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Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

We evaluated the potential of prospectively ECG-triggered high-pitch spiral acquisition with low tube voltage and current in combination with iterative reconstruction to achieve coronary CT angiography with sufficient image quality at an effective dose below 0.1 mSv.

Methods

Contrast-enhanced coronary dual source CT angiography (2 × 128 × 0.6 mm, 80 kV, 50 mAs) in prospectively ECG-triggered high-pitch spiral acquisition mode was performed in 21 consecutive individuals (body weight <100 kg, heart rate ≤60/min). Images were reconstructed with raw data-based filtered back projection (FBP) and iterative reconstruction (IR). Image quality was assessed on a 4-point scale (1 = no artefacts, 4 = unevaluable).

Results

Mean effective dose was 0.06 ± 0.01 mSv. Image noise was significantly reduced in IR (128.9 ± 46.6 vs. 158.2 ± 44.7 HU). The mean image quality score was lower for IR (1.9 ± 1.1 vs. 2.2 ± 1.0, P < 0.0001). Of 292 coronary segments, 55 in FBP and 40 in IR (P = 0.12) were graded “unevaluable”. In patients with a body weight ≤75 kg, both in FBP and in IR, the rates of fully evaluable segments were significantly higher in comparison to patients >75 kg.

Conclusions

Coronary CT angiography with an estimated effective dose <0.1 mSv may provide sufficient image quality in selected patients through the combination of high-pitch spiral acquisition and raw data-based iterative reconstruction.

Key Points

• Coronary CT angiography with an estimated effective dose <0.1 mSv is possible.

• Combination of high-pitch spiral acquisition with iterative reconstruction achieves sufficient image quality.

• Diagnostic accuracy remains to be assessed in future trials.

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Acknowledgments

This study was supported by the German Government, Bundesministerium für Bildung und Forschung (01EX1012B, “Spitzencluster Medical Valley”)

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Authors and Affiliations

  1. Department of Cardiology, University of Gießen, Klinikstr. 33, 35392, Gießen, Germany

    Annika Schuhbaeck, Stephan Achenbach, Franziska Hecker & Johannes Rixe

  2. Departments of Cardiology and Radiology, University of Erlangen, Erlangen, Germany

    Christian Layritz, Jasmin Eisentopf, Tobias Pflederer, Soeren Gauss, Willi Kalender, Werner G. Daniel, Michael Lell & Dieter Ropers

Authors
  1. Annika Schuhbaeck
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  2. Stephan Achenbach
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  3. Christian Layritz
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  4. Jasmin Eisentopf
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  5. Franziska Hecker
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  6. Tobias Pflederer
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Correspondence to Annika Schuhbaeck.

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Schuhbaeck, A., Achenbach, S., Layritz, C. et al. Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction. Eur Radiol 23, 597–606 (2013). https://doi.org/10.1007/s00330-012-2656-2

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  • DOI: https://doi.org/10.1007/s00330-012-2656-2

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