Improved image quality with simultaneously reduced radiation exposure: Knowledge-based iterative model reconstruction algorithms for coronary CT angiography in a clinical setting.
J Cardiovasc Comput Tomogr
; 11(3): 213-220, 2017.
Article
en En
| MEDLINE
| ID: mdl-28314613
ABSTRACT
BACKGROUND:
The aim of this study was to assess the potential for radiation dose reduction using knowledge-based iterative model reconstruction (K-IMR) algorithms in combination with ultra-low dose body mass index (BMI)-adapted protocols in coronary CT angiography (coronary CTA).METHODS:
Forty patients undergoing clinically indicated coronary CTA were randomly assigned to two groups with BMI-adapted (I <25.0 kg/m2, II <28.0 kg/m2, III <30.0 kg/m2, IV ≥30.0 kg/m2) low dose (LD, I 100kVp/75 mAs, II 100kVp/100 mAs, III 100kVp/150 mAs, IV 120kVp/150 mAs, n = 20) or ultra-low dose (ULD, I 100kVp/50 mAs, II 100kVp/75 mAs, III 100kVp/100 mAs, IV 120kVp/100 mAs, n = 20) protocols. Prospectively-triggered coronary CTA was performed using a 256-MDCT with the lowest reasonable scan length. Images were generated with filtered back projection (FBP), a noise-reducing hybrid iterative algorithm (iD, levels 2/5) and K-IMR using cardiac routine (CR) and cardiac sharp settings, levels 1-3.RESULTS:
Groups were comparable regarding anthropometric parameters, heart rate, and scan length. The use of ULD protocols resulted in a significant reduction of radiation exposure (0.7 (0.6-0.9) mSv vs. 1.1 (0.9-1.7) mSv; p < 0.02). Image quality was significantly better in the ULD group using K-IMR CR 1 compared to FBP, iD 2 and iD 5 in the LD group, resulting in fewer non-diagnostic coronary segments (2.4% vs. 11.6%, 9.2% and 6.1%; p < 0.05).CONCLUSIONS:
The combination of K-IMR with BMI-adapted ULD protocols results in significant radiation dose savings while simultaneously improving image quality compared to LD protocols with FBP or hybrid iterative algorithms. Therefore, K-IMR allows for coronary CTA examinations with high diagnostic value and very low radiation exposure in clinical routine.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Dosis de Radiación
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Algoritmos
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Enfermedad de la Arteria Coronaria
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Interpretación de Imagen Radiográfica Asistida por Computador
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Angiografía Coronaria
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Exposición a la Radiación
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Vasos Coronarios
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Bases del Conocimiento
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Tomografía Computarizada Multidetector
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Angiografía por Tomografía Computarizada
Tipo de estudio:
Clinical_trials
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Guideline
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Prognostic_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Año:
2017
Tipo del documento:
Article