Image Quality and Radiation Dose of CT Coronary Angiography with Automatic Tube Current Modulation and Strong Adaptive Iterative Dose Reduction Three-Dimensional (AIDR3D)

Shen, Hesong; Dai, Guochao; Luo, Mingzhang; Duan, Chaijie; Cai, Wenli; Liang, Dan; Wang, Xinhua; Zhu, Dongyun; Li, Wenru; Qiu, Jianping

doi:10.1371/journal.pone.0142185

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…Also, both SNR and CNR showed significant improvement with increasing the levels of iterative reconstruction. This phenomenon is consistent to AlShammakhi & Sun [29] in their retrospective study and many others researchers [8,11,24,25].…”

Section: Discussionsupporting

confidence: 90%

“…As per Shen, et al [8] CT densities were measured at aortic root cranial to left coronary ostium, left main coronary artery, and epicardial fat surrounding left main coronary artery. Image noise was defined as the standard deviation of CT density at aortic root; cranial to left coronary ostium.…”

Section: Image Analysismentioning

confidence: 99%

“…The continuing advances of multislice computed tomography (MSCT) have provided ongoing opportunities to improve the current practice in computed tomography (CT) clinical applications and in particular in cardiovascular imaging [3][4][5][6]. Quantification of coronary artery calcification (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk [7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Iterative Reconstruction Technique on the Diagnosis of Coronary Artery Calcification

Khamis¹,

Malhari²,

Mohammed³

et al. 2021

Int Arch Cardiovasc Dis

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Objectives: This study aimed to assess the impact of iterative reconstruction (IR) algorithms for the evaluation of coronary artery calcification (CAC) in terms of image quality and subjective diagnostic performance. Methods:This study was performed in a single center and written informed consent was obtained from all patients. Thirty-one consecutive patients (26 men/5 women) underwent CT calcium score to rule out CAC. Image data were reconstructed with both; filtered back projection (FBP) and different levels of IR algorithms. Both the qualitative and quantitative image quality and subjective diagnostic performance were compared; Agatston scores and calcium density were measured for a total of 100 coronary arteries.Results: Quantitatively; image noise was substantially reduced with high levels of IR reflecting high significances of noise level (p < 0.001). In terms of subjective diagnostic performance, it was observed with increased IR levels; 49% of coronary arteries showed decrease, 14% showed increase, 32% were constant and 5% of coronary arteries showed fluctuation in total Agatston scores. Certain Agatston scores were not detected in coronary arteries in some levels of IR algorithms.Conclusions: IR resulted in substantial noise reduction and improved in both signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Higher levels of IR might lead to disappearance or underestimation of detectable calcium in coronary arteries with low calcium burden. Iterative reconstruction technique should be used with caution for better calcium quantification.

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Section: Discussionsupporting

confidence: 90%

Section: Image Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Influence of Iterative Reconstruction Technique on the Diagnosis of Coronary Artery Calcification

Khamis¹,

Malhari²,

Mohammed³

et al. 2021

Int Arch Cardiovasc Dis

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“…IR algorithms adaptively apply noise correction at a reduced X-ray exposure without compromising spatial resolution[ 14 ]. AIDR and more recently 3D AIDR (AIDR3D) decreases image noise thus allowing for reductions in tube current while preserving overall image quality[ 15 ]. BMI-adapted tube voltage and current work synergistically with AIDR3D to reduce image noise while achieving a 75% radiation dose reduction relative to a scan reconstructed with filtered back-projection[ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Low-radiation and high image quality coronary computed tomography angiography in “real-world” unselected patients

