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Shim J, Chung YE, Jeong HW, Lee Y. Feasibility Study of Dose Modulation for Reducing Radiation Dose with Arms-Down Patient Position in Abdominal Computed Tomography. Diagnostics (Basel) 2022; 12:diagnostics12020323. [PMID: 35204414 PMCID: PMC8871179 DOI: 10.3390/diagnostics12020323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
This study was carried out to demonstrate whether the radiation dose for patients in arms-down position can be reduced without affecting the diagnosis on abdominal computed tomography (CT). The patients were divided into two groups: group A, which included patients with arms-down position using dose modulation on, and group B, which included patients with arms-down position using dose modulation turned off. Quantitative evaluation was compared using Hounsfield units, standard deviation, and signal-to-noise ratio of the four regions. The qualitative evaluation was assessed for overall image quality, subjective image noise, and beam hardening artifacts. Dose evaluation for CT dose index (CTDI) and dose length product (DLP) was compared by comparing the CT images with dose modulation turned on and off. In the quantitative and qualitative evaluation, there was no statistically significant difference between groups A and B (p > 0.05). In the dose evaluation, the CT images with dose modulation turned off had significantly lower CTDI and DLP than the CT images with dose modulation turned on (p < 0.05). Our results suggest that, for the GE Revolution EVO CT scanner, turning off dose modulation and increasing the tube voltage can reduce the radiation dose for patients with the arms-down position without affecting the diagnosis. This study did not consider the change of tube potential according to the use of dose modulation, and we plan to conduct additional research in the future.
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Affiliation(s)
- Jina Shim
- Department of Diagnostic Radiology, Severance Hospital, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea;
| | - Yong Eun Chung
- Department of Radiology, Yonsei University Health System, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea;
| | - Hyun-Woo Jeong
- Department of Biomedical Engineering, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si 13135, Gyeonggi-do, Korea
- Correspondence: (H.-W.J.); (Y.L.); Tel.: +82-31-740-7135 (H.-W.J.); +82-32-820-4362 (Y.L.)
| | - Youngjin Lee
- Department of Radiological Science, Gachon University, 191, Hambakmoero, Yeonsu-gu, Incheon 21936, Korea
- Correspondence: (H.-W.J.); (Y.L.); Tel.: +82-31-740-7135 (H.-W.J.); +82-32-820-4362 (Y.L.)
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Sookpeng S, Martin CJ, Krisanachinda A. Effects of tube potential selection together with computed tomography automatic tube current modulation on CT imaging performance. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:809-831. [PMID: 33657533 DOI: 10.1088/1361-6498/abebb4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
The effects of tube potential selection with a computed tomography (CT) automatic tube current modulation (ATCM) system on radiation dose and image quality have been investigated on a Canon CT scanner. The use of different values of tube voltage for imaging, and the appropriate settings of the ATCM system, were evaluated. The custom-made phantom consisted of three sections of different sizes with inserts of various materials. It was scanned using tube potentials of 80-140 kV and different image quality ATCM settings. CTDIvoland image quality in terms of noise, contrast, and contrast-to-noise ratio (CNR) for air, polyethylene (PE), acrylic, polyoxymethylene (POM) and polyvinylchloride (PVC) were analysed. A figure of merit (FOM) was estimated by combining CNR and CTDIvol. CTDIvolvalues were similar for all values of tube voltage and individual image quality ATCM settings when tube current was not restricted by the maximum value. The contrasts were independent of ATCM image quality setting, but CNR increased at the higher image quality level as image noise decreased. Both contrast and CNR decreased with increasing tube voltage for PVC and PE, but increased for POM and acrylic. PVC was the only insert material for which there was a significant improvement in contrast at lower tube potentials. FOM indicated that standard (SD = 10) and low dose (SD = 12.5) ATCM settings might be appropriate. The optimum tube voltage settings for imaging the PVC was 80-100 kV, but not for the lower contrast POM and acrylic, for which the standard tube voltage setting of 120 kV was better. The tube potential should be carefully set to gain radiological protection optimisation and keep the radiation dose as low as possible. Results indicate that 100 kV is likely to be appropriate for imaging small and medium-sized Thai patients when iodine contrast is used.
