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Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Imaging Studies for Cardiovascular System V: CT01:28

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Submillisievert coronary calcium quantification using model-based iterative reconstruction: A within-patient

Annemarie M den Harder1, Jelmer M Wolterink2, Martin J Willemink1

  • 1Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

European Journal of Radiology
|October 26, 2016
PubMed
Summary

Coronary calcium scoring can be safely performed at 0.4mSv using hybrid iterative reconstruction (HIR) and model-based iterative reconstruction (MIR). Filtered back projection (FBP) is not feasible at these low doses, and further dose reduction may underestimate calcium scores.

Keywords:
CardiacComputed tomographyCoronary artery calcificationIterative reconstruction

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Area of Science:

  • Radiology
  • Medical Imaging
  • Cardiovascular Imaging

Background:

  • Coronary artery disease (CAD) risk stratification relies on coronary calcium scoring.
  • Reducing radiation dose in CT scans is a priority in medical imaging.
  • Iterative reconstruction (IR) techniques offer potential for dose reduction in CT.

Purpose of the Study:

  • To evaluate the impact of model-based iterative reconstruction (MIR) on coronary calcium quantification.
  • To assess different submillisievert CT acquisition protocols for coronary calcium scoring.
  • To compare MIR with hybrid iterative reconstruction (HIR) and filtered back projection (FBP) at reduced radiation doses.

Main Methods:

  • Twenty-eight patients underwent non-contrast cardiac CT with routine dose acquisition.
  • Low-dose acquisitions were performed at 60%, 40%, and 20% of routine dose mAs.
  • Images were reconstructed using FBP, HIR, and MIR, followed by Agatston score, calcium volume, and mass score determination.

Main Results:

  • Effective doses ranged from 0.9 to 0.2 mSv.
  • At 0.5 and 0.4 mSv, Agatston score differences with HIR and MIR were minimal (-0.1% to -2.9%) compared to FBP at routine dose.
  • At 0.2 mSv, Agatston scores decreased significantly (-12.6% to -14.6%), with MIR showing higher risk reclassification (21-25%) than HIR (18%).

Conclusions:

  • Radiation dose for coronary calcium scoring can be safely reduced to 0.4 mSv using HIR and MIR.
  • FBP is unsuitable for submillisievert coronary calcium scoring due to excessive noise.
  • Further dose reduction below 0.4 mSv risks underestimation of Agatston scores and incorrect risk stratification; mass scores remained unaffected.