Individual selection of X-ray tube settings in computed tomography coronary angiography: Reliability of an automated software algorithm to maintain constant image quality

Low tube voltage prospectively ECG-triggered coronary CT angiography: a systematic review of image quality and radiation dose

“…However, those measurements were more complex and prone to errors. 28 Compared with manual selection techniques, ATVS is a fully-automated algorithm that utilises CNR as the image quality index to adjust the CT tube voltage based on patients' size and attenuation characteristics estimated from topograms. 54 Patient-specific tube current curves are generated for all tube voltage levels to achieve the desired CNR with the selected scan range on the patients' topogram.…”

“…The lowest doses at 80 kVp (0.31 mSv), 100 kVp (0.69 mSv) and 120 kVp (1.53 mSv) were reported by Durmus et al which combined automated tube voltage selection (ATVS) and automatic tube current modulation (ATCM) techniques. 28 Nine studies reported increase in image noise at 80 kVp (n = 4) and 100 kVp (n = 5). Overall, improved or similar image quality was achieved in all the studies when using lower tube voltage, except in one study 32 which reported deteriorating qualitative image quality at 100 kVp as compared to 120 kVp.…”

“…Therefore, only 20 studies were finally selected for analysis. [15][16][17][18][19][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] A detailed overview of the inclusion and data extraction processes is shown in Figure 1.…”

“…In the two studies at 80 kVp, two different methods were used to determine the CM volume for the first bolus; (i) a calculation Zhang et al 2015 40 Durmus et al 2016 28 Mangold et al 2016 31 Image acquisition (1) Manual tube current adaptation to: Nakaura et al 2013 18 Nakaura et al 2013 32 Iyama et al 2016 17 (c) Reference effective tube current-time product Automatically modulate the tube current with reference to a target tube current level for a standard-sized patient to achieve constant image quality.…”

“…Alkadhi et al 2008 27 Zhang et al 2014 41 Shen et al 2015 35 Yin et al 2015 37 Zhang et al 2015 40 Durmus et al 2016 28 Mangold et al 2016 31 Wu et al 2016 19 (d) SD (noise) Automatically modulate the tube current to a target SD of noise to achieve constant image noise regardless of attenuation level.…”