp were 143 ± 370 mm3 and 149 ± 392 mm3 (P = 0.26), with perfect correlation (r = 1.0; P < 0.0001; 95% limits of agreement, -35 to 32 mm3; bias, -1.4 mm3). The mean absolute difference for Agatston scores between the protocols was 16.9, with excellent agreement (κ = 0.95; P < 0.0001). Mean effective radiation dose for the 100-kVp protocol was significantly lower (1.17 mSv versus 1.70 mSv; P < 0.0001).

Conclusion

A reduced tube current protocol using 100 kVp gives equivalent CCS results at reduced radiation exposure compared with a standard protocol at 120 kVp.

Keywords: Coronary artery disease, Coronary calcium scoring, Coronary calcium, Dual-source CT, Radiation dose, X-ray tube voltage

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 Conflict of interest: Ludovic Le Meunier is an employee of Siemens Medical Systems, PET Division. The other authors report no conflicts of interest.

 This study was supported by in part by grant 6318 from the Glazer Foundation, Los Angeles, CA, and in part by The Lincy Foundation, Los Angeles, CA. Dr Nakazato is supported in part by a grant from the Society of Nuclear Medicine Wagner-Torizuka Fellowship, Virginia.

 Dr Nakazato and Dr Dey contributed equally to this study.

PII: S1934-5925(09)00508-5

doi:10.1016/j.jcct.2009.10.002

Journal of Cardiovascular Computed Tomography
Volume 3, Issue 6 , Pages 394-400, November 2009

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