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Affiliation(s)
- S Sookpeng
- Department of Radiological Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - C J Martin
- Department of Clinical Physics and Bio-engineering, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A Krisanachinda
- Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Naseri M, Shahsavan M, Salahshour F, Peiman S, Allameh SF, Farzanehfar S, Emami-Ardekani AR, Pouraliakbar H, Abbasi M. EFFECTIVE DOSE FOR RADIOLOGICAL PROCEDURES IN AN EMERGENCY DEPARTMENT: A CROSS-SECTIONAL STUDY. RADIATION PROTECTION DOSIMETRY 2020; 189:63-68. [PMID: 32140712 DOI: 10.1093/rpd/ncaa013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/05/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
The extent of radiation exposure in emergency settings is not well documented; here, the corresponding effective dose (ED) is provided. In 500 patients admitted in row to the emergency department, ED was compared in patients according to complaints and their visiting physicians. Out of all, 220 patients aged 43.5 ± 22.2 years (admission: 2.0 ± 1.6 days) had at least an imaging. The main reasons for admission were trauma (10.5%) and then orthopedic problems (8.6%). EDs from CT and radiography were 1.66 ± 3.59 and 0.71 ± 1.67 mSv, respectively (from all 2.29 ± 4.12). Patients with abdominal (5.8 ± 5.2 mSv; p < 0.002) and pelvic (12.0 ± 6.3 mSv; p < 0.007) complaints received higher ED from CT and radiography and, also, patients visited by surgeons (7.94 ± 6.9 mSv). CT scan was the main source for ED to patients. Irrespective of the final diagnosis, patients with abdominopelvic complaints and those visited by surgeons are at higher exposure risk.
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Affiliation(s)
- Maryam Naseri
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shahsavan
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Salahshour
- Department of Radiology, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farshad Allameh
- Department of Internal Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Farzanehfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Emami-Ardekani
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Application of Low Tube Voltage, Low-concentration Contrast Agent Using a 320-row CT in Coronary CT Angiography: Evaluation of Image Quality, Radiation Dose and Iodine Intake. Curr Med Sci 2020; 40:178-183. [PMID: 32166681 DOI: 10.1007/s11596-020-2162-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 12/15/2019] [Indexed: 10/24/2022]
Abstract
The effect of low voltage and low concentration contrast agent on image quality of coronary CT angiography, radiation dose and iodine intake was evaluated. A total of 121 patients with body mass index (BMI) <26 kg/m2 and heart rate (HR) <70 beats/min were randomly divided into four groups: group A (n=31, 80 kVp, 270 mgI/mL); group B (n=33, 100 kVp, 270 mgI/mL); group C (n=30, 100 kVp, 320 mgI/mL); group D (n=27, 100 kVp, 400 mgI/mL). The automatic current modulation system and the iterative algorithm for reconstruction were adopted in each group. The CT values and SD values of the aortic root (AR), subcutaneous fat, left coronary artery opening (LCA), and right coronary artery opening (RCA) were measured in all groups, the signal-to-noise ratio (SNR) and contrast noise ratio (CNR) were calculated, and effective radiation dose and iodine intake were recorded. The subjective assessment for image quality was performed by two physicians using a 4-point scale. The results were compared using the one-way ANOVA and rank sum tests. The image quality of the four groups met the clinical diagnostic requirements. The CT values of AR in groups A, B, C, and D were 537.6±71.4, 447.2±81.9, 445.2±64.9 and 518.5±94.9 Hu, respectively, with no significant difference between group A and group D, or between group B and group C, while CT values in groups B and C were significantly lower than those in groups A and D (P<0.05). In groups A, B, C, and D, the LCA SNR values were 22.7±9.1, 23.3±9.1, 23.3±7.7 and 26.6±8.9, and the RCA CNR values were 26.9±9.8, 28.5±11.4, 27.7±8.8 and 32.1±10.6, respectively. The AR visual scores in groups A, B, C and D were 3.8±0.2, 3.9±0.3, 3.9±0.3 and 4.0±0.3, respectively. There were no significant differences in SNR, CNR and visual score among the four groups (P>0.05). The radiation doses in groups A, B, C and D were 2.6±1.4, 3.6±1.8, 4.9±3.5 and 4.9±2.8 mSv, respectively. The radiation dose in group A was significantly less than that in the rest three groups (P<0.05). The iodine intakes in groups A, B, C and D were 14.9±1.5, 15.0±1.5, 17.7±2.0 and 18.1±2.5 g, respectively. There was no significant difference in the intake of iodine between groups C and D, or between groups A and B, while iodine intake in groups A and B were significantly reduced as compared with that in groups C and D (P<0.05). It was concluded that for patients with low BMI and controlled HR, compared to 100 kVp tube voltage combined with multiple concentration contrast agents, 80 kVp combined with 270 mgI/mL contrast agent is enough to ensure the quality of the images, and can reduce the radiation dose significantly, while reducing the amount of iodine intake notably, thus reducing the incidence of adverse reaction.
