Highlights
- •A third-generation dual-source CT system is capable of producing 450 mAs tube current at 70 kVp tube voltage.
- •We evaluated feasibility, image quality, and radiation dose.
- •High-pitch spiral acquisition was used with filtered back projection and iterative reconstruction algorithms.
- •Mean estimated effective radiation dose was 0.3 mSv.
- •The rate of CT scans with diagnostic image quality was 99.4%.
Abstract
Background
Low tube voltage reduces radiation exposure in coronary CT angiography (CTA). Using
70 kVp tube potential has so far not been possible because CT systems were unable
to provide sufficiently high tube current with low voltage.
Objective
We evaluated feasibility, image quality (IQ), and radiation dose of coronary CTA using
a third-generation dual-source CT system capable of producing 450 mAs tube current
at 70 kVp tube voltage.
Methods
Coronary CTA was performed in 26 consecutive patients with suspected coronary artery
disease, selected for body weight <100 kg and heart rate <60 beats/min. High-pitch
spiral acquisition was used. Filtered back projection (FBP) and iterative reconstruction
(IR) algorithms were applied. IQ was assessed using a 4-point rating scale (1 = excellent,
4 = nondiagnostic) and objective parameters.
Results
Mean age was 62 ± 9 years (46% males; mean body mass index, 27.7 ± 3.8 kg/m2; mean heart rate, 54 ± 5 beats/min). Mean dose-length product was 20.6 ± 1.9 mGy ×
cm; mean estimated effective radiation dose was 0.3 ± 0.03 mSv. Diagnostic IQ was
found in 365 of 367 (FBP) and 366 of 367 (IR) segments (P nonsignificant). IQ was rated “excellent” in 53% (FBP) and 86% (IR) segments (P = .001) and “nondiagnostic” in 2 (FBP) and 1 segment (IR) (P nonsignificant). Mean IQ score was lesser in FBP vs IR (1.5 ± 0.4 vs 1.1 ± 0.2; P < .001). Image noise was lower in IR vs FBP (60 ± 10 HU vs 74 ± 8 HU; P < .001).
Conclusion
In patients <100 kg and with a regular heart rate <60 beats/min, third-generation
dual-source CT using high-pitch spiral acquisition and 70 kVp tube voltage is feasible
and provides both robust IQ and very low radiation exposure.
Keywords
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Article info
Publication history
Published online: September 14, 2014
Accepted:
September 3,
2014
Received in revised form:
August 28,
2014
Received:
July 28,
2014
Footnotes
Conflict of interest: Mohamed Marwan, Stephan Achenbach, Michael Lell, and Michael Uder have received speaker's honoraria from Siemens Healthcare. The remaining authors report no conflicts of interest.
Identification
Copyright
© 2014 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
