Top

Published in:

01-12-2003 | Cardiac

Individually weight-adapted examination protocol in retrospectively ECG-gated MSCT of the heart

Authors: B. Jung, A. H. Mahnken, A. Stargardt, J. Simon, T. G. Flohr, S. Schaller, R. Koos, R. W. Günther, J. E. Wildberger

Published in: European Radiology | Issue 12/2003

Abstract

The standard protocol in multislice spiral CT (MSCT) angiography for coronary arteries with fixed tube current-time settings leads to an overexposure and thus to an unnecessary high radiation dose in patients with lower weight when compared to heavier patients. The purpose of this study was to estimate the effect of reducing the radiation dose by adapting the tube current-time settings individually. Fifty patients underwent retrospectively ECG-gated MSCT of the heart. In 25 patients (group A₁) a standard protocol with constant tube current-time settings was used (4×1-mm collimation, 120 kV, 400 mAs_eff). Subsequently, artificial image noise was added to the data of these patients simulating a directive for weight-adapted tube current-time settings (group A₂). In the other 25 patients (group B) an alternative protocol with individually weight-adapted tube current-time settings was applied. The data of all groups were evaluated by a regression analysis. The image quality was assessed objectively by measuring the CT attenuation in standardised regions of interest and subjectively by three radiologists using a five-point scoring system in a consensus reading. Applying the weight-adapted tube current-time settings the effective radiation dose was reduced by 17.9% for men and 26.3% for women. The standard protocol leads to an overexposure in light patients as seen in the plot of noise vs weight (slope 0.16±0.07 HU/kg). By applying the weight-adapted tube current-time settings a weight-independent, constant image noise is achieved (slope 0.04±0.1 HU/kg). Diagnostic image quality was preserved in all patients. Individually weight-adapted tube current-time settings allow for a substantial dose reduction when performing retrospectively ECG-gated MSCT angiography for coronary arteries without impairment of diagnostic image quality.

Schmidt T (2000) A few remarks on radiation exposure in CT. In: Nagel HD (ed) Radiation exposure in computed tomography. European Coordination committee on the radiological and electromedical industries (COCIR), Hamburg, pp 1–4

Kaul A, Bauer J, Bernhardt D, Nosske D, Veit R (1997) Effective doses to members of the public from the diagnostic application of the ionizing radiation in Germany. Eur Radiol 7:1127–1132CrossRefPubMed

Commission of the European Community (1998) Quality criteria for computed tomography. Working document EUR 16262. European Commission, Luxembourg

Kopp AF, Ohnesorge B, Flohr T, Georg C, Schroder S, Kuttner A, Martensen J, Claussen CD (2000) Cardiac multidetector-row CT: first clinical results of retrospectively ECG-gated spiral with optimized temporal and spatial resolution. Fortschr Röntgenstr 172:429–435 (in German)

Nieman K, Oudkerk M, Rensing BJ, van Ooijen P, Munne A, van Geuns RJ, de Feyter PJ (2001) Coronary angiography with multi-slice computed tomography. Lancet 357:599–603PubMed

Achenbach S, Ulzheimer S, Baum U, Kachelriess M, Ropers D, Giesler T, Bautz W, Daniel WG, Kalender WA, Moshage W (2000) Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. Circulation 102:2823–2828PubMed

Ohnesorge B, Flohr T, Becker C, Knez A, Knopp AF, Fukuda K, Reiser MF (2000) Cardiac imaging with rapid, retrospective ECG synchronized multilevel spiral CT. Radiologe 40:111–117 (in German)PubMed

McCollough CH (2003) Patient dose in cardiac computed tomography. Herz 28:1–6PubMed

Greess H, Nomayr A, Wolf H, Baum U, Lell M, Bowing B, Kalender W, Bautz WA (2002) Dose reduction in CT examination of children by an attenuation-based on-line modulation of tube current (CARE Dose). Eur Radiol 12:1571–1576PubMed

10.

Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ, Reiser MF (2002) Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 12:1081–1086PubMed

11.

Wildberger JE, Mahnken AH, Schmitz-Rode T, Flohr T, Stargardt A, Haage P, Schaller S, Günther RW (2001) Individually adapted examination protocols for reduction of radiation exposure in chest CT. Invest Radiol 36:604–611CrossRefPubMed

12.

