Coronary CT angiography using the second-generation 320-detector row CT: assessment of image quality and radiation dose in various heart rates compared with the first-generation scanner

To assess the image quality and radiation dose reduction in various heart rates in coronary CT angiography using the second-generation 320-detector row CT compared with the first-generation CT. Ninety-six patients were retrospectively included. The first 48 patients underwent coronary CT angiography with the first-generation 320-detector row CT, while the last 48 patients underwent with the second-generation CT. Subjective image quality was graded using a 4-point scale (4, excellent; 1, unable to evaluate). Image noise and contrast-to-noise ratio were also analyzed. Subgroup analysis was performed based on the heart rate. The mean effective dose was derived from the dose length product multiplied by a conversion coefficient for the chest (κ = 0.014 mSv × mGy⁻¹ × cm⁻¹). The overall subjective image quality score showed no significant difference (3.66 vs 3.69, respectively, p = 0.25). The image quality score of the second-generation group tended to be higher than that of the first-generation group in the 66- to 75-bpm subgroup (3.36 vs 3.53, respectively, p = 0.07). No significant difference was observed in image noise and contrast-to-noise ratio. The overall radiation dose reduced by 24 % (3.3 vs 2.5 mSv, respectively, p = 0.03), and the reduction was substantial in patients with higher heart rate (66- to 75-bpm, 4.3 vs 2.2 mSv, respectively, p = 0.009; >75 bpm, 8.2 vs 3.7 mSv, respectively, p = 0.005). The second-generation 320-detector row CT could maintain the image quality while reducing the radiation dose in coronary CT angiography. The dose reduction was larger in patients with higher heart rate.