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01-07-2007 | Cardiac

Evaluation of automated attenuation-based tube current adaptation for coronary calcium scoring in MDCT in a cohort of 262 patients

Authors: Georg Mühlenbruch, Christian Hohl, Marco Das, Joachim E. Wildberger, Christoph Suess, Ernst Klotz, Thomas Flohr, Ralf Koos, Christoph Thomas, Rolf W. Günther, Andreas H. Mahnken

Published in: European Radiology | Issue 7/2007

Abstract

The aim of our study was to evaluate attenuation-based tube current adaptation in coronary calcium scoring using ECG-gated multi-detector-row CT (MDCT). A total of 262 patients underwent non-enhanced cardiac MDCT. Group 1 was scanned using a standard protocol with 120 kV and 150 mAs_eff. Groups 2–4 were scanned using an attenuation-based dose-adaptation template (CARE Dose) with different effective reference mAs settings (150, 180, 210 mAs_eff). Body-mass index (BMI) and CT-dose index values were calculated for each patient. Image noise and subjective image quality were assessed. Regression analysis was performed, and the variation coefficient of image noise was determined. Compared to the standard scan protocol a dose reduction of 31.1% for group 2 and 20.1% for group 3 was observed. Measurement variation of image noise was smaller for the attenuation-based dose adaptation protocols (group 2–4) (16.2–17.1%) compared to the standard scan protocol (32.3%). Regression analysis of groups 2–4 showed better correlation with improved dose usage based on BMI (all P ≤ 0.001). Median image quality was “excellent” in groups 2–4 and “good” in group 1. Automated attenuation-based tube current adaptation in coronary calcium scoring is technically feasible, can decrease patient dose, and reduces variation in image noise as a sign of improved dose usage.

Frink RJ, Achor RW, Brown AL Jr, Kincaid OW, Brandenburg RO (1970) Significance of calcification of the coronary arteries. Am J Cardiol 26:241–247PubMedCrossRef

Heussel CP, Voigtlaender T, Kauczor H, Braun M, Meyer J, Thelen M (1998) Detection of coronary artery calcifications predicting coronary heart disease: comparison of fluoroscopy and spiral CT. Eur Radiol 8:1016–1024PubMedCrossRef

Rumberger JA, Sheedy PF, Breen JF, Schwartz RS (1997) Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen stenosis. J Am Coll Cardiol 29:1542–1548PubMedCrossRef

Guerci AD, Spadaro LA, Goodman KJ et al (1998) Comparison of electron beam computed tomography scanning and conventional risk factor assessment for the prediction of angiographic coronary artery disease. J Am Coll Cardiol 32:673–679PubMedCrossRef

Janssen CH, Kuijpers D, Vliegenthart R, Overbosch J, van Dijkman PR, Zijlstra F, Oudkerk M (2005) Coronary artery calcification score by multislice computed tomography predicts the outcome of dobutamine cardiovascular magnetic resonance imaging. Eur Radiol 15:1128–1134PubMedCrossRef

Becker CR, Majeed A, Crispin A et al (2005) CT measurement of coronary calcium mass: impact on global cardiac risk assessment. Eur Radiol 15:96–101PubMedCrossRef

Rumberger JA, Brundage BH, Rader DJ, Kondos G (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74:243–252PubMedCrossRef

Becker CR, Jakobs TF, Aydemir S et al (2000) Helical and single-slice conventional CT versus electron beam CT for the quantification of coronary artery calcification. Am J Roentgenol 174:543–547

Becker CR, Kleffel T, Crispin A et al (2001) Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. Am J Roentgenol 176:1295–1298

10.

Carr JJ, Crouse JR 3rd, Goff DC Jr, D’Agostino RB Jr, Peterson NP, Burke GL (2000) Evaluation of subsecond gated helical CT for quantification of coronary artery calcium and comparison with electron beam CT. Am J Roentgenol 174:915–921

11.

Kopp AF, Ohnesorge B, Becker C et al (2002) Reproducibility and accuracy of coronary calcium measurements with multi-detector row versus electron-beam CT. Radiology 225:113–119PubMedCrossRef

12.

Horiguchi J, Nakanishi T, Ito K (2001) Quantification of coronary artery calcium using multidetector CT and a retrospective ECG-gating reconstruction algorithm. Am J Roentgenol 177:1429–1435

13.

Horiguchi J, Shen Y, Akiyama Y, Hirai N, Sasaki K, Ishifuro M, Ito K (2006) Electron beam CT versus 16-slice spiral CT: how accurately can we measure coronary artery calcium volume? Eur Radiol 16:374–380PubMedCrossRef

14.

Nasir K, Budoff MJ, Post WS, Fishman EK, Mahesh M, Lima JA, Blumenthal RS (2003) Electron beam CT versus helical CT scans for assessing coronary calcification: current utility and future directions. Am Heart J 146:969–977PubMedCrossRef

15.

