MDCT of the Coronary Arteries: Feasibility of Low-Dose CT with ECG-Pulsed Tube Current Modulation to Reduce Radiation Dose

Abada, Hicham T.; Larchez, Christophe; Daoud, B.; Sigal-Cinqualbre, Anne; Paul, Jean-François

doi:10.2214/ajr.05.0216

Cited by 182 publications

(133 citation statements)

References 11 publications

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“…44 Additionally, with the advent of new MDCT technology, the radiation dose for CTA could be minimized to the level of background radiation (Ͻ3 mSv). 45 Our study has several limitations. This analysis is one of a cross-sectional nature, so it is not possible to make causal inferences.…”

Section: Discussionmentioning

confidence: 91%

Association Between High-Sensitivity C-Reactive Protein and Coronary Plaque Subtypes Assessed by 64-Slice Coronary Computed Tomography Angiography in an Asymptomatic Population

Rubin

Chang

Nasir

et al. 2011

Circ: Cardiovascular Imaging

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Section: Discussionmentioning

confidence: 91%

Association Between High-Sensitivity C-Reactive Protein and Coronary Plaque Subtypes Assessed by 64-Slice Coronary Computed Tomography Angiography in an Asymptomatic Population

Rubin

Chang

Nasir

et al. 2011

Circ: Cardiovascular Imaging

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“…It has been shown that lower tube voltages considerably reduce the radiation dose of CT examinations [11,36,37]. For CS, this relevant dose reduction is possible without compromising the reproducibility and accuracy of the method.…”

Section: Discussionmentioning

confidence: 99%

“…In order to keep radiation exposure as low as reasonably achievable (ALARA), recent modifications of multi-slice CT scanning protocols have been implemented, such as the use of a low tube current [8,9], attenuation-based tube current modulation [10], and use of low tube voltage protocols [11,12]. In general, two modes of phase synchronization have been traditionally used, i.e., the retrospective electrocardiography (ECG)-gating technique [13,14] that acquires continuous data in a helical (spiral) mode and the prospective ECGtriggering technique [15,16] that obtains data at predefined time points of the cardiac cycle in an axial step-and-shoot mode, the latter usually being associated with a lower radiation dose.…”

Section: Introductionmentioning

confidence: 99%

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Stolzmann

Leschka

Betschart

et al. 2008

Int J Cardiovasc Imaging

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Purpose The purpose of this study was to assess the radiation dose and associated image noise of previously suggested calcium scoring protocols using dual-source CT. Methods One hundred consecutive patients underwent coronary calcium scoring using dual-source CT. Patients were randomly assigned to five different protocols: retrospective ECG-gating and tube current reduction to 4% outside the pulsing window at 120 (protocol A) and 100 kV (B), prospective ECG-triggering at 120 (C) and 100 kV (D), and prospective ECG-triggering at 100 kV with attenuation-based tube current modulation (E). Radiation dose parameters and image noise were determined and compared. Results Protocol A resulted in an effective dose of 1.3 ± 0.2 mSv, protocol B in 0.8 ± 0.2 mSv, protocol C in 1.0 ± 0.2 mSv, protocol D in 0.6 ± 0.1 mSv, and protocol E in 0.7 ± 0.1 mSv. Effective doses were significantly lower (P \ 0.001) with 100 kV when compared to 120 kV protocols, and were significantly lower (P \ 0.001) for prospective versus retrospective ECG-gating. No significant difference was found between protocol D and E. Significant negative correlations were found between the CTDI vol and heart rate for both retrospective ECGgating protocols (protocol A: r = -0.98, P \ 0.001; protocol B: r = -0.83, P \ 0.001). The mean image noise was 29.0 ± 6.7 HU, with no significant differences between the five protocols. The image noise was significantly correlated with the body weight (r = 0.21, P \ 0.05) and BMI (r = 0.31, P \ 0.01). Conclusions Effective dose of calcium scoring using dual-source CT ranges from 0.6 to 1.3 mSv. Prospective triggering and lower tube voltage significantly reduces the radiation but yield similar image noise.

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“…25 • With correct dose reduction strategies in slim patients, the dose can be reduced by up to 88% with no reduction in image quality. 26 The use of prospective gating may deliver doses as low as 1mSv. 27 • Nevertheless, a recent study (proposing a more appropriate dosecorrection factor) concluded that CTCA could be associated with a higher dose than previously thought.…”

Section: Calcium Scorementioning

confidence: 99%

The role of coronary CT in the assessment and diagnosis of patients with chest pain

2012

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-The role of cardiac computed tomography (CT) in the assessment and management of patients with suspected cardiac chest pain has been formally recognised in NICE guidance 95. When the technique and patient selection are appropriate, cardiac CT is a valuable diagnostic tool, particularly for patients with a low to intermediate pre-test probability of coronary artery disease. The physician must be aware of the implications of the recent guidelines; hence, we present an illustrated synopsis on the current technique and the indications for the use of calcium scoring and cardiac CT in the assessment and management of patients with suspected cardiac chest pain.

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MDCT of the Coronary Arteries: Feasibility of Low-Dose CT with ECG-Pulsed Tube Current Modulation to Reduce Radiation Dose

Abstract: This study showed the combined effect of lowering the kilovoltage setting (80 kV) and using an automatic modulation technique (ECG-pulsed tube current modulation) for coronary CT. Radiation dose exposure can be reduced by up to 88% for slim patients without impairing image quality.

Cited by 182 publications

References 11 publications

Association Between High-Sensitivity C-Reactive Protein and Coronary Plaque Subtypes Assessed by 64-Slice Coronary Computed Tomography Angiography in an Asymptomatic Population

Association Between High-Sensitivity C-Reactive Protein and Coronary Plaque Subtypes Assessed by 64-Slice Coronary Computed Tomography Angiography in an Asymptomatic Population

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

The role of coronary CT in the assessment and diagnosis of patients with chest pain

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