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European Radiology
Published in: European Radiology 9/2014

01-09-2014 | Cardiac

The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring

Authors: Martin J. Willemink, Richard A. P. Takx, Pim A. de Jong, Ricardo P. J. Budde, Ronald L. A. W. Bleys, Marco Das, Joachim E. Wildberger, Mathias Prokop, Nico Buls, Johan de Mey, Arnold M. R. Schilham, Tim Leiner

Published in: European Radiology | Issue 9/2014

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Abstract

Objectives

To analyse the effects of radiation dose reduction and iterative reconstruction (IR) algorithms on coronary calcium scoring (CCS).

Methods

Fifteen ex vivo human hearts were examined in an anthropomorphic chest phantom using computed tomography (CT) systems from four vendors and examined at four dose levels using unenhanced prospectively ECG-triggered protocols. Tube voltage was 120 kV and tube current differed between protocols. CT data were reconstructed with filtered back projection (FBP) and reduced dose CT data with IR. CCS was quantified with Agatston scores, calcification mass and calcification volume. Differences were analysed with the Friedman test.

Results

Fourteen hearts showed coronary calcifications. Dose reduction with FBP did not significantly change Agatston scores, calcification volumes and calcification masses (P > 0.05). Maximum differences in Agatston scores were 76, 26, 51 and 161 units, in calcification volume 97, 27, 42 and 162 mm3, and in calcification mass 23, 23, 20 and 48 mg, respectively. IR resulted in a trend towards lower Agatston scores and calcification volumes with significant differences for one vendor (P < 0.05). Median relative differences between reference FBP and reduced dose IR for Agatston scores remained within 2.0–4.6 %, 1.0–5.3 %, 1.2–7.7 % and 2.6–4.5 %, for calcification volumes within 2.4–3.9 %, 1.0–5.6 %, 1.1–6.4 % and 3.7–4.7 %, for calcification masses within 1.9–4.1 %, 0.9–7.8 %, 2.9–4.7 % and 2.5–3.9 %, respectively. IR resulted in increased, decreased or similar calcification masses.

Conclusions

CCS derived from standard FBP acquisitions was not affected by radiation dose reductions up to 80 %. IR resulted in a trend towards lower Agatston scores and calcification volumes.

Key points

• In this ex vivo study, radiation dose could be reduced by 80 % for coronary calcium scoring
• Iterative reconstruction resulted in a trend towards lower Agatston scores and calcification volumes
• Caution should be taken for coronary calcium scoring with iterative reconstruction
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Metadata
Title
The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring
Authors
Martin J. Willemink
Richard A. P. Takx
Pim A. de Jong
Ricardo P. J. Budde
Ronald L. A. W. Bleys
Marco Das
Joachim E. Wildberger
Mathias Prokop
Nico Buls
Johan de Mey
Arnold M. R. Schilham
Tim Leiner
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3217-7

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