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Kai N, Oda S, Utsunomiya D, Nakaura T, Funama Y, Kidoh M, Taguchi N, Iyama Y, Nagayama Y, Hirata K, Yuki H, Sakabe D, Hatemura M, Yamashita Y. Dual-region-of-interest bolus-tracking technique for coronary computed tomographic angiography on a 320-row scanner: reduction in the interpatient variability of arterial contrast enhancement. Br J Radiol 2017; 91:20170541. [PMID: 29072853 DOI: 10.1259/bjr.20170541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We compared the effect of a dual-region-of-interest (ROI) bolus-tracking technique on interpatient variability of arterial contrast enhancement with that of the conventional bolus-tracking technique in coronary computed tomographic angiography (CTA) on a 320-row scanner. METHODS This study included 100 patients who underwent coronary CTA using one of two protocols: (1) 50 patients underwent scanning using a conventional single-ROI bolus-tracking technique (P-single) with an ROI placed in the ascending aorta, and (2) 50 patients underwent scanning using a dual-ROI technique (P-dual) with two ROIs placed in the pulmonary trunk and the ascending aorta. CT attenuation in the ascending aorta and coronary arteries, and the interpatient variability were compared between the two scanning protocols. RESULTS The mean CT attenuation of the ascending aorta and coronary arteries tended to be higher for P-dual than for P-single, but the difference was not significant (p = 0.08-0.30). The interpatient variability of contrast enhancement (SD of the CT attenuation) was significantly smaller for P-dual than for P-single (p < 0.01). CONCLUSION The dual-ROI bolus-tracking technique can reduce interpatient variability of arterial contrast enhancement in coronary CTA on a 320-row scanner. Advances in knowledge: The use of a dual-ROI bolus-tracking technique can provide sufficient and consistent arterial enhancement of coronary CTA.
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Affiliation(s)
- Noriyuki Kai
- 1 Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Seitaro Oda
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Utsunomiya
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Nakaura
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshinori Funama
- 3 Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masafumi Kidoh
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Narumi Taguchi
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuji Iyama
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasunori Nagayama
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichiro Hirata
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideaki Yuki
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Sakabe
- 1 Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Masahiro Hatemura
- 1 Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yasuyuki Yamashita
- 2 Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Contijoch FJ, Groves DW, Chen Z, Chen MY, McVeigh ER. A novel method for evaluating regional RV function in the adult congenital heart with low-dose CT and SQUEEZ processing. Int J Cardiol 2017; 249:461-466. [PMID: 28970037 DOI: 10.1016/j.ijcard.2017.08.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/17/2017] [Accepted: 08/14/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Measuring local RV function in adult congenital heart disease (ACHD) with echocardiography or MRI is challenging because of the complex geometry and existing pacing devices. Visual assessment of ventricular function via low-dose cardiac CT has been recently performed. This pilot study assessed whether low-dose 4D cine CT combined with automatic measurement of regional shortening could quantify right-ventricular function in ACHD patients. METHODS Seven patients with Tetralogy of Fallot either contraindicated for MRI or assessed for coronary artery disease and seven non-congenital patients were imaged with ECG-gated cardiac CT utilizing a 320-detector row scanner. Right ventricular global function and regional shortening were quantified. RESULTS Non-congenital patients were imaged with 2.9±2.1mSv and 395±359 HU blood-myocardium contrast. The ACHD patients were imaged with 2.1±1.3mSv and 726±296 HU contrast. Right ventricles of the ACHD patients had higher end-diastolic volume (297±107mL vs 123±34mL, p=0.001), lower ejection fraction (32.0±4.9% vs 45.0±6.0%, p=0.001), and higher dyskinetic fraction (10.9±3.7% vs 2.6±2.8%, p<0.001) relative to the non-congenital controls. CONCLUSIONS In this initial pilot study, right ventricular global and regional systolic function were measured using low-dose cine CT with SQUEEZ quantification in non-congenital patients as well as ACHD patients with Tetralogy of Fallot. Unique regional features of RV dyskinesia were identified in the ACHD patients which could yield a more precise quantification of RV function.
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Affiliation(s)
- Francisco J Contijoch
- Department of Bioengineering, UC San Diego, La Jolla, CA, United States; Department of Radiology, UC San Diego, La Jolla, CA, United States
| | - Daniel W Groves
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Zhennong Chen
- Department of Bioengineering, UC San Diego, La Jolla, CA, United States
| | - Marcus Y Chen
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Elliot R McVeigh
- Department of Bioengineering, UC San Diego, La Jolla, CA, United States; Department of Radiology, UC San Diego, La Jolla, CA, United States; Division of Cardiology, Department of Medicine, UC San Diego, La Jolla, CA, United States.
