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Non-inferior low-dose coronary computed tomography angiography image quality with knowledge-based iterative model reconstruction for overweight patients

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 In Kyung Park  ;  Jeffrey Park  ;  Tae Hoon Kim  ;  Joohee Lee  ;  Kyunghwa Han  ;  Chisuk Oh  ;  Chul Hwan Park 
 PLOS ONE, Vol.13(12) : e209243, 2018 
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We investigated the feasibility of low-dose coronary computed tomography angiography (CCTA), using a prospective electrocardiogram (ECG)-triggered axial scan protocol, knowledge-based iterative model reconstruction (IMR), and fixed tube current, in overweight subjects. Forty non-overweight (group A; body-mass index [BMI] < 25 kg/m2) and 40 overweight individuals (group B; BMI = 25-30 kg/m2), who underwent CCTA for coronary artery disease screening, were retrospectively and consecutively enrolled. A 64-slice CT scanner was used at 100-kVp tube voltage and 150-mA tube current, and images were reconstructed using IMR techniques. Image noise, attenuation at the aorta, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) at the proximal right and left main coronary arteries (pRCA and LMCA) were calculated. CCTA images were qualitatively evaluated using a four-point scale (1, poor; 4, excellent) and analyzed using a non-inferiority test with a pre-defined non-inferiority margin of -0.2. The mean CCTA radiation dose (Group A: 1.33 ± 0.02 mSv; Group B: 1.35 ± 0.10 mSv; p = 0.151) and mean aortic root CT attenuation values (Group A: 447.9 ± 81.6 HU; Group B: 439.5 ± 63.6 HU; p = 0.571) did not differ significantly between the two groups. The mean noise in groups A and B was 26.0 ± 4.8 HU and 29.2 ± 4.4 HU, respectively (p = 0.005). The noise reduction ratio in the groups, compared to filtered back projection, was 65.0% and 68.1%, respectively. The mean grade of image quality did not differ significantly (3.75 ± 0.04 vs. 3.71 ± 0.04, p = 0.478). Group B CCTA image quality was non-inferior (mean difference = -0.043, 95% CI = -0.162-0.077) to that of Group A. We concluded that low-dose CCTA with prospective ECG-triggering and IMR might be applied to overweight subjects, as well as to normal-weight subjects, by using a fixed tube current without an increase in tube current based on the patient's body size.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 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
Oh, Chi Suk(오치석)
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