Comparing feasibility of low-tube-voltage protocol with low-iodine-concentration contrast and high-tube-voltage protocol with high-iodine-concentration contrast in coronary computed tomography angiography

• Published in: PloS one 2020-07, Vol.15 (7), p.e0236108
• Main Authors: Cha, Min Jae, Kim, Sung Mok, Ahn, Tae Ran, Choe, Yeon Hyeon
• Format: Article
• Language: English
• Subjects: Angiography; Arteries; Attenuation; Biology and Life Sciences; Body mass; Body mass index; Body size; Cardiovascular disease; CAT scans; Comparative analysis; Computed tomography; Contrast agents; Contrast media; Coronary angiography; Coronary artery; Coronary heart disease; Coronary vessels; Diagnosis; Drug dosages; Electric potential; Engineering and Technology; Feasibility; Heart rate; Image contrast; Image processing; Image quality; Image reconstruction; Iodine; Iterative methods; Likert scale; Medical imaging; Medicine; Medicine and Health Sciences; Methods; Noise; Physical Sciences; Radiation; Radiation dosage; Radiation effects; Research and Analysis Methods; Signal to noise ratio; Standard deviation; Studies; Thoracic surgery; Voltage
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0236108

To investigate the feasibility of a low tube voltage (80 kVp) protocol with low concentration contrast media (CM) (iodixanol 320 mgl/ml) as compared with a high tube voltage (100 kVp) protocol with high concentration CM (iomeprol 400 mgl/ml) in coronary CT angiography (CCTA) for patients with body mass index less than 30. A total of 93 patients were randomly assigned into three groups and underwent CCTA as follows: Group A) 100 kVp, 100-350 mAs, 400 mgl/ml CM at 4ml/s, and reconstructed with filtered back projection; Group B and C) 80 kVp, 100-450 mAs, 320 mgl/ml CM at 4 ml/s and 5 ml/s, respectively and reconstructed with iterative reconstruction. Objective and subjective image quality (IQ) was analyzed. The image noise, intravascular attenuation, signal-to-noise ratio and contrast-to-noise ratio of major coronary arteries did not differ significantly among three groups. Subjective IQ analyses on vascular attenuation and image noise did not differ significantly, either (all of p > 0.05). Qualitative IQ of Group B and C was non-inferior to that of Group A. Substantial reduction of radiation exposure was achieved in group B (2.60 ± 0.48 mSv) and C (2.72 ± 0.54 mSv), compared with group A (3.58 ± 0.67 mSv) (p < 0.05). CCTA at 80 kVp with 320 mgl/ml CM and iterative reconstruction is feasible, achieving radiation dose reduction, while preserving IQ.