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The feasibility of sub-millisievert coronary CT angiography with low tube voltage, prospective ECG gating, and a knowledge-based iterative model reconstruction algorithm

 Chul Hwan Park  ;  Joohee Lee  ;  Chisuk Oh  ;  Kyung Hwa Han  ;  Tae Hoon Kim 
 International Journal of Cardiovascular Imaging, Vol.31(2) : 197-203, 2015 
Journal Title
 International Journal of Cardiovascular Imaging 
Issue Date
Adult ; Algorithms ; Cardiac-Gated Imaging Techniques* ; Coronary Angiography/methods* ; Coronary Vessels/diagnostic imaging* ; Electrocardiography* ; Feasibility Studies ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/methods* ; Predictive Value of Tests ; Radiation Dosage ; Radiation Exposure/prevention & control ; Radiographic Image Interpretation, Computer-Assisted/methods* ; Retrospective Studies
Coronary artery disease ; Iterative model reconstruction ; Low tube voltage ; Multidetector computed tomography ; Prospective ECG gating
We evaluated the feasibility of sub-millisievert (mSv) coronary CT angiography (CCTA) using low tube voltage, prospective ECG gating, and a knowledge-based iterative model reconstruction algorithm. Twenty-four non-obese healthy subjects (M:F 13:11; mean age 50.2 ± 7.8 years) were enrolled. Three sets of CT images were reconstructed using three different reconstruction methods: filtered back projection (FBP), iterative reconstruction (IR), and knowledge-based iterative model reconstruction (IMR). The scanning parameters were as follows: step-and-shoot axial scanning, 80 kVp, and 200 mAs. On the three sets of CT images, the attenuation and image noise values were measured at the aortic root. The signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) were calculated at the proximal right coronary artery and the left main coronary artery. The qualitative image quality of the CCTA with IMR was assessed using a 4-point grading scale (grade 1, poor; grade 4, excellent). The mean radiation dose of the CCTA was 0.89 ± 0.09 mSv. The attenuation values with IMR were not different from those of other reconstruction methods. The image noise with IMR was significantly lower than with IR and FBP. Compared to FBP, the noise reduction rate of IMR was 69 %. The SNR and CNR of CCTA with IMR were significantly higher than with FBP or IR. On the qualitative analysis with IMR, all included segments were diagnostic (grades 2, 3, and 4), and the mean image quality score was 3.6 ± 0.6. In conclusion, CCTA with low tube voltage, prospective ECG gating, and an IMR algorithm might be a feasible method that allows for sub-millisievert radiation doses and good image quality when used with non-obese subjects.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
Lee, Joohee(이주희) ORCID logo https://orcid.org/0000-0002-7721-8935
Han, Kyung Hwa(한경화)
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