Japanese Survey of Radiation Dose Associated With Coronary Computed Tomography Angiography　― 2013 Data From a Multicenter Registry in Daily Practice ―

Tanabe, Yuji; Kido, Teruhiko; Kimura, Fumiko; Kobayashi, Yasuyuki; Matsunaga, Naofumi; Yoshioka, Kunihiro; Yoshimura, Norihiko; Mochizuki, Takashi

doi:10.1253/circj.cj-19-0843

Cited by 6 publications

(6 citation statements)

References 32 publications

(24 reference statements)

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“…Fifth, we lacked a sufficient number of patients who underwent coronary CT angiography using other contrast injection protocols, since our initial study demonstrated the feasibility of the diluted-contrast injection protocol with regard to the homogeneity of intra-coronary CT attenuation compared to the body-weight-based contrast injection protocol ( 6 ). Sixth, there are some concerns about radiation exposure with CT. A 2013 survey in Japan showed that the coronary CT angiography radiation dose was higher than that with routine chest CT ( 29 ). The implementation of strategies to reduce CT radiation exposure (e.g.…”

Section: Discussionmentioning

confidence: 99%

Plaque Characterization with Computed Tomography Angiography Based on a Diluted-contrast Injection Protocol

et al. 2021

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Objective Coronary plaques with low attenuation on computed tomography (CT) angiography may indicate vulnerable plaques. However, plaque CT attenuation is reported to be significantly affected by intracoronary attenuation. Recently, the diluted-contrast injection protocol was established to facilitate more uniform intracoronary attenuation than can be achieved with the generally used body-weight-adjusted protocol. We validated the relationship between low-attenuation plaque on CT and lipid-rich plaque using integrated backscatter-intravascular ultrasound (IB-IVUS) as the standard reference. Methods Plaques were divided into tertiles (T1, T2, and T3) according to the plaque CT attenuation, calculated as the average of five intra-plaque regions of interest, and compared with the plaque characteristics noted on IB-IVUS. Patients Patients who underwent both CT angiography using a diluted-contrast injection protocol and IB-IVUS were retrospectively analyzed. Results Thirty-nine plaques in 32 patients were analyzed by CT angiography and IB-IVUS. The median plaque CT attenuation (Hounsfield units) of each tertile was 30 (T1), 48 (T2), and 68 (T3). Although no significant difference was noted in conventional quantitative IVUS parameters (e.g. plaque burden), the T1 with lowest plaque CT attenuation had the highest percentage lipid area by IB-IVUS [75.1% (T1), 57.8% (T2), and 50.8% (T3), respectively, p<0.01]. Furthermore, the plaque CT attenuation had a significant negative correlation with the percentage lipid area (r=-0.59, p<0.01). Conclusion CT angiography-based plaque characterization using a diluted-contrast injection protocol may aid in the quantitative detection of lipid-rich plaque.

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Section: Discussionmentioning

confidence: 99%

Plaque Characterization with Computed Tomography Angiography Based on a Diluted-contrast Injection Protocol

et al. 2021

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“…using a commercially available software program (Ziostation 2; Ziosoft, Tokyo, Japan). The effective scanning dose for the evaluation coronary arteries was calculated from the dose-length product in a dose report in both groups (conversion factor 0.014) ( 9 , 12 ).…”

Section: Methodsmentioning

confidence: 99%

“…After a scout scan, a non-contrast electrocardiogram (ECG)-gated cardiac scan was performed using a prospective ECG-gated technique. After a non-contrast scan, conventional enhanced 320-slice CT was performed with a slice thickness of 0.5 mm and a tube voltage of 120 kV in both groups, using a retrospective ECG-gated with dose modulation technique and decreasing the radiation dose during the systolic phases (if possible) (Table 1) (8)(9)(10). The tube current during the scan was set based on the autoexposure control system (100-750 mA).…”

Section: Ct Protocolmentioning

confidence: 99%

An Increased Diagnostic Accuracy of Significant Coronary Artery Stenosis Using 320-slice Computed Tomography with Model-based Iterative Reconstruction in Cases with Severely Calcified Coronary Arteries

et al. 2023

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Purpose High-quality images can be obtained with 320-slice computed tomography (CT) with model-based iterative reconstruction (MBIR). We therefore investigated the diagnostic accuracy of 320-slice CT with MBIR for detecting significant coronary artery stenosis. Methods This was a retrospective study of 160 patients who underwent coronary CT and invasive coronary angiography (ICA). The first 100 consecutive patients (Group 1) underwent 320-slice CT without MBIR or small-focus scanning. The next 60 consecutive patients (Group 2) underwent 320-slice CT with both MBIR and small-focus scanning. Patients who underwent coronary artery bypass surgery were excluded. The diagnostic performance of 320-slice CT without MBIR or small-focus scanning and 320-slice CT with both of them, with ICA regarded as a reference standard, was compared to detect significant coronary artery stenosis (! 70% on CT, ! 75% on ICA). Results In a patient-based analysis, the sensitivity, specificity, and overall accuracy of detection of significant stenosis on CT against ICA were 95%, 85%, and 91% in Group 1, and 93%, 83%, and 90% in Group 2, respectively. No significant differences were observed between the two groups in the patient-and segmentbased analyses. However, among cases with a severe coronary artery calcium score >400 (31 cases in Group 1 and 28 in Group 2), the specificity and overall accuracy were significantly higher (all p<0.01) in Group 2 than in Group 1 according to the segment-based analysis. ConclusionThe diagnostic accuracy of the detection of coronary artery stenosis on CT was improved using 320-slice CT with MBIR.