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Stepusin EJ, Long DJ, Ficarrotta KR, Hintenlang DE, Bolch WE. Physical validation of a Monte Carlo-based, phantom-derived approach to computed tomography organ dosimetry under tube current modulation. Med Phys 2017; 44:5423-5432. [PMID: 28688151 DOI: 10.1002/mp.12461] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/26/2017] [Accepted: 06/30/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To physically validate the accuracy of a Monte Carlo-based, phantom-derived methodology for computed tomography (CT) dosimetry that utilizes organ doses from precomputed axial scans and that accounts for tube current modulation (TCM). METHODS The output of a Toshiba Aquilion ONE CT scanner was modeled, based on physical measurement, in the Monte Carlo radiation transport code MCNPX (v2.70). CT examinations were taken of two anthropomorphic phantoms representing pediatric and adult patients (15-yr-old female and adult male) at various energies, in which physical organ dose measurements were made using optically stimulated luminescence dosimeters (OSLDs). These exams (chest-abdomen-pelvis) were modeled using organ dose data obtained from the computationally equivalent phantom of each anthropomorphic phantom. TCM was accounted for by weighting all organ dose contributions by both the relative attenuation of the phantom and the image-derived mA value (from the DICOM header) at the same z-extent (cranial-caudal direction) of the axial dose data. RESULTS The root mean squares of percent difference in organ dose when comparing the physical organ dose measurements to the computational estimates were 21.2, 12.1, and 15.1% for the uniform (no attenuation weighting), weighted (computationally derived), and image-based methodologies, respectively. CONCLUSIONS Overall, these data suggest that the Monte Carlo-based dosimetry presented in this work is viable for CT dosimetry. Additionally, for CT exams with TCM, local attenuation weighting of organ dose contributions from precomputed axial dosimetry libraries increases organ dose accuracy.
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Affiliation(s)
- Elliott J Stepusin
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611-6131, USA
| | - Daniel J Long
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Kayla R Ficarrotta
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611-6131, USA
| | - David E Hintenlang
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611-6131, USA
| | - Wesley E Bolch
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611-6131, USA
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Nerlekar N, Ko BS, Nasis A, Cameron JD, Leung M, Brown AJ, Wong DTL, Ngu PJ, Troupis JM, Seneviratne SK. Impact of heart rate on diagnostic accuracy of second generation 320-detector computed tomography coronary angiography. Cardiovasc Diagn Ther 2017; 7:296-304. [PMID: 28567355 DOI: 10.21037/cdt.2017.03.05] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the impact of elevated heart rate (HR) on the diagnostic accuracy and image quality of second-generation 320-detector computed tomography coronary angiography (320-CTCA). METHODS Consecutive patients with suspected coronary disease referred for invasive coronary angiography (ICA) were prospectively recruited and underwent 320-CTCA. Pre-scan beta-blockers were administered if native HR>80 bpm and post-scan cohorts stratified by traditional (HR ≤60 bpm) and elevated HR (61-80 bpm). A wider phase window was used for the elevated HR group (30-80%). 320-CTCA and ICA were analyzed by independent readers blinded to other data. Significant disease was defined as ≥50% visual stenosis on ICA. Uninterpretable segments by 320-CTCA were considered to be significant on an intention-to-diagnose principle. Image quality was assessed by 5-point Likert score. RESULTS Of 107 patients studied (1,662 segments), there was no significant difference in sensitivity, specificity, positive and negative predictive value between patients with HR ≤60 bpm (n=55) vs. HR 61-80 bpm (n=52): 97%, 88%, 95%, 94% vs. 100%, 88%, 95%, 100%; Receiver operator characteristic-area under the curve 0.93 vs. 0.94, P=0.82). Overall per-patient diagnostic accuracy was 96% in both groups with no significant difference in interpretable segments (Likert ≥2) or median radiation dose (2.4 mSv vs. 2.7 mSv, P=0.35). Only 4/1,662 (0.2%) segments were uninterpretable by motion artefact in the whole cohort. CONCLUSIONS In patients with HR >60 and up to 80bpm, second generation 320-CTCA provides comparably adequate diagnostic accuracy to HR ≤60 without significantly impacting upon overall segmental evaluability.
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Affiliation(s)
- Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - Brian S Ko
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - Arthur Nasis
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - James D Cameron
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - Michael Leung
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - Adam J Brown
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - Philip J Ngu
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
| | - John M Troupis
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia.,Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Sujith K Seneviratne
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Road, Clayton, 3168 VIC, Australia
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Groves DW, Olivieri LJ, Shanbhag SM, Bronson KC, Yu JH, Nelson EA, Rollison SF, Stagliano MS, John AS, Kuehl K, Chen MY. Feasibility of low radiation dose retrospectively-gated cardiac CT for functional analysis in adult congenital heart disease. Int J Cardiol 2016; 228:180-183. [PMID: 27865183 PMCID: PMC6323633 DOI: 10.1016/j.ijcard.2016.11.108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/26/2016] [Accepted: 11/06/2016] [Indexed: 11/28/2022]
Abstract
Background: The use of cardiac computed tomography (CT) in the evaluation of adult congenital heart disease patients is limited due to concerns of high radiation doses. The purpose of this study was to prospectively assess whether low radiation dose cardiac CT is feasible to evaluate ventricular systolic function in adults with congenital heart disease. Methods: The study group included 30 consecutive patients with significant congenital heart disease who underwent a total of 35 ECG-gated cardiac CT scans utilizing a 320-detector row CT scanner. Each study included a non-contrast scan and subsequent contrast-enhanced retrospectively-gated acquisition. Effective radiation dose was estimated by multiplying the dose length product by a k-factor of 0.014 mSv/mGy cm. Results: The mean age of the patients was 34.4 ± 8.9 years, 60% were men, and mean body mass index was 24.2 ± 4.3 kg/m2. A majority of patients (n = 28, 93.3%) had contraindications to cardiac MRI. A tube potential of 80 kV was used in 27 (77.1%) of the contrast-enhanced scans. The mean signal-to-noise and contrast-to-noise ratios were 11.5 ± 3.9 and 10.3 ± 3.7, respectively. The median radiation dose for non-contrast and contrast-enhanced images were 0.1 mSv (0.07–0.2 mSv) and 0.94 mSv (0.5–2.1 mSv), respectively. All 35 CT scans were successfully analyzed for ventricular systolic function. Conclusions: A low radiation contrast-enhanced, retrospectively-gated cardiac CT with a median radiation dose of less than 1 mSv was successful in evaluating ventricular systolic function in 30 consecutive adult congenital heart disease patients who underwent a total of 35 scans.
