High-pitch coronary CT angiography at 70 kVp with low contrast medium volume: comparison of 80 and 100 kVp high-pitch protocols

Long Jiang Zhang, Li Qi, Carlo N De Cecco, Chang Sheng Zhou, James V Spearman, U Joseph Schoepf, Guang Ming Lu, Long Jiang Zhang, Li Qi, Carlo N De Cecco, Chang Sheng Zhou, James V Spearman, U Joseph Schoepf, Guang Ming Lu

Abstract

The purpose of this article is to evaluate image quality and radiation dose of prospectively electrocardiogram (ECG)-triggered high-pitch coronary computed tomography angiography (CCTA) at 70 kVp and 30 mL contrast medium.One hundred fifty patients with a heart rate ≤70 beats per minute (bpm) underwent CCTA using a second-generation dual-source computed tomography (CT) scanner and were randomized into 3 groups according to tube voltage and contrast medium volume (370 mg/mL iodine concentration) (100 kVp group, 100 kVp/60 mL, n = 55; 80 kVp group, 80 kVp/60 mL, n = 44; 70 kVp group, 70 kVp/30 mL, n = 51). Objective and subjective image quality along with the effect of heart rate (HR) and body mass index (BMI) was evaluated and compared between the groups. Radiation dose was estimated for each patient.CT attenuation and image noise were higher in the 80 and 70 kVp groups than in the 100 kVp group (all P < 0.001). Signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) were lower in the 70 kVp group than in the 80 and 100 kVp groups (all P < 0.05). There was no difference for subjective image quality between the groups (P > 0.05). HR did not affect subjective image quality (all P > 0.05), while patients with BMI <23 kg/m had higher image quality than patients with BMI ≥23 kg/m (P < 0.05). Compared with the 100 kVp group, the radiation dose of the 70 kVp group was reduced by 75%.In conclusion, prospectively ECG-triggered high-pitch 70 kVp/30 mL CCTA can obtain diagnostic image quality with lower radiation dose in selected patients with BMI <23 kg/m compared with 80/100 kVp/60 mL CCTA.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Image examples illustrating the four-point rating scale for image quality. Shown are automatically generated curved multiplanar reformations along the vessel center line of coronary arteries studied with CCTA. Panel A shows a 100 kVp CCTA study which was given a score of 1 because of marked motion artifact in segment 2. Panel B shows a 100 kVp CCTA study which was given a score of 2 because of mild motion artifact in segment 2. Panel C shows a 70 kVp CCTA study which was given a score of 3 because of a mild irregular contour of segment 2. Panel D shows an 80 kVp CCTA study which was given a score of 4.
FIGURE 2
FIGURE 2
Representative CCTA images in three different patients investigated with 70 kVp, 80 kVp, and 100 kVp. All CCTA images were assigned a score of 4 by the two readers. Note severe stenosis (arrows) in the proximal segment of the LAD of the subject in the 100 kVp group. VR = volume rendering; RCA = right coronary artery; LAD = left descending coronary artery; LCX = left circumflex coronary artery.

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Source: PubMed

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