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

Tan, Sock Keow; Yeong, Chai Hong; Aman, Raja Rizal Azman Raja; Ng, Kwan Hoong; Aziz, Yang Faridah Abdul; Chee, Kok Han; Sun, Zhonghua

doi:10.1259/bjr.20170874

Cited by 17 publications

(13 citation statements)

References 53 publications

(100 reference statements)

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“…Initially, many studies have attempted to reduce TID by adjusting the contrast concentration or volume, and they mostly use a low iodine delivery rate (IDR) which was between 1.08 and 1.70 gI•s -1 (6)(7)(8)(9)(10)(11)(12). IDR represents the rate at which iodine is delivered into the arterial system and is the main determinant of VCE in CCTA.…”

Section: Introductionmentioning

confidence: 99%

Personalized administration of contrast medium with high delivery rate in low tube voltage coronary computed tomography angiography

Tan¹,

Ng²,

Yeong³

et al. 2019

Quant. Imaging Med. Surg

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Background: High delivery rate is an important factor in optimizing contrast medium administration in coronary computed tomography angiography (CCTA). A personalized contrast volume calculation algorithm incorporating high iodine delivery rate (IDR) can reduce total iodine dose (TID) and produce optimal vessel contrast enhancement (VCE) in low tube voltage CCTA. In this study, we developed and validated an algorithm for calculating the volume of contrast medium delivered at a high rate for patients undergoing retrospectively ECG-gated CCTA with low tube voltage protocol. Methods:The algorithm for an IDR of 2.22 gI•s -1 was developed based on the relationship between VCE and contrast volume in 141 patients; test bolus parameters and characteristics in 75 patients; and, tube voltage in a phantom study. The algorithm was retrospectively tested in 45 patients who underwent retrospectively ECG-gated CCTA with a 100 kVp protocol. Image quality, TID and radiation dose exposure were compared with those produced using the 120 kVp and routine contrast protocols.Results: Age, sex, body surface area (BSA) and peak contrast enhancement (PCE) were significant predictors for VCE (P<0.05). A strong linear correlation was observed between VCE and contrast volume (r=0.97, P<0.05). The 100-to-120 kVp contrast enhancement conversion factor (E c ) was calculated at 0.81.Optimal VCE (250 to 450 HU) and diagnostic image quality were obtained with significant reductions in TID (32.1%) and radiation dose (38.5%) when using 100 kVp and personalized contrast volume calculation algorithm compared with 120 kVp and routine contrast protocols (P<0.05). Conclusions:The proposed algorithm could significantly reduce TID and radiation exposure while maintaining optimal VCE and image quality in CCTA with 100 kVp protocol.

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Section: Introductionmentioning

confidence: 99%

Personalized administration of contrast medium with high delivery rate in low tube voltage coronary computed tomography angiography

Tan¹,

Ng²,

Yeong³

et al. 2019

Quant. Imaging Med. Surg

Self Cite

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“…In the human body, iodine contrast agents are filtered by glomerulus but not absorbed by renal tubules. During the process of glomerular filtration, concentration in the kidney increases, which may lead to a series of adverse reactions, such as renal damage ( 20 ). Low contrast agent flow rate and low contrast agent dose usually reduce the enhancement density of coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

Influence of Contrast Agent Injection Scheme Customized by Dual-Source CT Based on Automatic Tube Voltage Technology on Image Quality and Radiation Dose of Coronary Artery Imaging

Chen

et al. 2022

Front. Surg.

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ObjectiveTo explore the influence of a contrast agent injection scheme customized by dual-source CT based on automatic tube voltage technology on coronary imaging image quality and radiation dose.MethodsA total of 205 patients who underwent coronary CT angiography (CCTA) in our hospital from June 2021 to September 2021 were selected. 105 patients in the control group who underwent routine scanning according to body mass (BMI) and 100 patients in the observation group who set tube voltage and contrast agent dosage according to automatic tube voltage selection technology. CT values of the aortic root (AO); left anterior descending (LAD) branch; proximal, middle, and distal segments of the right coronary artery (RCA); and proximal and distal segments of left circumflex (LCX) branch were measured. We calculated the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image. Image quality scoring and effective dose (ED) calculation were carried out.ResultsThere was no significant difference in the CT value, SNR value, and CNR value of each part of the artery between the two groups (P > 0.05). Image quality scores of the control group and the observation group were 1.28 ± 0.25 and 1.25 ± 0.23, respectively, and there was no significant difference in scores (P > 0.05). In the control group, the dosage of comparator was 43.81 ± 6.74 ml, and the ED was 4.92 ± 1.26 mSv. The dosage of contrast agent in the observation group was 34.23 ± 6.39 ml, and ED was 3.05 ± 0.94 mSv. The dosage of contrast agent and ED in the observation group were lower than those in the control group (P < 0.05).ConclusionThe contrast agent injection scheme customized by dual-source CT based on automatic tube voltage technology can meet the clinical requirements of coronary image quality, reduce the radiation dose and contrast agent consumption, and help doctors choose a more accurate and reasonable examination scheme, which has certain clinical application value.

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“…Our results showed that using 100 kV instead of 120 kV resulted in up to 38% reduction in radiation dose. Similar studies reported different amount of radiation dose reduction regarding scanner type, ECG gating technique, and range of applied tube current . Furthermore, we achieved 21% reduction in iodine intake through lowering the concentration of contrast media.…”

Section: Discussionmentioning

confidence: 99%

Coronary CT angiography by modifying tube voltage and contrast medium concentration: Evaluation of image quality and radiation dose

et al. 2019

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Background Currently, there is an increasing interest in noninvasive imaging of cardiovascular system such as computed tomography coronary angiography (CCTA). The risks of radiation‐induced cancer and contrast‐induced nephropathy (CIN) have always been regarded as concerns which increased demand for CCTA using reduced radiation dose and iodine intake. We aimed to evaluate the image quality and radiation dose of CCTA by modifying tube voltage and concentration of contrast media. Methods The present study includes 105 patients who underwent CCTA for clinical indications. Specific inclusion and exclusion criteria in terms of patient's weight, body mass index, calcium score, and stenting were used. First group of patients scanned by 120 kV and 370 mg I/mL contrast medium, compared with second and third groups for which scanning was performed using 100 kV and 370 mg I/mL and 100 kV and 300 mg I/mL, respectively. Image quality was evaluated both subjectively and objectively. The effective dose and iodine intake were also measured. Results Using low kV protocols led to radiation dose reduction up to 38% and applying low contrast medium concentration with consequent reduced iodine intake up to 21%. Moreover, there were significant differences in image quality of new scanning protocols. Conclusion Reduction in tube voltage with lowering of contrast medium concentration can reduce radiation dose and iodine intake with acceptable image quality.

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

Cited by 17 publications

References 53 publications

Personalized administration of contrast medium with high delivery rate in low tube voltage coronary computed tomography angiography

Personalized administration of contrast medium with high delivery rate in low tube voltage coronary computed tomography angiography

Influence of Contrast Agent Injection Scheme Customized by Dual-Source CT Based on Automatic Tube Voltage Technology on Image Quality and Radiation Dose of Coronary Artery Imaging

Coronary CT angiography by modifying tube voltage and contrast medium concentration: Evaluation of image quality and radiation dose

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