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Affiliation(s)
- Daniel W Groves
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Laura J Olivieri
- Department of Cardiology, Children's National Medical Center, Washington, DC, USA
| | - Sujata M Shanbhag
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kathie C Bronson
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jeannie H Yu
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Evan A Nelson
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shirley F Rollison
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael S Stagliano
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Anitha S John
- Department of Cardiology, Children's National Medical Center, Washington, DC, USA
| | - Karen Kuehl
- Department of Cardiology, Children's National Medical Center, Washington, DC, USA
| | - Marcus Y Chen
- Department of Health and Human Services, Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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Performance of adaptive iterative dose reduction 3D integrated with automatic tube current modulation in radiation dose and image noise reduction compared with filtered-back projection for 80-kVp abdominal CT: Anthropomorphic phantom and patient study. Eur J Radiol 2016; 85:1666-72. [DOI: 10.1016/j.ejrad.2016.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/04/2016] [Accepted: 07/11/2016] [Indexed: 01/16/2023]
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Using 80 kVp on a 320-row scanner for hepatic multiphasic CT reduces the contrast dose by 50 % in patients at risk for contrast-induced nephropathy. Eur Radiol 2016; 27:812-820. [PMID: 27240454 DOI: 10.1007/s00330-016-4435-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/17/2016] [Accepted: 05/20/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We evaluated the effects of a low contrast material (CM) dose protocol using 80-kVp on the image quality of hepatic multiphasic CT scans acquired on a 320-row CT scanner. METHODS We scanned 30 patients with renal insufficiency (eGFR < 45 mL/min/1.73 m2) using 80-kVp and a CM dose of 300mgI/kg. Another 30 patients without renal insufficiency (eGFR > 60 mL/min/1.73 m2) were scanned with the conventional 120-kVp protocol and the standard CM dose of 600mgI/kg. Quantitative image quality parameters, i.e. CT attenuation, image noise, and the contrast-to-noise ratio (CNR) were compared and the visual image quality was scored on a four-point scale. The volume CT dose index (CTDIvol) and the size-specific dose estimate (SSDE) recorded with the 80- and the 120-kVp protocols were also compared. RESULTS Image noise and contrast enhancement were equivalent for the two protocols. There was no significant difference in the CNR of all anatomic sites and in the visual scores for overall image quality. The CTDIvol and SSDE were approximately 25-30 % lower under the 80-kVp protocol. CONCLUSION Hepatic multiphase CT using 80-kVp on a 320-row CT scanner allowed for a decrease in the CM dose and a reduction in the radiation dose without image quality degradation in patients with renal insufficiency. KEY POINTS • The 80-kVp CT protocol enabled reduction of contrast dose by 50 % • The 80-kVp CT protocol reduced the radiation dose by 25-33 % • There was no degradation in the image quality of the 80-kVp protocol.
