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European Radiology
Published in: European Radiology 11/2020

01-11-2020 | Computed Tomography | Computed Tomography

Individualized coronary calcium scoring at any tube voltage using a kV-independent reconstruction algorithm

Authors: Vincenzo Vingiani, Andres F. Abadia, U. Joseph Schoepf, Andreas M. Fischer, Akos Varga-Szemes, Pooyan Sahbaee, Thomas Allmendinger, Dante A. Giovagnoli, H. Todd Hudson, Riccardo Marano, Fiona C. Tinnefeld, Simon S. Martin

Published in: European Radiology | Issue 11/2020

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Abstract

Purpose

We prospectively investigate the feasibility of a patient specific automated tube voltage selection (ATVS)-based coronary artery calcium scoring (CACS) protocol, using a kV-independent reconstruction algorithm, to achieve significant dose reductions while maintaining the overall cardiac risk classification.

Methods

Forty-three patients (mean age, 61.8 ± 9.0 years; 40% male) underwent a clinically indicated CACS scan at 120kVp, as well as an additional CACS acquisition using an individualized tube voltage between 70 and 130kVp based on the ATVS selection (CARE-kV). Datasets of the additional CACS scans were reconstructed using a kV-independent algorithm that allows for calcium scoring without changing the weighting threshold of 130HU, regardless of the tube voltage chosen for image acquisition. Agatston scores and radiation dose derived from the different ATVS-based CACS studies were compared to the standard acquisition at 120kVp.

Results

Thirteen patients displayed a score of 0 and were correctly identified with the ATVS protocol. Agatston scores derived from the standard 120kVp (median, 33.4; IQR, 0–289.7) and the patient-tailored kV-independent protocol (median, 47.5; IQR, 0–287.5) showed no significant differences (p = 0.094). The intra-class correlation for Agatston scores derived from the two different protocols was excellent (ICC = 0.99). The mean dose-length-product was 29.8 ± 11.9 mGy × cm using the ATVS protocol and 31.7 ± 11.4 mGy × cm using the standard 120kVp protocol (p < 0.001). Additionally, 95% of patients were classified into the same risk category (0, 1–10, 11–100, 101–400, or > 400) using the patient-tailored protocol.

Conclusions

ATVS-based CACS, using a kV-independent algorithm, allows for high accuracy compared to the standard 120kVp scanning, while significantly reducing radiation dose parameters.

Key Points

• ATVS allows for CT scanning with reduced radiation dose values.
• KV-independent CACS is feasible at any tube voltage between 70 and 130 kVp.
• ATVS applied to kV-independent CACS can significantly reduce the radiation dose.
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Metadata
Title
Individualized coronary calcium scoring at any tube voltage using a kV-independent reconstruction algorithm
Authors
Vincenzo Vingiani
Andres F. Abadia
U. Joseph Schoepf
Andreas M. Fischer
Akos Varga-Szemes
Pooyan Sahbaee
Thomas Allmendinger
Dante A. Giovagnoli
H. Todd Hudson
Riccardo Marano
Fiona C. Tinnefeld
Simon S. Martin
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-06951-1

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