Publication

Dose levels and image quality of second-generation 128-slice dual-source coronary CT angiography in clinical routine

Journal Paper/Review - May 16, 2015

Units
PubMed
Doi

Citation
Wichmann J, Bauer R, Vogl T, Luboldt W, Frellesen C, Beeres M, Kerl J, Engler A, Hu X, Lehnert T. Dose levels and image quality of second-generation 128-slice dual-source coronary CT angiography in clinical routine. Radiol Med 2015; 120:1112-21.
Type
Journal Paper/Review (English)
Journal
Radiol Med 2015; 120
Publication Date
May 16, 2015
Issn Electronic
1826-6983
Pages
1112-21
Brief description/objective

OBJECTIVES
To compare radiation exposure and image quality of second-generation 128-slice dual-source CT (DSCT) coronary angiography (cCTA) protocols.

MATERIALS AND METHODS
We retrospectively analyzed data from four groups with 25 patients, each examined by one of the following DSCT cCTA protocols: prospectively ECG-gated high-pitch (group 1) or sequential (group 2) acquisition, retrospectively ECG-gated acquisition in dual-energy (DECT, group 3) or dual-source (group 4) mode. CT dose index volume, dose length product, estimated radiation dose, contrast-to-noise- and signal-to-noise-ratios were compared. Subjective image quality was rated by two observers blinded to the protocols.

RESULTS
High-pitch DSCT showed a mean estimated radiation dose of 1.27 ± 0.62 mSv, significantly (p < 0.01) lower than sequential (2.04 ± 0.94 mSv), dual-energy (3.97 ± 1.29 mSv) or dual-source (8.11 ± 4.95 mSv) acquisition. Image noise showed no statistical difference (p > 0.91), ranging from 15.2 ± 4.4 (group 2) up to 24.5 ± 22.0 (group 4). Each protocol showed diagnostic image quality in at least 98.1 % of evaluated coronary segments without significant differences (p > 0.05).

CONCLUSIONS
Prospectively ECG-gated DSCT protocols enable cCTA with significant dose reduction and consistently diagnostic image quality. In patients requiring retrospectively ECG-gated DSCT for functional analysis or due to arrhythmia, dual-energy mode should be preferred over dual-source mode as it significantly decreases estimated dose without compromising image quality.