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12
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Rest and stress transluminal attenuation gradient and contrast opacification difference for detection of hemodynamically significant stenoses in patients with suspected coronary artery disease. Int J Cardiovasc Imaging 2016; 32:1131-41. [DOI: 10.1007/s10554-016-0867-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/29/2016] [Indexed: 11/24/2022]
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Kidoh M, Utsunomiya D, Oda S, Funama Y, Nakaura T, Yuki H, Hirata K, Namimoto T, Yamashita Y. Evaluation of the Effect of Intracoronary Attenuation on Coronary Plaque Measurements Using a Dual-phase Coronary CT Angiography Technique on a 320-row CT Scanner--In Vivo Validation Study. Acad Radiol 2016; 23:315-20. [PMID: 26777592 DOI: 10.1016/j.acra.2015.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/08/2015] [Accepted: 11/10/2015] [Indexed: 01/08/2023]
Abstract
RATIONALE AND OBJECTIVES The characterization of plaques based on their computed tomography (CT) number is important for the detection of vulnerable atherosclerotic plaques. An earlier in vitro study showed that intravascular attenuation affected the attenuation of coronary atherosclerotic plaques. We attempted to validate this finding in vivo and here we introduce a dual-phase coronary CT angiography (CCTA) technique to address this issue. MATERIALS AND METHODS Institutional ethics committee approval and informed consent were obtained. Thirty patients (30 noncalcified plaques) underwent dual-phase CCTA. Two CT datasets were obtained, one with coronary artery enhancement and the other without coronary artery enhancement. The CT number of the plaque and the adjacent vessel lumen was measured in a circular region of interest on curved planar reconstruction images. The region of interest setting was consistent between the two CT datasets. We performed linear regression analysis of the changes in the CT numbers (ΔHounsfield unit), calculated by subtracting the two CT datasets, for the lumen and for the plaque. We also evaluated the relationship between plaque attenuation on nonenhanced coronary artery images and luminal attenuation with and without contrast enhancement. RESULTS The ΔHounsfield unit for the plaque and the lumen showed a strong correlation (r = 0.61). There was no significant correlation between plaque attenuation on nonenhanced coronary artery images and luminal attenuation with and without contrast enhancement (r = 0.23 and 0.24, respectively). CONCLUSIONS Intravascular attenuation changed the attenuation of coronary atherosclerotic plaques. Using the copy-paste technique, the CT number of identical plaques can be measured in registered dual-phase CCTA images for the evaluation of coronary plaques.
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Kidoh M, Utsunomiya D, Oda S, Funama Y, Yuki H, Nakaura T, Kai N, Nozaki T, Yamashita Y. Validity of the size-specific dose estimate in adults undergoing coronary CT angiography: comparison with the volume CT dose index. Int J Cardiovasc Imaging 2015; 31 Suppl 2:205-11. [PMID: 26440660 DOI: 10.1007/s10554-015-0782-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 09/30/2015] [Indexed: 11/25/2022]
Abstract
Size-specific dose estimate (SSDE) takes into account the patient size but remains to be fully validated for adult coronary computed tomography angiography (CCTA). We investigated the appropriateness of SSDE for accurate estimation of patient dose by comparing the SSDE and the volume CT dose index (CTDIvol) in adult CCTA. This prospective study received institutional review board approval, and informed consent was obtained from each patient. We enrolled 37 adults who underwent CCTA with a 320-row CT. High-sensitivity metal oxide semiconductor field effect transistor dosimeters were placed on the anterior chest. CTDIvol reported by the scanner based on a 32-cm phantom was recorded. We measured chest diameter to convert CTDIvol to SSDE. Using linear regression, we then correlated SSDE with the mean measured skin dose. We also performed linear regression analyses between the skin dose/CTDIvol and the body mass index (BMI), and the skin dose/SSDE and BMI. There was a strong linear correlation (r = 0.93, P < 0.001) between SSDE (mean 37 ± 22 mGy) and mean skin dose (mean 17.7 ± 10 mGy). There was a moderate negative correlation between the skin dose/CTDIvol and BMI (r = 0.45, P < 0.01). The skin dose/SSDE was not affected by BMI (r = 0.06, P > 0.76). SSDE yields a more accurate estimation of the radiation dose without estimation errors attributable to the body size of adult patients undergoing CCTA.
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Affiliation(s)
- Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan.
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Hideaki Yuki
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Noriyuki Kai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Takeshi Nozaki
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
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Lopez-Rendon X, Bosmans H, Oyen R, Zanca F. Effective dose and organ doses estimation taking tube current modulation into account with a commercial software package. Eur Radiol 2015; 25:1919-25. [PMID: 25680725 DOI: 10.1007/s00330-015-3623-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 01/13/2015] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the effect of including tube current modulation (TCM) versus using the average mAs in estimating organ and effective dose (E) using commercial software. METHOD Forty adult patients (24 females, 16 males) with normal BMI underwent chest/abdomen computed tomography (CT) performed with TCM at 120 kVp, reference mAs of 110 (chest) and 200 (abdomen). Doses to fully irradiated organs (breasts, lungs, stomach, liver and ovaries) and E were calculated using two versions of a dosimetry software: v.2.0, which uses the average mAs, and v.2.2, which accounts for TCM by implementing a gender-specific mAs profile. Student's t-test was used to assess statistically significant differences between organ doses calculated with the two versions. RESULTS A statistically significant difference (p < 0.001) was found for E on chest and abdomen CT, with E being lower by 4.2% when TCM is considered. Similarly, organ doses were also significantly lower (p < 0.001): 13.7% for breasts, 7.3% for lungs, 9.1% for the liver and 8.5% for the stomach. Only the dose to the ovaries was higher with TCM (11.5%). CONCLUSION When TCM is used, for the stylized phantom, the doses to lungs, breasts, stomach and liver decreased while the dose to the ovaries increased. KEY POINTS • Estimated dose to the ovaries increased with TCM. • Estimated dose to lungs, breasts, stomach and liver decreased with TCM. • A unique but gender-specific mAs profile resulted in a radiation dose shift. • Even for normal size patients there is a variety in mAs profiles.
