A BMI-adjusted ultra-low-dose CT angiography protocol for the peripheral arteries-Image quality, diagnostic accuracy and radiation exposure
| Autor: | Hannes Platzgummer, Gabriel Mistelbauer, Sylvia Unterhumer, Markus M. Schreiner, Michael Weber, Christian Loewe, Ruediger Schernthaner |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Scanner Image quality Computed Tomography Angiography Computed tomography dose index Iterative reconstruction 030204 cardiovascular system & hematology Signal-To-Noise Ratio Radiation Dosage 030218 nuclear medicine & medical imaging Body Mass Index 03 medical and health sciences Peripheral Arterial Disease 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Aged Protocol (science) Aged 80 and over medicine.diagnostic_test business.industry Angiography Digital Subtraction General Medicine Digital subtraction angiography Arteries Middle Aged Radiation Exposure Peripheral Angiography Radiographic Image Interpretation Computer-Assisted Female Radiology Nuclear medicine business |
| Zdroj: | European journal of radiology. 93 |
| ISSN: | 1872-7727 |
| Popis: | To investigate radiation exposure, objective image quality, and the diagnostic accuracy of a BMI-adjusted ultra-low-dose CT angiography (CTA) protocol for the assessment of peripheral arterial disease (PAD), with digital subtraction angiography (DSA) as the standard of reference.In this prospective, IRB-approved study, 40 PAD patients (30 male, mean age 72 years) underwent CTA on a dual-source CT scanner at 80kV tube voltage. The reference amplitude for tube current modulation was personalized based on the body mass index (BMI) with 120 mAs for [BMI≤25] or 150 mAs for [25BMI≤30]. Iterative image reconstruction was applied. The presence of significant stenoses (70%) was assessed by two readers independently and compared to subsequent DSA. Radiation exposure was assessed with the computed tomography dose index (CTDIvol) and the dosis-length product (DLP). Objective image quality was assessed via contrast- and signal-to-noise ratio (CNR and SNR) measurements. Radiation exposure and image quality were compared between the BMI groups and between the BMI-adjusted ultra-low-dose protocol and the low-dose institutional standard protocol (ISP).The BMI-adjusted ultra-low-dose protocol reached high diagnostic accuracy values of 94% for Reader 1 and 93% for Reader 2. Moreover, in comparison to the ISP, it showed significantly (p0.001) lower CTDIvol (1.97±0.55mGy vs. 4.18±0.62 mGy) and DLP (256±81mGy x cm vs. 544±83mGy x cm) but similar image quality (p=0.37 for CNR). Furthermore, image quality was similar between BMI groups (p=0.86 for CNR).A CT protocol that incorporates low kV settings with a personalized (BMI-adjusted) reference amplitude for tube current modulation and iterative reconstruction enables very low radiation exposure CTA, while maintaining good image quality and high diagnostic accuracy in the assessment of PAD. |
| Databáze: | OpenAIRE |
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