Feasibility Study of Gemstone CT Coronary Angiography with Low Tube Voltage and Low Concentration Contrast Medium_West China Medical Journal

Authors：

 CHENJiao , GUANBin , LIUYong-xiu ,  HEChuan-dong , LIAOLi-ping , LIUQi-yu

Department of Radiology, Mianyang Center Hospital, Sichuan 621000, P. R. China;

Corresponding author：

HEChuan-dong, Email: chuandong0816@163.com

Keywords：

Coronary artery; Tube voltage; Contrast medium concentration; Radiation dose

DOI：

10.7507/1002-0179.20150590

Video：

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Objective To assess the image quality and radiation dose of gemstone CT coronary angiography (CCTA) with low tube voltage and low concentration contrast medium. Methods Sixty-nine patients who underwent CCTA from January to March 2014 were randomly divided into group A and B. CCTA was performed in thirty-four patients in group A with tube voltage of 100 kV and concentration of contrast medium of 300 mgI/mL. And thirty-five patients in group B underwent CCTA with 120 kV and 370 mgI/mL. According to upgrading American Heart Association standard all segments and all vessels were evaluated. We measured the CT value of ascending aortic root, left main coronary artery, and the initial segment of left anterior descending branch, left circumflex, right coronary artery, and also adjacent tissues. Besides, we recorded CT dose volume index (CTDIvol) and the dose length product (DLP) and calculated effective radiation dose. Results The image quality scores were not significantly different between two groups (P>0.05). The density in the contrast enhanced vessel lumens in group A were signifcantly higher than that in group B (P<0.05). There was no significant difference in signal to noise ratio and carrier to noise ratio between the two groups (P>0.05). Noise in group A was higher than that in group B (P<0.05). The CTDIvol and effective radiation dose in group A were significantly lower than those in group B (P<0.05). Conclusion The combination of 100 kV with low concentration contrast medium (300 mgI/mL) still maintains the image quality, as well as significantly lowers the radiation dose and the dose of iodine.

Citation： CHENJiao, GUANBin, LIUYong-xiu, HEChuan-dong, LIAOLi-ping, LIUQi-yu. Feasibility Study of Gemstone CT Coronary Angiography with Low Tube Voltage and Low Concentration Contrast Medium. West China Medical Journal, 2015, 30(11): 2085-2089. doi: 10.7507/1002-0179.20150590 Copy

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3.	黄美萍, 刘其顺, 刘辉, 等. 多层螺旋CT冠状动脉成像质量及对冠状动脉病变诊断准确性的评价[J]. 中华放射学杂志, 2006, 40(9):984-987.
4.	Ohashi K, Ichikawa K, Hara M, et al. Examination of the optimal temporal resolution required for computed tomography coronary angiography[J]. Radiol Phys Technol, 2013, 6(2):453-460.
5.	Lee SK, Jung JI, Ko JM, et al. Image quality and radiation exposure of coronary CT angiography in patients after coronary artery bypass graft surgery:influence of imaging direction with 64-slice dual-source CT[J]. J Cardiovasc Comput Tomogr, 2014, 8(2):124-130.
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7.	Meijboom WB, Meijs MF, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography:a prospective, multicenter, multivendor study[J]. J Am Coll Cardiol, 2008, 52(25):2135-2144.
8.	张兆琪, 徐磊. 冠状动脉CT成像的机遇与挑战[J]. 中华放射学杂志, 2011, 45(1):7-8.
9.	Sabarudin A, Sun Z. Coronary CT angiography:diagnostic value and clinical challenges[J]. World J Cardiol, 2013, 5(12):473-483.
10.	Gerber TC, Kantor B, McCollough CH. Radiation dose and safety in cardiac computed tomography[J]. Cardiol Clin, 2009, 27(4):665-677.
11.	Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography[J]. JAMA, 2007, 298(3):317-323.
12.	Mayo JR, Leipsic JA. Radiation dose in cardiac CT[J]. AJR Am J Roentgenol, 2009, 192(3):646-653.
13.	Sabarudin A, Yusof AK, Tay MF, et al. Dual-source CT coronary angiography:effectiveness of radiation dose reduction with lower tube voltage[J]. Radiat Prot Dosimetry, 2013, 153(4):441-447.
14.	Sabarudin A, Sun Z. Coronary CT angiography:dose reduction strategies[J]. World J Cardiol, 2013, 5(12):465-472.
15.	胡永胜, 何新华, 王自勇, 等. 双源CT低管电压冠状动脉成像的应用及心率对图像质量和辐射剂量的影响[J]. 中华放射医学与防护杂志, 2012, 32(5):530-534.
16.	Zheng M, Liu Y, Wei M, et al. Low concentration contrast medium for dual-source computed tomography coronary angiography by a combination of iterative reconstruction and low-tube-voltage technique:feasibility study[J]. Eur J Radiol, 2014, 83(2):e92-e99.
17.	王蕊, 张保翠, 王霄英, 等. 80kVp、低浓度对比剂冠状动脉CTA检查的初步研究[J]. 放射学实践, 2013, 28(5):501-504.
18.	Jun BR, Yong HS, Kang EY, et al. 64-slice coronary computed tomography angiography using low tube voltage of 80 kV in subjects with normal body mass indices:comparative study using 120 kV[J]. Acta radiol, 2012, 53(10):1099-1106.
19.	Kidoh M, Nakaura T, Nakamura SA, et al. Contrast material and radiation dose reduction strategy for triple-rule-out cardiac CT angiography:feasibility study of non-ECG-gated low kVp scan of the whole chest following coronary CT angiography[J]. Acta radiol, 2014, 55(10):1186-1196.
20.	Xu L, Zhang ZQ. Coronary CT angiography with low radiation dose[J]. Int J Cardiovasc Imaging, 2010, 26(1):17-25.

