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Open Access 01-06-2017 | Chest

Low-tube-voltage selection for triple-rule-out CTA: relation to patient size

Authors: Richard A. P. Takx, Radko Krissak, Christian Fink, Valentin Bachmann, Thomas Henzler, Mathias Meyer, John W. Nance, Stefan O. Schoenberg, Paul Apfaltrer

Published in: European Radiology | Issue 6/2017

Abstract

Objectives

To investigate the relationship between image quality and patient size at 100 kilovoltage (kV) compared to 120 kV ECG-gated Triple-Rule-Out CT angiography (TRO-CTA).

Methods

We retrospectively included 73 patients (age 64 ± 14 years) who underwent retrospective ECG-gated chest CTA. 40 patients were scanned with 100 kV while 33 patients with 120 kV. Body mass index (BMI), patients’ chest circumference (PC) and thoracic surface area (TSA) were recorded. Quantitative image quality was assessed as vascular attenuation in the ascending aorta (AA), pulmonary trunk (PA) and left coronary artery (LCA) and the signal-to-noise ratio (SNR) in the AA.

Results

There was no significant difference in BMI (26.0 ± 4.6 vs. 28.0 ± 6.7 kg/m²), PC (103 ± 7 vs. 104 ± 10 cm²) and TSA (92 ± 15 vs. 91 ± 19 cm²) between 100 kV and 120 kV group. Mean vascular attenuation was significantly higher in the 100 kV compared to the 120 kV group (AA 438 vs. 354 HU, PA 460 vs. 349 HU, LCA 370 vs. 299 HU all p < 0.001). SNR was not significantly different, even after adjusting for patient size. Radiation dose was significantly lower in the 100 kV group (10.7 ± 4.1 vs. 20.7 ± 10.7 mSv; p < 0.001).

Conclusions

100 kV TRO-CTA is feasible in normal-to-overweight patients while maintaining image quality and achieving substantial dose reduction.

Key Points

• 100 kV protocols result in a significantly lower radiation dose.

• Mean vascular attenuation is significantly higher using 100 kV.

• SNR and CNR are not significantly different between 100 kV and 120 kV.

• 100 kV CTA is feasible regardless of patient size while maintaining image quality.

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Title: Low-tube-voltage selection for triple-rule-out CTA: relation to patient size
Authors: Richard A. P. Takx
Radko Krissak
Christian Fink
Valentin Bachmann
Thomas Henzler
Mathias Meyer
John W. Nance
Stefan O. Schoenberg
Paul Apfaltrer
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4607-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Low-tube-voltage selection for triple-rule-out CTA: relation to patient size

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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