Daniell AL, Wong ND, Friedman JD et al (2005) Concordance of coronary artery calcium estimates between MDCT and electron beam tomography. Am J Roentgenol 185:1542–1545CrossRef

16.

Mahnken AH, Muhlenbruch G, Koos R et al (2006) Influence of a small field-of-view size on the detection of coronary artery calcifications with MSCT: in vitro and in vivo study. Eur Radiol 16:358–364PubMedCrossRef

17.

van Ooijen PM, Vliegenthart R, Witteman JC, Oudkerk M (2005) Influence of scoring parameter settings on Agatston and volume scores for coronary calcification. Eur Radiol 15:102–110PubMedCrossRef

18.

Hunold P, Vogt FM, Schmermund A et al (2003) Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT. Radiology 226:145–152PubMedCrossRef

19.

Trabold T, Buchgeister M, Kuttner A et al (2003) Estimation of radiation exposure in 16-detector row computed tomography of the heart with retrospective ECG-gating. Rofo 175:1051–1055PubMed

20.

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

21.

Hohl C, Mahnken AH, Klotz E et al (2005) Radiation dose reduction to the male gonads during MDCT: the effectiveness of a lead shield. Am J Roentgenol 184:128–130

22.

Wildberger JE, Mahnken AH, Schmitz-Rode T et al (2001) Individually adapted examination protocols for reduction of radiation exposure in chest CT. Invest Radiol 36:604–611PubMedCrossRef

23.

Das M, Mahnken AH, Muhlenbruch G et al (2005) Individually adapted examination protocols for reduction of radiation exposure for 16-MDCT chest examinations. Am J Roentgenol 184:1437–1443

24.

Mahnken AH, Wildberger JE, Simon J et al (2003) Detection of coronary calcifications: feasibility of dose reduction with a body weight-adapted examination protocol. Am J Roentgenol 181:533–538

25.

Jakobs TF, Wintersperger BJ, Herzog P et al (2003) Ultra-low-dose coronary artery calcium screening using multislice CT with retrospective ECG gating. Eur Radiol 13:1923–1930PubMedCrossRef

26.

Hohl C, Muhlenbruch G, Wildberger JE et al (2006) Estimation of radiation exposure in low-dose multislice computed tomography of the heart and comparison with a calculation program. Eur Radiol 16(8):1841–1846PubMedCrossRef

27.

Greess H, Lutze J, Nomayr A et al (2004) Dose reduction in subsecond multislice spiral CT examination of children by online tube current modulation. Eur Radiol 14:995–999PubMedCrossRef

28.

Kalra MK, Rizzo S, Maher MM et al (2005) Chest CT performed with z-axis modulation: scanning protocol and radiation dose. Radiology 237:303–308PubMedCrossRef

29.

Mulkens TH, Bellinck P, Baeyaert M et al (2005) Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: clinical evaluation. Radiology 237:213–223PubMedCrossRef

30.

Tack D, De Maertelaer V, Gevenois PA (2003) Dose reduction in multidetector CT using attenuation-based online tube current modulation. Am J Roentgenol 181:331–334

31.

Kalender WA, Wolf H, Suess C, Gies M, Greess H, Bautz WA (1999) Dose reduction in CT by on-line tube current control: principles and validation on phantoms and cadavers. Eur Radiol 9:323–328PubMedCrossRef

32.

Stamm G, Nagel HD (2002) CT-expo-a novel program for dose evaluation in CT. Rofo 174:1570–1576PubMed

33.

Hidajat N, Wolf M, Nunnemann A et al (2001) Survey of conventional and spiral CT doses. Radiology 218:395–401PubMed

34.

Commision of the European Community (1998) Quality criteria for CT. Working document EUR 16262. European Comission, Luxembourg

35.

Leschka S, Alkadhi H, Plass A et al (2005) Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 26:1482–1487PubMedCrossRef

36.

Jung B, Mahnken AH, Stargardt A et al (2003) Individually weight-adapted examination protocol in retrospectively ECG-gated MSCT of the heart. Eur Radiol 13:2560–2566PubMedCrossRef

37.

Ketteler M, Bongartz P, Westenfeld R et al (2003) Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: a cross-sectional study. Lancet 361:827–833PubMedCrossRef

38.

Flohr TG, McCollough CH, Bruder H et al (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef

39.

Anonymous (2004) Computertomographie des Herzens: Aktuelle Leitlinien. Fortschr Röntgenstr 176:632–637

Title: Evaluation of automated attenuation-based tube current adaptation for coronary calcium scoring in MDCT in a cohort of 262 patients
Authors: Georg Mühlenbruch
Christian Hohl
Marco Das
Joachim E. Wildberger
Christoph Suess
Ernst Klotz
Thomas Flohr
Ralf Koos
Christoph Thomas
Rolf W. Günther
Andreas H. Mahnken
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: European Radiology / Issue 7/2007
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-006-0543-4

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Evaluation of automated attenuation-based tube current adaptation for coronary calcium scoring in MDCT in a cohort of 262 patients

Abstract

Keynote webinar | Spotlight on sleep in brain health

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