Donnelly LF, Emery KH, Brody AS, Laor T, Gylys-Morin VM, Anton CG, Thomas SR, Frush DP (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children’s hospital. Am J Roentgenol 176:303–306PubMed

13.

Coppenrath E, Schmid C, Brandl R, Szeimis U, Hahn K (2001) Spiral CT of the abdomen: weight-adjusted dose reduction. Fortschr Röntgenstr 173:52–56 (in German)

14.

Greess H, Wolf H, Baum U, Lell M, Pirkl M, Kalender W, Bautz WA (2000) Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions. Eur Radiol 10:391–394PubMed

15.

Mahnken AH, Wildberger JE, Simon J, Koos R, Flohr TG, Schaller S, Günther RW (2003) Detection of coronary calcifications: feasibility of dose reduction with a body weight-adapted examination protocol. Am J Roentgenol 181:533–538

16.

Poll LW, Cohnen M, Brachten S, Ewen K, Modder U (2002) Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation (“ECG pulsing”): phantom measurements. Fortschr Röntgenstr 174:1500–1505 (in German)

17.

Flohr T, Ohnesorge B (2001) Heart rate adaptive optimization of spatial and temporal resolution for electrocardiogram-gated multislice spiral CT of the heart. J Comput Assist Tomogr 25:907–923CrossRefPubMed

18.

Siemens Inc. (2001) SOMATOM volume zoom application guide: special protocols. Software version A40. Siemens, Forchheim, p 28

19.

Frush DP, Slack CC, Hollingsworth CL, Bisset G, Donnelly LF, Hsieh J, Lavin-Wensell T, Mayo JR (2002) Computer-simulated radiation dose reduction for abdominal multidetector CT of pediatric patients. Am J Roentgenol 179:1107–1113

20.

Kalender WA (2000) Computed tomography, 1st edn. Publicis MCD, Munich, pp 84–85

21.

Kalender WA, Schmidt B, Zankl M, Schmidt M (1999) A PC program for estimating organ dose and effective dose values in computed tomography. Eur Radiol 9:552–562CrossRefPubMed

22.

Cohnen M, Poll L, Puttmann C, Ewen K, Modder U (2001) Radiation exposure in multi-slice CT of the heart. Fortschr Röntgenstr 173:295–299

23.

Becker CR, Kleffel T, Crispin A, Knez A, Young J, Schoepf UJ, Haberl R, Reiser MF (2001) Coronary artery calcium measurement: agreement of multirow detector and electron-beam CT. Am J Roentgenol 176:1295–1298

24.

Kopp AF, Kuttner A, Heuschmid M, Schroder S, Ohnesorge B, Claussen CD (2002) Multidetector-row CT cardiac imaging with 4 and 16 slices for coronary CTA and imaging of atherosclerotic plaques. Eur Radiol 12 (Suppl 2):S17–S24CrossRefPubMed

25.

Knez A, Becker C, Ohnesorge B, Haberl R, Reiser M, Steinbeck G (2000) Noninvasive detection of coronary artery stenosis by multislice helical computed tomography. Circulation 101:E221–E222PubMed

26.

Sevkurov A, Pratap A, Doss C, Jelnin V, Hoff JA, Kondos GT (2002) Electron-beam tomography imaging of coronary calcium: the effect of body mass index on radiologic noise. J Comput Assist Tomogr 26:592–597CrossRefPubMed

Title: Individually weight-adapted examination protocol in retrospectively ECG-gated MSCT of the heart
Authors: B. Jung
A. H. Mahnken
A. Stargardt
J. Simon
T. G. Flohr
S. Schaller
R. Koos
R. W. Günther
J. E. Wildberger
Publication date: 01-12-2003
Publisher: Springer-Verlag
Published in: European Radiology / Issue 12/2003
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-003-2111-5

At a glance: The STEP trials

Springer Medicine

Individually weight-adapted examination protocol in retrospectively ECG-gated MSCT of the heart

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2003

High-resolution T1-weighted 3D real IR imaging of the temporal bone using triple-dose contrast material

Synchrotron radiation in radiology: novel X-ray sources

CT findings and serum ca 125 levels in malignant peritoneal mesothelioma: report of 11 new cases and review of the literature

The fibrocartilaginous sesamoid: a cause of size and signal variation in the normal distal posterior tibial tendon

Clinical results of CsI-detector-based dual-exposure dual energy in chest radiography

Quantitative MR evaluation of body composition in patients with Duchenne muscular dystrophy