Image noise-based dose adaptation in dynamic volume CT of the heart: dose and image quality optimisation in comparison with BMI-based dose adaptation

Odedra, Devang; Blobel, Joerg; Al-Humayyd, S.; Durand, Miranda; Jiménez-Juan, Laura; Paul, Narinder

doi:10.1007/s00330-013-2980-1

Cited by 8 publications

(5 citation statements)

References 32 publications

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“…These are subjective by nature, evaluated visually as apparent blurring of the coronary artery contours and luminal visualization using Likert scales. 4,11,12 FACTORS AFFECTING IMAGE QUALITY Technical parameters mainly include temporal resolution, spatial resolution, contrast resolution and radiation dose. It is further essential to synchronize image acquisition with cardiac motion by simultaneous electrocardiogram (ECG) recording.…”

Section: Image Quality In Coronary Ct Angiographymentioning

confidence: 99%

Image quality in coronary CT angiography: challenges and technical solutions

Ghekiere

Salgado

Buls

et al. 2017

BJR

104

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Multidetector CT angiography (CTA) has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high-quality examinations. In this review, we discuss several key elements that may adversely affect coronary CTA image quality as well as potential measures that can be taken to mitigate their impact. In addition, several recent vendor-specific advances and future directions to improve image quality are discussed. INTRODUCTIONThe high negative-predictive value of coronary CT angiography (CTA) makes it a suitable tool for excluding significant coronary artery disease.1 Coronary CTA is technically complex and places a greater emphasis on scanning technologies than any other type of CT examination. Indeed, coronary arteries both have small calibre and varying degrees of motion during the cardiac cycle.2 Image quality can be degraded by many patient-and technique-related factors. Image artefacts are causes for misinterpretation, making the diagnostic accuracy of coronary CTA to a great extent dependent on their recognition and operator-awareness.2,3 Potential problems related to these artefacts include insufficient tissue contrast, limited spatial and temporal resolution and inadequate volume coverage. The aim of this review was to discuss these technical issues, important recent vendorspecific solutions as well as future directions.

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Section: Image Quality In Coronary Ct Angiographymentioning

confidence: 99%

Image quality in coronary CT angiography: challenges and technical solutions

Ghekiere

Salgado

Buls

et al. 2017

BJR

104

View full text Add to dashboard Cite

show abstract

“…This increase in DLP using the modulated CT protocol is most possibly attributed to the increase the photon flux (variable mA) in areas of high attenuation and noise standardisation. The relationships between obesity and increasing DLP from CT scanning protocols have been published previously [11,12,13]. An increase in DLP has been shown to directly relate to the increased risk of cancer induction and heritable disease [1].…”

Section: Discussionmentioning

confidence: 99%

The Relationship of CT Mean Modulated Dose-Length Product and Body Mass Index During Routine 18F- FDG PET/CT Studies

Atkins¹

2015

IJMI

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AIM: To determine the relationship of body mass index (BMI) on the mean dose length product (DLP) values acquired using modulated (automatic exposure control) and standard computed tomography (CT) scanning protocols as part of a typical 18 F-FDG PET/CT study. METHODS: A retrospective study was performed and the dose-length product and BMI values from routine 18 F-FDG PET/CT scans of 51 patients were recorded. The scans were performed on a 16-slice PET/CT scanner by using an automatic exposure control (AEC) system. DLP, BMI, age, sex and number of bed positions were documented for each patient. RESULTS: Twenty-four women and 27 men were included in the study (mean age, 52.5 years). The mean BMI was 24.76 kg/m 2. The mean modulated DLP was 528.25 mGy/cm. Patients were grouped according to BMI (normal: BMI <25, overweight: BMI 25-30, obese: BMI >30) and age (≤18 years, 19-59 years, ≥ 60 years). The mean modulated DLP decreased by 22.77% for patients in the normal BMI group (P < 0.001). The obese group of patient's mean modulated DLP was 26.29% higher (P < 0.01). The DLP decreased by 22.43% for patients aged 60 years and above compared with patients in the 19-59 age group. CONCLUSION: The use of modulated scanning protocol significantly reduces the integrated dose received from a whole body CT scan for patients with a BMI < 25. Increasing patient size (BMI >25) significantly increases the integrated dose received. The possible change in body composition with age may also indicate a reduction in dose received from a whole body CT scan using AEC.

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“…All CCTA studies were performed on a wide volume multidetector computed tomography [MDCT] scanner (Aquilion ONE, Canon Medical Systems, Ottawa, Japan) using 280-320 x 0.5 mm detectors and a standard procedure for x-ray dose adaptation to individual patient body habitus to ensure diagnostic image quality. 10 All scans were acquired using prospective ECG gated image acquisition with x-ray exposure window being automatically optimized to the patient’s HR using pre-determined manufacturer settings. 50-70 ml of iodinated, non-ionic water-soluble contrast medium (Iopromide 370 mg iodine/mL) was power injected at 4.5-5.0 mL/s, determined by patient bodyweight, followed by a 20 ml saline push.…”

Section: Methodsmentioning

confidence: 99%

Prospective Clinical Trial Comparing IV Esmolol to IV Metoprolol in CT Coronary Angiography: Effect on Hemodynamic, Technical Parameters and Cost

et al. 2021

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Background: Intravenous [IV] esmolol, an alternative to IV metoprolol for coronary computed tomography angiography [CCTA], has shorter half-life that decreases the risk of prolonged hypotension. The primary aim was to prospectively compare IV esmolol alone to IV metoprolol alone for effectiveness in achieving heart rate [HR] of 60 beats per minute[bpm] during CCTA. The secondary aim was to compare hemodynamic response, image quality, radiation dose and cost. Materials and Methods: Institutional Review Board approved prospective randomized study of 28 CCTA patients medicated in a 1:1 blinded match with IV esmolol or IV metoprolol to achieve HR of 60 bpm. Serial hemodynamic response was measured at 6 specified times. Two cardiac radiologists independently scored the image quality. Results: Both IV esmolol and IV metoprolol achieved the target HR. IV esmolol resulted in significantly less profound and shorter duration of reduction in systolic blood pressure [BP] than IV metoprolol with a difference of -10, -14 and -9 mm Hg compared to -20, -26 and -25 mmHg at 2, 15 & 30 min respectively. No significant difference in HR at image acquisition, exposure window, radiation dose and image quality. Although IV esmolol was expensive, the overall cost of care was comparable to IV metoprolol due to shortened post CCTA observation period consequent to faster restoration of hemodynamic status. Conclusion: Comparison of IV esmolol and IV metoprolol demonstrate that both are effective in achieving the target HR but significantly faster recovery of HR and BP in patients who receive IV esmolol was found.

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Image noise-based dose adaptation in dynamic volume CT of the heart: dose and image quality optimisation in comparison with BMI-based dose adaptation

Cited by 8 publications

References 32 publications

Image quality in coronary CT angiography: challenges and technical solutions

Image quality in coronary CT angiography: challenges and technical solutions

The Relationship of CT Mean Modulated Dose-Length Product and Body Mass Index During Routine 18F- FDG PET/CT Studies

Prospective Clinical Trial Comparing IV Esmolol to IV Metoprolol in CT Coronary Angiography: Effect on Hemodynamic, Technical Parameters and Cost

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