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Coronary computed tomography angiography with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination

Fuchs, Tobias A. ; Stehli, Julia ; Bull, Sacha ; Dougoud, Svetlana ; Clerc, Olivier F. ; Herzog, Bernhard A. ; Buechel, Ronny R. ; Gaemperli, Oliver ; Kaufmann, Philipp A.

In: European Heart Journal, 2014, vol. 35, no. 17, p. 1131-1136

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    Titre
    • Coronary computed tomography angiography with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination
    Auteur
    • Fuchs, Tobias A.
    • Stehli, Julia
    • Bull, Sacha. Division of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, CH-8091 Zurich, Switzerland
    • Dougoud, Svetlana. Division of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, CH-8091 Zurich, Switzerland
    • Clerc, Olivier F.. Division of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, CH-8091 Zurich, Switzerland
    • Herzog, Bernhard A.. Division of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, CH-8091 Zurich, Switzerland
    • Buechel, Ronny R.. Division of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, CH-8091 Zurich, Switzerland
    • Gaemperli, Oliver. Division of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, CH-8091 Zurich, Switzerland
    • Kaufmann, Philipp A.. E-mail: pak@usz.ch
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Heart Journal, 2014, vol. 35, no. 17, p. 1131-1136. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:296902
    Summary
    Aims To evaluate the feasibility and image quality of coronary computed tomography angiography (CCTA) acquisition with a submillisievert fraction of effective radiation dose using model-based iterative reconstruction (MBIR) for noise reduction. Methods and results In 42 patients undergoing standard low-dose (100-120 kV; 450-700 mA) and additional ultra-low-dose CCTA (80-100 kV; 150-210 mA) reconstructed with MBIR, segmental image quality was graded on a four-point scale [(i): non-evaluative, (ii): good, (iii): adequate, and (iv): excellent]. Signal-to-noise ratio (SNR) was calculated dividing left main artery (LMA) and right coronary artery (RCA) attenuation by the aortic root noise. Over a wide range of body mass index (18-40 kg/m2), the estimated median radiation dose exposure was 1.19 mSv [interquartile range (IQR): 1.07-1.30 mSv] for standard and 0.21 mSv (IQR: 0.18-0.23 mSv) for ultra-low-dose CCTA (P < 0.001). The median image quality score per segment was 3.5 (IQR: 3.0-4.0) in standard CCTA vs. 3.5 (IQR: 2.5-4.0) in ultra-low dose with MBIR (P = 0.29). Diagnostic image quality (scores 2-4) was found in 98.7 vs. 97.8% coronary segments (P = 0.36). Introduction of MBIR for ultra-low-dose CCTA resulted in a significant increase in SNR (P < 0.001) for LMA (from 15 ± 5 to 29 ± 7) and RCA (from 14 ± 4 to 27 ± 6) despite 82% dose reduction. Conclusion Coronary computed tomography angiography acquisition with diagnostic image quality is feasible at an ultra-lowradiation dose of 0.21 mSv, e.g. in the range reported for a postero-anterior and lateral chest X-ray