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European Radiology
Published in: European Radiology 10/2014

01-10-2014 | Computed Tomography

Tube potential can be lowered to 80 kVp in test bolus phase of CT coronary angiography (CTCA) and CT pulmonary angiography (CTPA) to save dose without compromising diagnostic quality

Authors: J. C. L. Rodrigues, D. Joshi, S. M. Lyen, I. S. Negus, N. E. Manghat, M. C. K. Hamilton

Published in: European Radiology | Issue 10/2014

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Abstract

Objectives

The purpose of this study was to determine whether performing the test bolus (TB) of computed tomography coronary angiography (CTCA) and computed tomography pulmonary angiography (CTPA) at 80 kVp reduces dose without compromising diagnostic quality.

Methods

An 80 kVp TB protocol for CTCA and CTPA was retrospectively compared to standard TB protocol (non-obese: 100 kVp, obese: 120 kVp). CT angiogram parameters were unchanged between cohorts. Thirty-seven consecutive 80 kVp TB CTCA images were compared to 53 standard CTCA images. Fifty consecutive CTPAs from each protocol were analysed. Diagnostic quality of the CT angiogram was assessed by: mean attenuation, signal-to-noise ratio (SNR) in the ascending aorta (AA) in CTCA and in the main pulmonary artery (MPA) in CTPA, diagnostic rate, and number of repeated monitoring scans. Mean effective dose was estimated using the dose-length product.

Results

Mean TB effective doses were significantly lower (P < 0.0001) for 80 kVp scans compared to the standard in non-obese CTCA (0.15 ± 0.04 mSv Vs 0.33 ± 0.09 mSv), obese CTCA (0.17 ± 0.06 mSv Vs 0.57 ± 0.12 mSv), and CTPA patients (0.07 ± 0.03 mSv Vs 0.15 ± 0.06 mSv). No difference was demonstrated in mean attenuation, SNR (AA), SNR (MPA), diagnostic rates, or number of repeated monitoring scans between protocols.

Conclusions

Routinely performing TB at 80 kVp, regardless of body habitus, in CTCA and CTPA results in a small but significant dose reduction, without compromising CT angiogram diagnostic quality.

Key Points

• CT coronary angiography is performed to exclude the presence of significant coronary atherosclerosis.
• CT pulmonary angiography is performed to diagnose pulmonary thromboembolism.
• This retrospective study showed dose reduction by performing test bolus at 80 kVp.
• Diagnosis can be made with reduced exposure to ionising radiation.
Literature
1.
(2010) Chest pain of recent onset: assessment and investigation of recent onset chest pain or discomfort of suspected cardiac origin. NICE guideline: CG95
2.
Rodrigues JC, Mathias H, Negus IS, Manghat NE, Hamilton MC (2012) Intravenous contrast medium administration at 128 multi-detector row CT pulmonary angiography: bolus tracking versus test bolus and the implications for diagnostic quality and effective dose. Clin Radiol 67:1053–1060PubMedCrossRef
3.
Gosling O, Morgan-Hughes G, Iyengar S et al (2013) Computed tomography to diagnose coronary artery disease: a reduction in radiation dose increases applicability. Clin Radiol 68:340–345PubMedCrossRef
4.
Bjorkdahl P, Nyman U (2010) Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality. Acta Radiol 51:260–270PubMedCrossRef
5.
6.
Stolzmann P, Scheffel H, Schertler T et al (2008) Radiation dose estimated in dual-source computed tomography coronary angiography. Eur Radiol 18:592–599PubMedCrossRef
7.
Bongartz G, Golding SJ, Jurik AG et al. (2000) European Guidelines on quality criteria for computed tomography. EUR 16262 EN. European Commission
8.
Gosling O, Loader R, Venables P, Rowles N, Morgan-Hughes G, Roobottom C (2010) Cardiac CT: are we underestimating the dose? A radiation dose study utilizing the 2007 ICRP tissue weighting factors and a cardiac specific scan volume. Clin Radiol 65:1013–1017PubMedCrossRef
9.
10.
11.
Mortimer AM, Singh RK, Hughes J, Greenwood R, Hamilton MC (2011) Use of expiratory CT pulmonary angiography to reduce inspiration and breath-hold associated artefact: contrast dynamics and implications for scan protocol. Clin Radiol 66:1159–1166PubMedCrossRef
12.
Henk CB, Grampp S, Linnau KF et al (2003) Suspected pulmonary embolism: enhancement of pulmonary arteries at deep inspiration CT angiography – influence of patent foramen ovale and atrial-septal defect. Radiology 226:749–755PubMedCrossRef
13.
Bellenger NG, Davies LC, Francis JM, Coats AJ, Pennell DJ (2000) Reduction in sample size for studies of remodelling in heart failure by the use of cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2:271–278PubMedCrossRef
14.
15.
Chem MY, Steigner ML, Leung SW et al (2013) Simulated 50 % radiation dose reduction in coronary CT angiography using adaptive iterative dose reduction in three-dimensions (AIDR3D). Int J Cardiovasc Imaging 29:1167–1175CrossRef
Metadata
Title
Tube potential can be lowered to 80 kVp in test bolus phase of CT coronary angiography (CTCA) and CT pulmonary angiography (CTPA) to save dose without compromising diagnostic quality
Authors
J. C. L. Rodrigues
D. Joshi
S. M. Lyen
I. S. Negus
N. E. Manghat
M. C. K. Hamilton
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3281-z

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