Hu X, Tao X, Zhang Y, Niu Z, Zhang Y, Allmendinger T, Kuang Y, Chen B. Accurate Measurement of Agatston Score Using kVp-Independent Reconstruction Algorithm for Ultra-High-Pitch Sn150 kVp CT.
Korean J Radiol 2021;
22:1777-1785. [PMID:
34431246 PMCID:
PMC8546135 DOI:
10.3348/kjr.2021.0050]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE
To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose.
MATERIALS AND METHODS
This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared.
RESULTS
No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode.
CONCLUSION
The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.
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