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http://dx.doi.org/10.3348/kjr.2015.16.1.13

Evaluation of a Chest Circumference-Adapted Protocol for Low-Dose 128-Slice Coronary CT Angiography with Prospective Electrocardiogram Triggering  

Lu, Chenying (Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College)
Wang, Zufei (Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College)
Ji, Jiansong (Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College)
Wang, Hailin (Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College)
Hu, Xianghua (Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College)
Chen, Chunmiao (Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College)
Publication Information
Korean Journal of Radiology / v.16, no.1, 2015 , pp. 13-20 More about this Journal
Abstract
Objective: To assess the effect of chest circumference-adapted scanning protocol on radiation exposure and image quality in patients undergoing prospective electrocardiogram (ECG)-triggered coronary CT angiography (CCTA). Materials and Methods: One hundred-eighty-five consecutive patients, who had undergone prospective ECG triggering CCTA with a 128-slice CT, were included in the present study. Nipple-level chest circumference, body weight and height were measured before CT examinations. Patients were divided into four groups based on $kV/ref{\cdot}mAs$ = 100/200, 100/250, 120/200, and 120/250, when patient's chest circumference was ${\leq}85.0$ (n = 56), 85.0-90.0 (n = 53), 90.0-95.0 (n = 44), and > 95.0 (n = 32), respectively. Image quality per-segment was independently assessed by two experienced observers. Image noise and attenuation were also measured. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The effective radiation dose was calculated using CT dose volume index and the dose-length product. Results: A significant correlation was observed between patients' chest circumference and body mass index (r = 0.762, p < 0.001). Chest circumference ranged from 74 to 105 cm, and the mean effective radiation dose was 1.9-3.8 mSv. Diagnostic image quality was obtained in 98.5% (2440/2478) of all evaluated coronary segments without any significant differences among the four groups (p = 0.650). No significant difference in image noise was observed among the four groups (p = 0.439), thus supporting the validity of the chest circumference-adapted scanning protocol. However, vessel attenuation, SNR and CNR were significantly higher in the 100 kV groups than in the 120 kV groups (p < 0.05). Conclusion: A measure of chest circumference can be used to adapt tube voltage and current for individualized radiation dose control, with resultant similar image noise and sustained diagnostic image quality.
Keywords
Chest circumference; Computed tomography; Coronary angiography; Radiation dose; Image quality;
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