1. Dill T, Deetjen A, Ekinci O, et al. Radiation dose exposure in multislice computed tomography of the coronaries in comparison with conventional coronary angiography[J]. Int J Cardiol, 2008, 124(3):307-311.
2. Deek H, Newton P, Sheerin N, et al. Contrast media induced nephropathy:a literature review of the available evidence and recommendations for practice[J]. Aust Crit Care, 2014, 27(4):166-171.
3. 黄美萍, 刘其顺, 刘辉, 等. 多层螺旋CT冠状动脉成像质量及对冠状动脉病变诊断准确性的评价[J]. 中华放射学杂志, 2006, 40(9):984-987.
4. Ohashi K, Ichikawa K, Hara M, et al. Examination of the optimal temporal resolution required for computed tomography coronary angiography[J]. Radiol Phys Technol, 2013, 6(2):453-460.
5. Lee SK, Jung JI, Ko JM, et al. Image quality and radiation exposure of coronary CT angiography in patients after coronary artery bypass graft surgery:influence of imaging direction with 64-slice dual-source CT[J]. J Cardiovasc Comput Tomogr, 2014, 8(2):124-130.
6. Sabarudin A, Sun Z. Radiation dose measurements in coronary CT angiography[J]. World J Cardiol, 2013, 5(12):459-464.
7. Meijboom WB, Meijs MF, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography:a prospective, multicenter, multivendor study[J]. J Am Coll Cardiol, 2008, 52(25):2135-2144.
8. 张兆琪, 徐磊. 冠状动脉CT成像的机遇与挑战[J]. 中华放射学杂志, 2011, 45(1):7-8.
9. Sabarudin A, Sun Z. Coronary CT angiography:diagnostic value and clinical challenges[J]. World J Cardiol, 2013, 5(12):473-483.
10. Gerber TC, Kantor B, McCollough CH. Radiation dose and safety in cardiac computed tomography[J]. Cardiol Clin, 2009, 27(4):665-677.
11. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography[J]. JAMA, 2007, 298(3):317-323.
12. Mayo JR, Leipsic JA. Radiation dose in cardiac CT[J]. AJR Am J Roentgenol, 2009, 192(3):646-653.
13. Sabarudin A, Yusof AK, Tay MF, et al. Dual-source CT coronary angiography:effectiveness of radiation dose reduction with lower tube voltage[J]. Radiat Prot Dosimetry, 2013, 153(4):441-447.
14. Sabarudin A, Sun Z. Coronary CT angiography:dose reduction strategies[J]. World J Cardiol, 2013, 5(12):465-472.
15. 胡永胜, 何新华, 王自勇, 等. 双源CT低管电压冠状动脉成像的应用及心率对图像质量和辐射剂量的影响[J]. 中华放射医学与防护杂志, 2012, 32(5):530-534.
16. Zheng M, Liu Y, Wei M, et al. Low concentration contrast medium for dual-source computed tomography coronary angiography by a combination of iterative reconstruction and low-tube-voltage technique:feasibility study[J]. Eur J Radiol, 2014, 83(2):e92-e99.
17. 王蕊, 张保翠, 王霄英, 等. 80kVp、低浓度对比剂冠状动脉CTA检查的初步研究[J]. 放射学实践, 2013, 28(5):501-504.
18. Jun BR, Yong HS, Kang EY, et al. 64-slice coronary computed tomography angiography using low tube voltage of 80 kV in subjects with normal body mass indices:comparative study using 120 kV[J]. Acta radiol, 2012, 53(10):1099-1106.
19. Kidoh M, Nakaura T, Nakamura SA, et al. Contrast material and radiation dose reduction strategy for triple-rule-out cardiac CT angiography:feasibility study of non-ECG-gated low kVp scan of the whole chest following coronary CT angiography[J]. Acta radiol, 2014, 55(10):1186-1196.
20. Xu L, Zhang ZQ. Coronary CT angiography with low radiation dose[J]. Int J Cardiovasc Imaging, 2010, 26(1):17-25.

West China Medical Journal

Feasibility Study of Gemstone CT Coronary Angiography with Low Tube Voltage and Low Concentration Contrast Medium

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