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“…Coronary computed tomography angiography (CCTA) is the first-line diagnostic imaging method for children with coronary artery diseases (1)(2)(3), such as those of abnormal origin (4) and coronary aneurysm (5). Reducing radiation and contrast medium doses while providing acceptable image quality (6,7), eliminating motion artifacts (8,9), and maintaining fast and easy operation remains the research focuses. In recent years, through the application of faster gantry rotation and motion correction algorithms such as the Snapshot Freeze (SSF) and wide-detector coverage for the single-beat cardiac scan technique and other technologies, CCTA image quality has been significantly improved.…”

Section: Introductionmentioning

confidence: 99%

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

Sun¹,

Li²,

Li³

et al. 2021

Quant Imaging Med Surg

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Background: Iterative reconstruction algorithms are often used to reduce image noise in low-dose coronary computed tomography angiography (CCTA) but encounter limitations. The newly introduced deep learning image reconstruction (DLIR) algorithm may provide new opportunities. We assessed the image quality and diagnostic performance of DLIR in low radiation dose and contrast medium dose CCTA of pediatric patients with 70 kVp and a shortened injection protocol.Methods: This was a prospective study. A total of 27 consecutive arrhythmic pediatric patients were enrolled in the study group and underwent CCTA using a prospective ECG-triggered single-beat protocol: tube voltage 70 kVp, automatic tube current modulation for a noise index (NI) of 22, and contrast dose of 0.4-0.6 mL/kg. Images were reconstructed with DLIR. They were compared with 27 matched patients in the control group scanned with 80 kVp, a lower NI setting (NI =19), and a higher contrast dose (0.8-1.2 mL/kg).The images in the control group were reconstructed using the adaptive statistical iterative reconstruction (ASIR-V) algorithm. The image contrast, image quality, and diagnostic confidence were assessed by 2 experienced radiologists using a 5-point scale (1: nondiagnostic and 5: excellent). The CT value and standard deviation of the aorta and perivascular tissue were measured, and the contrast-to-noise ratio (CNR) for the aorta was calculated. The contrast medium and radiation doses were compared. Results: The study and control groups had similar image contrast scores (4.75±0.57 vs. 4.78±0.42), image quality scores (3.67±0.47 vs. 3.44±0.51), and diagnostic confidence (4.74±0.44 vs. 4.74±0.45) (all P>0.05). There was an adequate enhancement in the aorta (614.74±127.73 vs. 705.89±111.20 HU) and similar CNR (20.34±4.64 vs. 20.99±4.14) in both groups. The image noise of the study group was lower in the aorta (30.61±3.88 vs. 34.77±3.49) and similar in perivascular tissue (27.66±6.24 vs. 27.55±3.33) compared with the control group. The study group reduced the total contrast medium dose by 53% to 15.07±3.68 ml and radiation dose by 36% to 0.57±0.31 mSv. Conclusions:The DLIR algorithm in CCTA for children using 70 kVp tube voltage with a shortened contrast medium injection protocol maintains image quality and diagnostic confidence while significantly reducing contrast medium dose and radiation dose compared with the use of the conventional CCTA protocol.

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Japanese Survey of Radiation Dose Associated With Coronary Computed Tomography Angiography　― 2013 Data From a Multicenter Registry in Daily Practice ―

Cited by 6 publications

References 32 publications

Plaque Characterization with Computed Tomography Angiography Based on a Diluted-contrast Injection Protocol

Plaque Characterization with Computed Tomography Angiography Based on a Diluted-contrast Injection Protocol

An Increased Diagnostic Accuracy of Significant Coronary Artery Stenosis Using 320-slice Computed Tomography with Model-based Iterative Reconstruction in Cases with Severely Calcified Coronary Arteries

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

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Japanese Survey of Radiation Dose Associated With Coronary Computed Tomography Angiography ― 2013 Data From a Multicenter Registry in Daily Practice ―

Cited by 6 publications

References 32 publications

Plaque Characterization with Computed Tomography Angiography Based on a Diluted-contrast Injection Protocol

Plaque Characterization with Computed Tomography Angiography Based on a Diluted-contrast Injection Protocol

An Increased Diagnostic Accuracy of Significant Coronary Artery Stenosis Using 320-slice Computed Tomography with Model-based Iterative Reconstruction in Cases with Severely Calcified Coronary Arteries

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

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Japanese Survey of Radiation Dose Associated With Coronary Computed Tomography Angiography　― 2013 Data From a Multicenter Registry in Daily Practice ―