UZH-Logo

Maintenance Infos

Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters


Alkadhi, H; Stolzmann, P; Scheffel, H; Desbiolles, L; Baumüller, S; Plass, A; Genoni, M; Marincek, B; Leschka, S (2008). Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. European Journal of Radiology, 68(3):385-391.

Abstract

OBJECTIVE: To determine the radiation doses and image quality of different dual-source computed tomography coronary angiography (CTCA) protocols tailored to the heart rate (HR) and body mass index (BMI) of the patients. MATERIALS AND METHODS: Two hundred consecutive patients (68 women; mean age 61+/-9 years) underwent either helical CTCA with retrospective ECG-gating or sequential CT with prospective ECG-triggering: 50 patients (any BMI, any HR) were examined with a standard, non-tailored protocol (helical CTCA, 120kV, 330mAs), whereas the other 150 patients were examined with a tailored protocol: 40 patients (group A, BMI</=25kg/sqm, HR</=70bpm) with sequential CTCA (100kV, 190mAs(ref)), 43 patients (group B, BMI</=25kg/sqm, HR>70bpm) with helical CTCA (100kV, 220mAs), 28 patients (group C, BMI>25kg/sqm, HR</=70bpm) with sequential CTCA (120kV, 330mAs(ref)), and 39 patients (group D, BMI>25kg/sqm, HR>70bpm) with helical CTCA (120kV, 330mAs). The effective radiation dose estimates were calculated from the dose-length-product for each patient. Image quality was classified as being diagnostic or non-diagnostic in each coronary segment. RESULTS: Image quality was diagnostic in 2403/2460 (98%) and non-diagnostic in 57/2460 (2%) of all coronary segments. No significant differences in image quality were found among all five CTCA protocols (p=0.78). The non-tailored helical CTCA protocol was associated with a radiation dose of 9.0+/-1.0mSv, being significantly higher compared to that using sequential CTCA (group A: 1.3+/-0.3mSv, p<0.001; group C: 2.9+/-0.6mSv, p<0.001), and helical CTCA at reduced tube voltage and tube current (group B: 4.2+/-0.6mSv, p<0.01). No significant differences were found compared to the non-tailored CTCA protocol in patients with HR>70bpm (group D: 8.5+/-0.9mSv, p=0.51). CONCLUSIONS: Dual-source CTCA is associated with radiation doses ranging between 1.3 and 9.0mSv, depending on the protocol used. Tailoring of the CTCA protocol to the HR and BMI of the individual patient results in dose reductions of up to 86%, while maintaining a diagnostic image quality of the examination.

Abstract

OBJECTIVE: To determine the radiation doses and image quality of different dual-source computed tomography coronary angiography (CTCA) protocols tailored to the heart rate (HR) and body mass index (BMI) of the patients. MATERIALS AND METHODS: Two hundred consecutive patients (68 women; mean age 61+/-9 years) underwent either helical CTCA with retrospective ECG-gating or sequential CT with prospective ECG-triggering: 50 patients (any BMI, any HR) were examined with a standard, non-tailored protocol (helical CTCA, 120kV, 330mAs), whereas the other 150 patients were examined with a tailored protocol: 40 patients (group A, BMI</=25kg/sqm, HR</=70bpm) with sequential CTCA (100kV, 190mAs(ref)), 43 patients (group B, BMI</=25kg/sqm, HR>70bpm) with helical CTCA (100kV, 220mAs), 28 patients (group C, BMI>25kg/sqm, HR</=70bpm) with sequential CTCA (120kV, 330mAs(ref)), and 39 patients (group D, BMI>25kg/sqm, HR>70bpm) with helical CTCA (120kV, 330mAs). The effective radiation dose estimates were calculated from the dose-length-product for each patient. Image quality was classified as being diagnostic or non-diagnostic in each coronary segment. RESULTS: Image quality was diagnostic in 2403/2460 (98%) and non-diagnostic in 57/2460 (2%) of all coronary segments. No significant differences in image quality were found among all five CTCA protocols (p=0.78). The non-tailored helical CTCA protocol was associated with a radiation dose of 9.0+/-1.0mSv, being significantly higher compared to that using sequential CTCA (group A: 1.3+/-0.3mSv, p<0.001; group C: 2.9+/-0.6mSv, p<0.001), and helical CTCA at reduced tube voltage and tube current (group B: 4.2+/-0.6mSv, p<0.01). No significant differences were found compared to the non-tailored CTCA protocol in patients with HR>70bpm (group D: 8.5+/-0.9mSv, p=0.51). CONCLUSIONS: Dual-source CTCA is associated with radiation doses ranging between 1.3 and 9.0mSv, depending on the protocol used. Tailoring of the CTCA protocol to the HR and BMI of the individual patient results in dose reductions of up to 86%, while maintaining a diagnostic image quality of the examination.

Citations

66 citations in Web of Science®
89 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

2 downloads since deposited on 07 Jan 2009
0 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:07 Jan 2009 08:59
Last Modified:13 Sep 2016 07:29
Publisher:Elsevier
ISSN:0720-048X
Publisher DOI:https://doi.org/10.1016/j.ejrad.2008.08.015
PubMed ID:18976876

Download

[img]
Filetype: PDF - Registered users only
Size: 1MB
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations