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Effectiveness of automatic tube potential selection with tube current modulation in coronary CT angiography for obese patients: Comparison with a body mass index-based protocol using the propensity score matching method

 Hong Seon Lee  ;  Young Joo Suh  ;  Kyunghwa Han  ;  Jin Young Kim  ;  Suyon Chang  ;  Dong Jin Im  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Jin Hur  ;  Young Jin Kim  ;  Byoung Wook Choi 
 PLoS One, Vol.13(1) : e0190584, 2018 
Journal Title
 PLoS One 
Issue Date
Aged ; *Body Mass Index ; Computed Tomography Angiography/*methods ; Female ; Humans ; Male ; Middle Aged ; Obesity/*diagnostic imaging/physiopathology ; Radiation Dosage
BACKGROUND: Reduced image quality from increased X-ray scatter and image noise can be problematic when coronary computed tomography angiography (CCTA) imaging is performed in obese patients. The aim of this study was to compare the image quality and radiation dose obtained using automatic tube potential selection with tube current modulation (APSCM) with those obtained using a body mass index (BMI)-based protocol for CCTA in obese patients. METHODS: A total of 203 consecutive obese (BMI > 30 kg/m2) patients were retrospectively enrolled, of whom 96 underwent CCTA with APSCM and 107 underwent a BMI-based protocol. After applying the propensity score matching method, the clinical parameters, subjective and objective image quality, and radiation dose were compared between the APSCM group and the matched BMI-based group. These parameters were also compared among different tube potential subgroups. RESULTS: No significant differences were observed between the APSCM group and the BMI-based group with respect to image quality or radiation dose assessment (p > 0.05). Twenty patients (21%) examined with 140 kV in the APSCM group were exposed to significantly more radiation (p < 0.05) than patients in the BMI-based group or patients in the other APSCM kV subgroups; significant improvement in image quality was not observed in the 140 kV subgroup. Patients with a high BMI and a large effective diameter tended to be examined with 140 kV (p < 0.05). CONCLUSION: The use of APSCM for CCTA in obese patients did not significantly reduce the radiation dose or improve image quality compared with those in the matched BMI-based group. Our data indicate that it is better to avoid using APSCM when 140 kV is automatically selected, due to increased radiation dose and lack of significant improvement in image quality.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
김진영(Kim, Jin Young)
서영주(Suh, Young Joo) ORCID logo https://orcid.org/0000-0002-2078-5832
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
이홍선(Lee, Hong Seon) ORCID logo https://orcid.org/0000-0003-2427-2783
임동진(Im, Dong Jin) ORCID logo https://orcid.org/0000-0001-8139-5646
장수연(Chang, Su Yon)
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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