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Affiliation(s)
- X Lopez-Rendon
- Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, KU Leuven, Herestraat 49, box 7003, 3000, Leuven, Belgium,
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Oda S, Utsunomiya D, Yuki H, Kai N, Hatemura M, Funama Y, Kidoh M, Yoshida M, Namimoto T, Yamashita Y. Low contrast and radiation dose coronary CT angiography using a 320-row system and a refined contrast injection and timing method. J Cardiovasc Comput Tomogr 2014; 9:19-27. [PMID: 25677790 DOI: 10.1016/j.jcct.2014.12.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 11/24/2014] [Accepted: 12/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Among CT scanners, 320-row instruments feature decreased photon energy and yield strong contrast enhancement. Consequently, the contrast medium (CM) dose can be reduced. The results of low-tube-voltage coronary CT angiography (CCTA) performed on 320-row scanners have not been adequately assessed. OBJECTIVE We evaluated the effects of a low-contrast-dose protocol on the image quality of CCTA using 80 kVp tube voltage, iterative reconstruction (IR), and a 320-row scanner. METHODS We randomly assigned 90 patients (mean body weight, 56.5 ± 11.0 kg) to 1 of 3 CCTA protocols. Under protocol A, 30 were scanned using a conventional 120-kVp protocol and a standard CM dose (280 mg iodine/kg body weight [mgI/kg]). Another 30 underwent scanning at 80 kVp with a 25% CM dose reduction (210 mgI/kg; protocol B). Under protocol C, the remaining 30 patients were scanned at 80 kVp with a 50% CM dose reduction (140 mgI/kg). The 120 and 80 kVp images were processed with IR. Images obtained under the 3 protocols were subjected to quantitative and qualitative analysis. RESULTS The amount of CM used in protocol A, B, and C was 43.6 ± 10.1, 30.3 ± 4.4, and 21.0 ± 4.0 mL, respectively. Mean CT attenuation of the coronary arteries tended to be higher under protocol B than the other 2 protocols. The contrast-to-noise ratio was significantly higher under protocol B. The mean visual scores were significantly higher for protocols A and B than protocol C. The mean effective radiation dose was significantly lower under the 80-kVp protocol. CONCLUSION With a 320-row scanner and our refined CM injection and timing protocol, it is technically feasible to obtain sufficient vascular enhancement with a reduction in the CM and/or radiation dose at 80-kVp CCTA with IR.
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Affiliation(s)
- Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hideaki Yuki
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Noriyuki Kai
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Masahiro Hatemura
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Morikatsu Yoshida
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Tomohiro Namimoto
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
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Wong DTL, Soh SY, Ko BSH, Cameron JD, Crossett M, Nasis A, Troupis J, Meredith IT, Seneviratne SK. Superior CT coronary angiography image quality at lower radiation exposure with second generation 320-detector row CT in patients with elevated heart rate: a comparison with first generation 320-detector row CT. Cardiovasc Diagn Ther 2014; 4:299-306. [PMID: 25276615 DOI: 10.3978/j.issn.2223-3652.2014.08.05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 08/11/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study aims to compare the image quality of second generation versus first generation 320-computed tomography coronary angiography (CTCA) in patients with heart rate ≥65 bpm as it has not been specifically reported. METHODS Consecutive patients who underwent CTCA using second-generation-320-detector-row-CT were prospectively enrolled. A total of 50 patients with elevated (≥65 bpm) heart rate and 50 patients with controlled (<65 bpm) heart rate were included. Age and gender matched patients who were scanned with the first-generation-320-detector-row-CT were retrospectively identified. Image quality in each coronary artery segment was assessed by two blinded CT angiographers using the five-point Likert scale. RESULTS In the elevated heart rate cohorts, while there was no significant difference in heart rate during scan-acquisition (66 vs. 69 bpm, P=0.308), or body mass index (28.5 vs. 29.6, P=0.464), the second generation scanner was associated with better image quality (3.94±0.6 vs. 3.45±0.8, P=0.001), and with lower radiation (2.8 vs. 4.3 mSv, P=0.009). There was no difference in scan image quality for the controlled heart rate cohorts. CONCLUSIONS The second generation CT scanner provides better image quality at lower radiation dose in patients with elevated heart rate (≥65 bpm) compared to first generation CT scanner.
