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Dose Reduction in Coronary Artery Calcium Scoring Using Mono-Energetic Images from Reduced Tube Voltage Dual-Source
Niels R van der Werf1, Margo van Gent2, Ronald Booij1
1Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Diagnostics (Basel, Switzerland)
|December 24, 2021
Summary
Photon-counting computed tomography (PCCT) enables reproducible coronary artery calcium (CAC) quantification at reduced 90 kVp. This method significantly lowers radiation dose by up to 67% for medium- and high-density CAC.
Area of Science:
- Medical Imaging Physics
- Radiological Sciences
- Cardiovascular Imaging
Background:
- Coronary artery calcium (CAC) scoring is crucial for cardiovascular risk assessment.
- Photon-counting computed tomography (PCCT) offers potential for dose reduction and improved image quality.
- Assessing reproducibility of CAC quantification at reduced tube potentials is essential for clinical implementation.
Purpose of the Study:
- To evaluate the reproducibility of coronary artery calcium (CAC) quantification using photon-counting computed tomography (PCCT) at reduced tube potentials.
- To determine the impact of lower tube voltages on Agatston scores and radiation dose.
- To assess the clinical relevance of deviations in CAC quantification under reduced dose protocols.
Main Methods:
- An anthropomorphic thorax phantom with varying CAC densities was scanned using PCCT (NAEOTOM Alpha).
- Scans were performed at two heart rates (0 and 60-75 bpm) using five protocols, including 120 kVp (reference) and reduced tube potential (90 kVp) and dose protocols.
- Agatston scores were quantified and compared to the reference, with >10% deviation considered clinically relevant.
Main Results:
- Reduced tube current protocols showed clinically relevant differences for low-density CAC.
- For medium- and high-density CAC, 90 kVp protocols at both heart rates demonstrated no clinically relevant differences in Agatston scores compared to the reference.
- Radiation dose reductions of up to 67% were achieved with the 90 kVp protocols.
Conclusions:
- Photon-counting computed tomography (PCCT) allows for reproducible Agatston scores at a reduced tube voltage of 90 kVp.
- Significant radiation dose reductions are achievable (up to 67%) for medium- and high-density CAC quantification with PCCT at 90 kVp.
- Reduced tube potential protocols show promise for efficient and reliable CAC assessment in clinical practice.
Keywords:
X-ray computed tomographycalciumcoronary vesselsimage qualityimaging phantomsphoton counting detectorradiation doseMore Related Videos
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