Richards

Dorman

John

et al. 2018

WJR

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AIMTo determine the radiation dose and image quality in coronary computed tomography angiography (CCTA) using state-of-the-art dose reduction methods in unselected “real world” patients.METHODSIn this single-centre study, consecutive patients in sinus rhythm underwent CCTA for suspected coronary artery disease (CAD) using a 320-row detector CT scanner. All patients underwent the standard CT acquisition protocol at our institute (Morriston Hospital) a combination of dose saving advances including prospective electrocardiogram-gating, automated tube current modulation, tube voltage reduction, heart rate reduction, and the most recent novel adaptive iterative dose reconstruction 3D (AIDR3D) algorithm. The cohort comprised real-world patients for routine CCTA who were not selected on age, body mass index, or heart rate. Subjective image quality was graded on a 4-point scale (4 = excellent, 1 = non-diagnostic).RESULTSA total of 543 patients were included in the study with a mean body weight of 81 ± 18 kg and a pre-scan mean heart rate of 70 ± 11 beats per minute (bpm). When indicated, patients received rate-limiting medication with an oral beta-blocker followed by additional intravenous beta-blocker to achieve a heart rate below 65 bpm. The median effective radiation dose was 0.88 mSv (IQR, 0.6-1.4 mSv) derived from a Dose Length Product of 61.45 mGy.cm (IQR, 42.86-100.00 mGy.cm). This also includes what we believe to be the lowest ever-reported radiation dose for a routine clinical CCTA (0.18 mSv). The mean image quality (± SD) was 3.65 ± 0.61, with a subjective image quality score of 3 (“good”) or above for 93% of patient CCTAs.CONCLUSIONCombining a low-dose scan protocol and AIDR3D with a 320-detector row CT scanner can provide high quality images at exceptionally low radiation dose in unselected patients being investigated for CAD.

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“…Such low scanning parameters have an influence on the performance and image quality of AIDR 3D and temporal averaging in general and on contour sharpness in particular. There are different approaches to deal with multiple datasets [ 23 , 24 ]. It would be interesting to evaluate how they affect image quality parameters in 4D CTP of the myocardium.…”

Section: Discussionmentioning

confidence: 99%

Effect of iterative reconstruction and temporal averaging on contour sharpness in dynamic myocardial CT perfusion: Sub-analysis of the prospective 4D CT perfusion pilot study

et al. 2018

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PurposeMyocardial computed tomography perfusion (CTP) allows the assessment of the functional relevance of coronary artery stenosis. This study investigates to what extent the contour sharpness of sequences acquired by dynamic myocardial CTP is influenced by the following noise reduction methods: temporal averaging and adaptive iterative dose reduction 3D (AIDR 3D).Materials and methodsDynamic myocardial CT perfusion was conducted in 29 patients at a dose level of 9.5±2.0 mSv and was reconstructed with both filtered back projection (FBP) and strong levels of AIDR 3D. Temporal averaging to reduce noise was performed as a post-processing step by combining two, three, four, six and eight original consecutive 3D datasets. We evaluated the contour sharpness at four distinct edges of the left-ventricular myocardium based on two different approaches: the distance between 25% and 75% of the maximal grey value (d) and the slope in the contour (m).ResultsIterative reconstruction reduced contour sharpness: both measures of contour sharpness performed better for FBP than for AIDR 3D (d = 1.7±0.4 mm versus 2.0±0.5 mm, p>0.059 at all edges; m = 255.9±123.9 HU/mm versus 160.6±123.5 HU/mm; p<0.023 for all edges). Increasing levels of temporal averaging degraded contour sharpness. When FBP reconstruction was applied, contour sharpness was best without temporal averaging (d = 1.7±0.4 mm, m = 255.9±123.9 HU/mm) and poorest for the strongest levels of temporal averaging (d = 2.1±0.3 mm, m = 142.2±104.9 HU/mm; comparison between lowest and highest temporal averaging level: for d p>0.052 at all edges and for m p<0.001 at all edges).ConclusionThe use of both temporal averaging and iterative reconstruction degrades objective contour sharpness parameters of dynamic myocardial CTP. Thus, further advances in image processing are needed to optimise contour sharpness of 4D myocardial CTP.

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Image Quality and Radiation Dose of CT Coronary Angiography with Automatic Tube Current Modulation and Strong Adaptive Iterative Dose Reduction Three-Dimensional (AIDR3D)

Cited by 10 publications

References 27 publications

The Influence of Iterative Reconstruction Technique on the Diagnosis of Coronary Artery Calcification

The Influence of Iterative Reconstruction Technique on the Diagnosis of Coronary Artery Calcification

Low-radiation and high image quality coronary computed tomography angiography in “real-world” unselected patients

Effect of iterative reconstruction and temporal averaging on contour sharpness in dynamic myocardial CT perfusion: Sub-analysis of the prospective 4D CT perfusion pilot study

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