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Affiliation(s)
- Dennis T L Wong
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Siang Y Soh
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Brian S H Ko
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - James D Cameron
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Marcus Crossett
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Arthur Nasis
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - John Troupis
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Ian T Meredith
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
| | - Sujith K Seneviratne
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 Department of Diagnostic Imaging, MMC, Southern Health, Melbourne, Australia
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Martin Weber Kusk R. Incorrectly placed gonad shields: Effect on CT automatic exposure correction from four different scanners. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Differences in behavior of tube current modulation techniques for thoracic CT examinations between male and female anthropomorphic phantoms. Radiol Phys Technol 2014; 7:316-28. [DOI: 10.1007/s12194-014-0269-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 05/02/2014] [Accepted: 05/02/2014] [Indexed: 11/26/2022]
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Moro L, Panizza D, D'Ambrosio D, Carne I. Considerations on an automatic computed tomography tube current modulation system. RADIATION PROTECTION DOSIMETRY 2013; 156:525-530. [PMID: 23584497 DOI: 10.1093/rpd/nct095] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The scope of this study was to evaluate the effects on radiation output and image noise varying the acquisition parameters with an automatic tube current modulation (ATCM) system in computed tomography (CT). Chest CT examinations of an anthropomorphic phantom were acquired using a GE LightSpeed VCT 64-slice tomograph. Acquisitions were performed using different pitch, slice thickness and noise index (NI) values and varying the orientation of the scanned projection radiograph (SPR). The radiation output was determined by the CT dose index (CTDIvol). Image noise was evaluated measuring the standard deviation of CT numbers in several regions of interest. The radiation output was lower if the SPR was acquired in the anterior-posterior projection. The radiation dose with the posterior-anterior SPR was higher, because the divergence of the X-ray beam magnifies the anatomical structures closest to the tube, especially the spinal column, and this leads the ATCM system to estimate higher patient attenuation values and, therefore, to select higher tube current values. The NI was inversely proportional to the square root of the CTDIvol and, with fixed NI, the CTDIvol increased as the slice thickness decreased. This study suggests some important issues to use the GE ATCM system efficiently.
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Affiliation(s)
- Luca Moro
- Medical Physics Unit, Salvatore Maugeri Foundation, via S. Maugeri 10, Pavia I-27100, Italy
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21
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Chen MY, Shanbhag SM, Arai AE. Submillisievert median radiation dose for coronary angiography with a second-generation 320-detector row CT scanner in 107 consecutive patients. Radiology 2013; 267:76-85. [PMID: 23340461 DOI: 10.1148/radiol.13122621] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To (a) use a new second-generation wide-volume 320-detector row computed tomographic (CT) scanner to explore optimization of radiation exposure in coronary CT angiography in an unselected and consecutive cohort of patients referred for clinical purposes and (b) compare estimated radiation exposure and image quality with that from a cohort of similar patients who underwent imaging with a previous first-generation CT system. MATERIALS AND METHODS The study was approved by the institutional review board, and all subjects provided written consent. Coronary CT angiography was performed in 107 consecutive patients with a new second-generation 320-detector row unit. Estimated radiation exposure and image quality were compared with those from 100 consecutive patients who underwent imaging with a previous first-generation scanner. Effective radiation dose was estimated by multiplying the dose-length product by an effective dose conversion factor of 0.014 mSv/mGy ⋅ cm and reported with size-specific dose estimates (SSDEs). Image quality was evaluated by two independent readers. RESULTS The mean age of the 107 patients was 55.4 years ± 12.0 (standard deviation); 57 patients (53.3%) were men. The median body mass index was 27.3 kg/m(2) (range, 18.1-47.2 kg/m(2)); however, 71 patients (66.4%) were overweight, obese, or morbidly obese. A tube potential of 100 kV was used in 97 patients (90.6%), single-volume acquisition was used in 104 (97.2%), and prospective electrocardiographic gating was used in 106 (99.1%). The mean heart rate was 57.1 beats per minute ± 11.2 (range, 34-96 beats per minute), which enabled single-heartbeat scans in 100 patients (93.4%). The median radiation dose was 0.93 mSv (interquartile range [IQR], 0.58-1.74 mSv) with the second-generation unit and 2.67 mSv (IQR, 1.68-4.00 mSv) with the first-generation unit (P < .0001). The median SSDE was 6.0 mGy (IQR, 4.1-10.0 mGy) with the second-generation unit and 13.2 mGy (IQR, 10.2-18.6 mGy) with the first-generation unit (P < .0001). Overall, the radiation dose was less than 0.5 mSv for 23 of the 107 CT angiography examinations (21.5%), less than 1 mSv for 58 (54.2%), and less than 4 mSv for 103 (96.3%). All studies were of diagnostic quality, with most having excellent image quality. Three of four image quality indexes were significantly better with the second-generation unit compared with the first-generation unit. CONCLUSION The combination of a gantry rotation time of 275 msec, wide volume coverage, iterative reconstruction, automated exposure control, and larger x-ray power generator of the second-generation CT scanner provides excellent image quality over a wide range of body sizes and heart rates at low radiation doses. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13122621/-/DC1.
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Affiliation(s)
- Marcus Y Chen
- Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Department of Health and Human Services, 10 Center Dr, Building 10, Room B1D416, Bethesda, MD 20892-1061, USA.
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Practical Approaches to Dose Reduction: Toshiba Perspective. RADIATION DOSE FROM MULTIDETECTOR CT 2012. [DOI: 10.1007/174_2011_501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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