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01-02-2016 | Cardiac

Optimizing radiation dose by using advanced modelled iterative reconstruction in high-pitch coronary CT angiography

Authors: Sonja Gordic, Lotus Desbiolles, Martin Sedlmair, Robert Manka, André Plass, Bernhard Schmidt, Daniela B. Husarik, Francesco Maisano, Simon Wildermuth, Hatem Alkadhi, Sebastian Leschka

Published in: European Radiology | Issue 2/2016

Abstract

Purpose

To evaluate the potential of advanced modeled iterative reconstruction (ADMIRE) for optimizing radiation dose of high-pitch coronary CT angiography (CCTA).

Methods

High-pitch 192-slice dual-source CCTA was performed in 25 patients (group 1) according to standard settings (ref. 100 kVp, ref. 270 mAs/rot). Images were reconstructed with filtered back projection (FBP) and ADMIRE (strength levels 1–5). In another 25 patients (group 2), high-pitch CCTA protocol parameters were adapted according to results from group 1 (ref. 160 mAs/rot), and images were reconstructed with ADMIRE level 4. In ten patients of group 1, vessel sharpness using full width at half maximum (FWHM) analysis was determined. Image quality was assessed by two independent, blinded readers.

Results

Interobserver agreements for attenuation and noise were excellent (r = 0.88/0.85, p < 0.01). In group 1, ADMIRE level 4 images were most often selected (84 %, 21/25) as preferred data set; at this level noise reduction was 40 % compared to FBP. Vessel borders showed increasing sharpness (FWHM) at increasing ADMIRE levels (p < 0.05). Image quality in group 2 was similar to that of group 1 at ADMIRE levels 2–3. Radiation dose in group 2 (0.3 ± 0.1 mSv) was significantly lower than in group 1 (0.5 ± 0.3 mSv; p < 0.05).

Conclusions

In a selected population, ADMIRE can be used for optimizing high-pitch CCTA to an effective dose of 0.3 mSv.

Key points

• Advanced modeled IR (ADMIRE) reduces image noise up to 50 % as compared to FBP.

• Coronary artery vessel borders show an increasing sharpness at higher ADMIRE levels.

• High-pitch CCTA with ADMIRE is possible at a radiation dose of 0.3 mSv.

Tamm EP, Rong XJ, Cody DD, Ernst RD, Fitzgerald NE, Kundra V (2011) Quality initiatives: CT radiation dose reduction: how to implement change without sacrificing diagnostic quality. Radiographics 31:1823–1832PubMedCrossRef

Layritz C, Muschiol G, Flohr T et al (2013) Automated attenuation-based selection of tube voltage and tube current for coronary CT angiography: reduction of radiation exposure versus a BMI-based strategy with an expert investigator. J Cardiovasc Comput Tomogr 7:303–310PubMedCrossRef

Vardhanabhuti V, Riordan RD, Mitchell GR, Hyde C, Roobottom CA (2014) Image comparative assessment using iterative reconstructions: clinical comparison of low-dose abdominal/pelvic computed tomography between adaptive statistical, model-based iterative reconstructions and traditional filtered back projection in 65 patients. Invest Radiol 49:209–216PubMedCrossRef

Meyer M, Haubenreisser H, Schoepf UJ et al (2014) Closing in on the K edge: coronary CT angiography at 100, 80, and 70 kV-initial comparison of a second- versus a third-generation dual-source CT system. Radiology. doi:10.1148/radiol.14140244:140244

Morsbach F, Gordic S, Desbiolles L et al (2014) Performance of turbo high-pitch dual-source CT for coronary CT angiography: first ex vivo and patient experience. Eur Radiol 24:1889–1895PubMedCrossRef

Gordic S, Husarik DB, Desbiolles L, Leschka S, Frauenfelder T, Alkadhi H (2014) High-pitch coronary CT angiography with third generation dual-source CT: limits of heart rate. Int J Cardiovasc Imaging 30:1173–1179PubMedCrossRef

Gordic S, Morsbach F, Schmidt B et al (2014) Ultralow-dose chest computed tomography for pulmonary nodule detection: first performance evaluation of single energy scanning with spectral shaping. Invest Radiol 49:465–473PubMedCrossRef

Gordic S, Desbiolles L, Stolzmann P et al (2014) Advanced modelled iterative reconstruction for abdominal CT: qualitative and quantitative evaluation. Clin Radiol 69:e497–e504PubMedCrossRef

Pontana F, Pagniez J, Flohr T et al (2011) Chest computed tomography using iterative reconstruction vs filtered back projection (Part 1): evaluation of image noise reduction in 32 patients. Eur Radiol 21:627–635PubMedCrossRef

10.

