We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Diagnostic accuracy of low and high tube voltage coronary CT angiography using an X-ray tube potential-tailored contrast medium injection protocol.
- Authors
Albrecht, Moritz H.; Nance, John W.; Schoepf, U. Joseph; Jacobs, Brian E.; Bayer, Richard R.; Litwin, Sheldon E.; Reynolds, Michael A.; Otani, Katharina; Mangold, Stefanie; Varga-Szemes, Akos; De Santis, Domenico; Eid, Marwen; Apfaltrer, Georg; Tesche, Christian; Goeller, Markus; Vogl, Thomas J.; De Cecco, Carlo N.; Bayer, Richard R 2nd
- Abstract
<bold>Objectives: </bold>To compare the diagnostic accuracy between low-kilovolt peak (kVp) (≤ 100) and high-kVp (> 100) third-generation dual-source coronary CT angiography (CCTA) using a kVp-tailored contrast media injection protocol.<bold>Methods: </bold>One hundred twenty patients (mean age = 62.6 years, BMI = 29.0 kg/m2) who underwent catheter angiography and CCTA with automated kVp selection were separated into two cohorts (each n = 60, mean kVp = 84 and 117). Contrast media dose was tailored to the kVp level: 70 = 40 ml, 80 = 50 ml, 90 = 60 ml, 100 = 70 ml, 110 = 80 ml, and 120 = 90 ml. Contrast-to-noise ratio (CNR) was measured. Two observers evaluated image quality and the presence of significant coronary stenosis (> 50% luminal narrowing).<bold>Results: </bold>Diagnostic accuracy (sensitivity/specificity) with ≤ 100 vs. > 100 kVp CCTA was comparable: per patient = 93.9/92.6% vs. 90.9/92.6%, per vessel = 91.5/97.8% vs. 94.0/96.8%, and per segment = 90.0/96.7% vs. 90.7/95.2% (all P > 0.64). CNR was similar (P > 0.18) in the low-kVp vs. high-kVp group (12.0 vs. 11.1), as ws subjective image quality (P = 0.38). Contrast media requirements were reduced by 38.1% in the low- vs. high-kVp cohort (53.6 vs. 86.6 ml, P < 0.001) and radiation dose by 59.6% (4.3 vs. 10.6 mSv, P < 0.001).<bold>Conclusions: </bold>Automated tube voltage selection with a tailored contrast media injection protocol allows CCTA to be performed at ≤ 100 kVp with substantial dose reductions and equivalent diagnostic accuracy for coronary stenosis detection compared to acquisitions at > 100 kVp.<bold>Key Points: </bold>• Low-kVp coronary CT angiography (CCTA) enables reduced contrast and radiation dose. • Diagnostic accuracy is comparable between ≤ 100 and > 100 kVp CCTA. • Image quality is similar for low- and high-kVp CCTA. • Low-kVp image acquisition is facilitated by automated tube voltage selection. • Tailoring contrast injection protocols to the automatically selected kVp-level is feasible.
- Subjects
COMPUTED tomography; RADIATION doses; CHEMOEMBOLIZATION; CORONARY disease; ANGIOGRAPHY
- Publication
European Radiology, 2018, Vol 28, Issue 5, p2134
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-017-5150-z