Thibault JB, Sauer KD, Bouman CA, Hsieh J (2007) A three-dimensional statistical approach to improved image quality for multislice helical CT. Med Phys 34:4526–4544PubMedCrossRef

11.

Taylor AJ, Cerqueira M, Hodgson JM et al (2010) ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. Circulation 122:e525–e555PubMedCrossRef

12.

Pontana F, Duhamel A, Pagniez J et al (2011) Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients. Eur Radiol 21:636–643PubMedCrossRef

13.

Morsbach F, Desbiolles L, Plass A et al (2013) Stenosis quantification in coronary CT angiography: impact of an integrated circuit detector with iterative reconstruction. Invest Radiol 48:32–40PubMedCrossRef

14.

Wang R, Schoepf UJ, Wu R et al (2014) Diagnostic accuracy of coronary CT angiography: comparison of filtered back projection and iterative reconstruction with different strengths. J Comput Assist Tomogr 38:179–184PubMedCrossRef

15.

Richard S, Husarik DB, Yadava G, Murphy SN, Samei E (2012) Towards task-based assessment of CT performance: system and object MTF across different reconstruction algorithms. Med Phys 39:4115–4122PubMedCrossRef

16.

Menzel HG, Schibilla H, Teunen D (eds) (2000) European guidelines on quality criteria for computed tomography, EUR 16262 EN. European Commission, Luxembourg

17.

Einstein AJ, Elliston CD, Arai AE et al (2010) Radiation dose from single-heartbeat coronary CT angiography performed with a 320-detector row volume scanner. Radiology 254:698–706PubMedPubMedCentralCrossRef

18.

Boone JM, Strauus KJ, Cody DD, McCollough CH, McNitt-Gray MF, Toth TL (2011) Size specific dose estimates (SSDE) in pediatric and adult CT examinations. American Association of Physicists in Medicine, report of AAPM Task Group 204. AAPM, College Park, MD

19.

Hou Y, Liu X, Xv S, Guo W, Guo Q (2012) Comparisons of image quality and radiation dose between iterative reconstruction and filtered back projection reconstruction algorithms in 256-MDCT coronary angiography. AJR Am J Roentgenol 199:588–594PubMedCrossRef

20.

Leipsic J, Labounty TM, Heilbron B et al (2010) Adaptive statistical iterative reconstruction: assessment of image noise and image quality in coronary CT angiography. AJR Am J Roentgenol 195:649–654PubMedCrossRef

21.

Schuhbaeck A, Achenbach S, Layritz C et al (2013) Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction. Eur Radiol 23:597–606PubMedCrossRef

22.

Singh S, Khawaja RD, Pourjabbar S, Padole A, Lira D, Kalra MK (2013) Iterative image reconstruction and its role in cardiothoracic computed tomography. J Thorac Imaging 28:355–367PubMedCrossRef

23.

Yin WH, Lu B, Hou ZH et al (2013) Detection of coronary artery stenosis with sub-milliSievert radiation dose by prospectively ECG-triggered high-pitch spiral CT angiography and iterative reconstruction. Eur Radiol 23:2927–2933PubMedCrossRef

24.

Ebersberger U, Tricarico F, Schoepf UJ et al (2013) CT evaluation of coronary artery stents with iterative image reconstruction: improvements in image quality and potential for radiation dose reduction. Eur Radiol 23:125–132PubMedCrossRef

25.

Renker M, Nance JW Jr, Schoepf UJ et al (2011) Evaluation of heavily calcified vessels with coronary CT angiography: comparison of iterative and filtered back projection image reconstruction. Radiology 260:390–399PubMedCrossRef

26.

Husarik DB, Schindera ST, Morsbach F et al (2014) Combining automated attenuation-based tube voltage selection and iterative reconstruction: a liver phantom study. Eur Radiol 24:657–667PubMedCrossRef

27.

Winklehner A, Goetti R, Baumueller S et al (2011) Automated attenuation-based tube potential selection for thoracoabdominal computed tomography angiography: improved dose effectiveness. Invest Radiol 46:767–773PubMedCrossRef

Title: Optimizing radiation dose by using advanced modelled iterative reconstruction in high-pitch coronary CT angiography
Authors: Sonja Gordic
Lotus Desbiolles
Martin Sedlmair
Robert Manka
André Plass
Bernhard Schmidt
Daniela B. Husarik
Francesco Maisano
Simon Wildermuth
Hatem Alkadhi
Sebastian Leschka
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3862-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Optimizing radiation dose by using advanced modelled iterative reconstruction in high-pitch coronary CT angiography

Abstract

Purpose

Methods

Results

Conclusions

Key points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Key points

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